HHS report questions evidence for youth gender care
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HHS released a review Thursday that asserts gender-affirming care for minors has significant risks with little evidence of benefit.
Why it matters: The 409-page document contrasts the policies of major medical associations including the American Academy of Pediatrics, who say gender-affirming care can be life saving for transgender adolescents.
- The report stems from an executive order President Trump issued in January and does not include legislative or policy recommendations.
- HHS said it fills a gap in medical literature and clinical practice reviews on the ethical aspects of pediatric medical transition.
Zoom in: Interventions including puberty blockers, hormone therapies and surgeries all come with "significant risks" and most cause "irreversible physical or physiological effects," the report said.
- It repeatedly cites the UK's Cass Review, a controversial 2024 report on gender identity services that similarly criticizes gender-affirming care for youths as not evidence based.
- According to the BBC, 98% of the 103 scientific papers analyzed for that review were not considered high-quality.
What it says: "Some view the medical transition of minors as a pressing civil rights issue, while others regard it as a profound medical failure and a sobering reminder that even modern medicine is vulnerable to serious error," the HHS report said.
- Children and their families "require, and are entitled to, accurate, evidence-based information to guide their decisions," it stated.
Reality check: The overwhelming majority of youth who receive gender-affirming care report high levels of satisfaction and low levels of regret, research shows.
- Less than 0.1% of adolescents in the U.S. received gender-affirming care drugs between 2018 and 2022, per a recent JAMA Pediatrics study.
- Puberty blockers are reversible and also used for non-trans youth who experience early onset puberty. Gender-affirming surgery is rare in adolescents and considered on a case-by-case basis.
The American Academy of Pediatrics is "deeply alarmed" by the report, president Susan Kressly said in a statement.
- "This report misrepresents the current medical consensus and fails to reflect the realities of pediatric care," she said.
The fine print: HHS is not releasing the names of the contributors to the research "in order to help maintain the integrity of this process," per a release. Contributors include doctors, ethicists and one methodologists that HHS said were chosen for their commitment to scientific principles.
- The review will get a post-publication peer review, HHS said.
The White House has separately ordered NIH to study the effects of gender transition, including "regret" after a person transitions, Nature first reported.
