The Department of Health and Human Services (HHS) released a review of youth gender dysphoria research bolstering the administration’s stance against gender transition treatments such as hormones or surgery—and denouncing major medical associations for their opposing positions.
The review describes existing evidence on the outcomes of various treatments for gender dysphoria as low quality, which “indicates that the beneficial effects reported in the literature are likely to differ substantially from the true effects of the interventions,” according to the report.
At the same time, it places a substantial focus on the potential harms related to transition interventions—for which the evidence is “also sparse” but warrants caution, the review’s authors wrote.
Further, the Trump administration report calls for more investigation into regret following gender transition and advocates for psychotherapeutic interventions such as “exploratory therapy” that are described as lower risk compared to surgical procedures and unfairly equated with conversion therapy.
The release was quickly condemned by LGBTQ+ advocacy groups and providers, which said the report was politicized, stigmatizing and intentionally narrow in its inclusion of available data.
“It is deeply troubling to see the country’s top authority on health publish a collection of recommendations that seemingly have no basis in following established healthcare best practices, science, or input from providers who actually administer the type of healthcare in question,” Casey Pick, director of law and policy at The Trevor Project, an LGBTQ+ suicide prevention nonprofit, said in an emailed statement. “This report not only rejects health care best practices for transgender people—it goes a step further by recommending conversion therapy, though under a new, rebranded name, ‘exploratory therapy.’ Despite the report’s claims, this is, in fact, the same harmful practice of conversion therapy, just using friendlier language.”
Much of the report is also dedicated to critiquing U.S. medical associations for “creating a perception that there is a professional consensus” in favor of gender-affirming care. It accuses them of suppressing dissent on the issue among members, and references instances in which “the voices of whistleblowers and detransitioners … [were discounted, dismissed or ignored.”
At least one of the medical associations cited in the report for its stance in support of gender-affirming care, the American Academy of Pediatrics (AAP), said it was “deeply alarmed” by the methodology’s reliance on “select perspectives” and said the conclusion “misrepresents the current medical consensus.”
“AAP was not consulted in the development of this report, yet our policy and intentions behind our recommendations were cited throughout in inaccurate and misleading ways,” Susan Kressly, M.D., the organization’s president, said in a statement. “The report prioritizes opinions over dispassionate reviews of evidence.”
The Endocrine Society, the positions of which were also outlined in the publication, said in a statement it "is carefully reviewing this report" but said more generally that it "believes in access to health care, and that medical decisions should be made by the clinician and the patient’s family based on scientific evidence."
Fierce Healthcare has requested comment from the American Medical Association and the American Psychological Association. Each was also referenced in the report for their support of gender-affirming care, a range of social, behavioral and medical services that may include hormone therapy and, rarely, surgical procedures.
These and other groups, the report’s authors wrote, “have fallen short of their duty to prioritize the health interests of young patients, and that “when confronted with compelling evidence that [gender-affirming care] did not deliver the health benefits it promised, and that other countries were changing their policies appropriately, U.S. medical professionals and associations failed to reconsider” their support of gender-affirming care.
The roughly 400-page report, released Thursday morning, summarizes 17 systematic reviews related to patient outcomes following various interventions while excluding thousands of others for not meeting study criteria—including some excluded for “publication bias.” The write-up was subject to pre-publication peer review, the HHS said, with a post-publication peer review to come.
The HHS said the report was penned by multiple contributors including “medical doctors, medical ethicists and a methodologist,” who they noted “represent a wide range of political viewpoints and were chosen for their commitment to scientific principles.” The department did not, however, give the contributors’ names, and said they would not initially be doing so “in order to help maintain the integrity” of the post-publication peer review.
“Our duty is to protect our nation’s children—not expose them to unproven and irreversible medical interventions,” National Institutes of Health (NIH) Director Jay Bhattacharya, M.D., said in a release. “We must follow the gold standard of science, not activist agendas.”
Pushback on gender-affirming care for children and adolescents is in line with the directive laid out by President Donald Trump upon returning to the White House. Executive orders signed during his opening days made it the government’s official policy to recognizes two sexes, male and female, as unchangeable, to discard gender ideology as a “false claim that males can identify as and thus become women and vice versa” and recast hormone therapy and surgical procedures to affirm one’s gender identity as “chemical and surgical mutilation.”
Alongside broader directives to stop funding organizations that research or deliver gender-affirming care (which have in part been blocked in the courts), the president ordered departments like the HHS to adopt similar views and language in their guidance.
The HHS has since eliminated 215 federal research and education grants to medical institutions totaling $477 million related to gender-affirming care among youths, adopted policies limiting coverage of gender reassignment surgeries and hormone treatment, and warned of likely new regulations for hospitals on the matter. Some pediatric care providers have stopped delivering gender-affirming care, at least temporarily, in light of the policies.
The NIH was also ordered to launch new studies into “regret” among transgender people who have transitioned and detransition—both among the topics of Thursday’s analysis.
The departments under President Joe Biden had publicized guidances and research that supported gender-affirming care. They had also stressed that there was no evidence of behavioral health interventions being able to change gender identity or sexual orientation.
The Human Rights Campaign, the nation’s largest LGBTQ+ civil rights advocacy group, in a statement described Thursday’s report as “a politically-motivated document filled with outright lies and misinformation.”
The group said its findings were “predetermined” by the president’s executive order and intended to “lay the groundwork to replace … best-practice medical care for transgender and non-binary people with ‘gender exploratory therapy,’” which it similarly denounced. It also noted that conversion therapy is opposed by professional medical organizations, including those referenced in the report.
Plume, which providers gender-affirming care to trans adults, said the anonymously authored report could “easily be weaponized and be misused.”
“These types of efforts to weaponize science only serves to undermine legitimate scientific research and medical advancement, is a waste of taxpayer dollars and endangers the lives of every person seeking medical care—not just trans and gender-diverse individuals.”
The Trevor Project, in its statement, cited peer-reviewed research it had conducted that found heightened risk of attempted suicide among LGBTQ+ youth who underwent conversion therapy as well as 2024 survey data that found 13% of LGBTQ+ youth had either been threatened with or subjected to conversion therapy.