transgender

The APA’s 5 Failed Critiques of HHS Report Discrediting Sex-Rejecting Procedures for Kids

The American Psychiatric Association (APA) tried and failed to discredit the Department of Health and Human Services’ (HHS) report showing sex-rejecting procedures harm minors.

HHS commended the association last week for for peer-reviewing Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices, which the department first published in May. The American Academy of Pediatrics and Endocrine Society refused HHS’ invitation to review, though both support subjecting wrong-sex-identified children to surgical procedures, puberty blockers and [wrong]-sex hormones.

Though the APA agreed to review Treatment for Pediatric Gender Dysphoria, it did not do so carefully or in good faith. Its criticisms rely on half-truths, manipulations and outright falsehoods, demonstrating how little evidence “gender-affirming” organizations have to support procedures they call “evidence-based.”

Below are five of the America Psychiatric Association’s failed critiques of HHS’ Treatment for Pediatric Gender Dysphoria.

Failure to Read

The APA recommended HHS review 16 additional studies for the final version of Treatment for Pediatric Gender Dysphoria.

The original report had already addressed twelve of them.

Two other recommended studies examined the effect of sex-rejecting procedures on the wrong population (adults, not minors). Another did not investigate sex-rejecting procedures at all.  

HHS found only one of the APA’s recommended studies “potentially relevant.” Importantly, it came out after the department published Treatment for Pediatric Gender Dysphoria on May 1, 2025.

In its response to the association’s review, HHS speculates its “unfounded” criticisms “could have resulted from a failure to read core parts of the review.

Making Assumptions

The APA argued Treatment for Pediatric Gender Dysphoria failed to consider the risk of allowing children struggling with wrong-sex identification to go through puberty.

This critique reflects a common lie that sex-rejecting procedures stop wrong-sex-identified children from committing suicide or experiencing other debilitating mental illnesses.

More importantly, it subtly reveals the APA changes its conception and treatment of puberty based on the feelings of the developing child.

The association evidently considers puberty a natural and necessary process only when the child accepts it. Conversely, when puberty causes a child distress, the association considers it a sickness to be stopped and reversed.

HHS correctly recognizes puberty as a natural, necessary part of human life — regardless of the developing person’s feelings about growing up. Treatment for Pediatric Gender Dysphoria investigates the effects of disrupting this natural physical development with wrong-sex hormones, drugs that “block” puberty and sex-rejecting surgeries.

Cherry Picking

Treatment for Pediatric Gender Dysphoria references many findings and conclusions from The 2024 Cass Review — a comprehensive report on transgender medical interventions which prompted the UK to ban puberty blockers and prohibit the administration of wrong-sex hormones to minors outside experimental research.

The APA criticized HHS for cherry picking favorable portions of the Cass Review and ignoring lines like, “For some, the best outcome will be transition…”

Ironically, the association cherry picked this phrase from a larger paragraph, not on the benefit of sex-rejecting procedures, but on the UK National Health Service’s obligation to children struggling with wrong-sex identification:

For some, the best outcome will be transition, whereas others may resolve their distress in other ways. Some may transition and then de/retransition and/or experience regret. The NHS needs to care for all those seeking support.

The APA selected this paragraph out of context to suggest the Cass Review equivocates on the benefits of sex-rejecting procedures. It doesn’t. The review clearly concludes evidence for sex-rejecting procedures is weak and, further, that doctors can’t know whether children will grow out of their wrong-sex identification and regret harming their bodies.

“Any reasonable interpretation of The Cass Review’s statements … must grapple with its findings about lack of evidence for benefit and deep uncertainties about diagnoses,” HHS writes. “Unfortunately, the APA fails to do so.”

Unsupported Conclusions

The APA criticized HHS for obfuscating how it chose and evaluated evidence in Treatment for Pediatric Gender Dysphoria.

Most other peer reviewers praised the report for its transparency and methodological rigor.

HHS highlights a positive peer review from two methodologists at the Belgian Centre for Evidence-Based Medicine. The scientists commended the reports’ methodology and described the results as “[written] transparently” and “easy to follow.”  

Misapplication of Scientific Norms

Healthcare “stakeholders” refer to any population or entity impacted by changes to the medical system, including patients.

The APA argued HHS improperly excluded stakeholder perspectives, particularly those of “transgender individuals and their families,” from Treatment for Pediatric Gender Dysphoria.

But scientists don’t need patients’ input to write reliable evidentiary reviews.

HHS suspects the association confused its report with a clinical practice guide, which dictates how doctors should diagnose and treat medical conditions. Clinical practice guides generally require feedback from patients who will be impacted by the recommendations.

Treatment for Pediatric Gender Dysphoria does not weigh in on diagnoses and treatment; it compiles and evaluates all evidence on the effects of sex-rejecting procedures on minors. The perspectives of patients and other stakeholders do not — and should not — affect its scientific conclusions.  

Ironically, HHS notes, the current “gender affirming” clinical practice guides for wrong-sex-identified children score low on stakeholder involvement.

Why It Matters

Treatment for Pediatric Gender Dysphoria suggests the American medical system performed sex-rejecting procedures on wrong-sex-identified children with no evidence of those procedures’ benefits and every evidence of their harms.

HHS gave standard-bearers like the APA the opportunity to respond to this serious implication. They either refused or presented weak, deceptive arguments devoid of evidence.  

That’s unacceptable. Protecting children from sex-rejecting procedures requires illuminating these cop-outs and pursuing justice for families and children harmed by these unconscionable practices.

Additional Articles and Resources

Counseling Consultation & Referrals

Resources for families struggling with wrong-sex identification

HHS Finalizes Report Finding Sex-Rejecting Procedures Harm Minors

HHS Releases Report on Harms of ‘Transgender’ Medical Interventions for Minors

FTC Begins Investigating ‘Gender-Affirming’ Medical Community for Deception, False Advertising

The Shifting Ground of ‘Gender-Affirming Care’

Don’t Fall for the ‘Affirm Them or They Will Die’ Lie

Transgenderism and Minors: What Does the Research Really Show?

UK Bans Puberty Blockers for ‘Transgender’ Minors

U.K.’s Review of Child Gender Policy Reveals Profound Failures That U.S. Still Defends

England’s NHS Stops Dispensing Puberty Blockers for Children — Not Safe or Effective

Addressing Gender Identity with Honesty and Compassion

Newsom Signs Bill Connecting Students to ‘LGBT Hotline’ and Unsafe Chatrooms

HHS Finalizes Report Finding Sex-Rejecting Procedures Harm Minors

The Department of Health and Human Services (HHS) released its final, peer-reviewed report on the effects of sex-rejecting procedures on minors last week.

Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices, which HHS first published in May, found “transgender” medical interventions — including puberty blockers, [wrong]-sex hormones and surgical operations — pose “significant, long term and too often ignored” harms to children.

The report’s groundbreaking conclusion remains unchanged in the final version published November 19. The latest copy includes peer reviewers’ evaluations of the report and the department’s responses to their critiques. It also reveals the names of review’s nine prestigious authors.

HHS invited three of the report’s biggest critics — the American Academy of Pediatrics, the American Psychiatric Association and the Endocrine Society — to participate in the peer review process.

All three organizations recommend sex-rejecting procedures for minors struggling with wrong-sex identification. Upon the release of Treatment for Pediatric Gender Dysphoria in May, the American Academy of Pediatrics claimed it “misrepresented the current medical consensus and failed to reflect the realities of pediatric care.”

But only the American Psychiatric Association agreed to review the report. HHS thoroughly refuted its critiques, such that The Washington Post editorial board wrote:

[The HHS report’s] core finding — that the evidence for [transgender medical] interventions is highly uncertain — echoes the results of systematic reviews in other countries. None of the peer reviews of the HHS report ultimately rebut that conclusion.

Critics attacked HHS for bias and lack of transparency in May, when it kept the authors of Treatment for Pediatric Gender Dysphoria anonymous.

“That’s one more reason why I can tell you this is an ideological, political document and not a scientific one,” Casey Pick, director of law and policy at the Trevor Project, a radical LGBT activist group, told Science in May. “Scientists stand by their work.”

In the final report, HHS notes withholding authors’ names is an “established practice in scientific review” meant to reduce bias in the peer reviews.

Nine multi-disciplinary experts authored Treatment for Pediatric Gender Dysphoria, HHS reveals, including two bioethicists, two psychiatrists, a philosopher, an evidence-based medicine specialist, an endocrinologist and two researchers — one who specializes in healthcare and another who covers “pediatric gender issues” for a think tank.

“These are not ideological cranks; they are thoughtful researchers,” the Post’s editorial board admits, concluding:

It is fair to say [the authors’] work has withstood scrutiny, with minor updates.

Treatment for Pediatric Gender Dysphoria withstands even the most critical peer reviews. That means Americans must acknowledge national medical authorities perform sex-rejecting procedures on children struggling with wrong-sex identification, despite evidence showing such interventions cause irrevocable harm.

“The American Medical Association and American Academy of Pediatrics peddled the lie that chemical and surgical sex-rejecting procedures could be good for children,” HHS Secretary Robert F. Kennedy Jr. castigated in a press release announcing the final report.

He continued:

They betrayed their oath to first do no harm, and their so-called “gender-affirming care” has inflicted lasting physical and psychological damage on vulnerable young people. That is not medicine — it’s malpractice.

The Daily Citizen heartily agrees.

Additional Articles and Resources

Counseling Consultation & Referrals

Resources for families struggling with wrong-sex identification

HHS Releases Report on Harms of ‘Transgender’ Medical Interventions for Minors

FTC Begins Investigating ‘Gender-Affirming’ Medical Community for Deception, False Advertising

The Shifting Ground of ‘Gender-Affirming Care’

Transgenderism and Minors: What Does the Research Really Show?

UK Bans Puberty Blockers for ‘Transgender’ Minors

U.K.’s Review of Child Gender Policy Reveals Profound Failures That U.S. Still Defends

Addressing Gender Identity with Honesty and Compassion

Newsom Signs Bill Connecting Students to ‘LGBT Hotline’ and Unsafe Chatrooms

Gender Ideology is Wrong: There Are Only Two Sexes

Anti-scientific gender theory holds that human sexuality is a glorious “gender spectrum,” a veritable rainbow of possibilities.

One can find seemingly scientific books and articles making this case here, here, here, here and here.

But a new article published in the esteemed Archives of Sexual Behavior explains why such talk is bunk. Entitled “Why There are Exactly Two Sexes,” it is authored by evolutionary biologist Colin Wright. Evolutionists, after all, have a keen interest in what male and female are, and how both cooperate to pass DNA down through the generations.

Wright explains that science defines male and female in their reproductive function. The very first line of his article states, “Across anisogamous species, the existence of two – and only two – sexes has been a settled matter in modern biology.”

“The sexes – male and female – refer to these two distinct reproductive strategies in anisogamous species. Males are defined as the sex that produces numerous small gametes (sperm). Females, conversely, are defined as the sex that yields fewer but larger gametes (ova),” Wright correctly states.

Of course, this long established view is supported by other scholars. Wright explains, “Because sperm and ova are the only two gamete classes in anisogamous systems, there are only two sexes.” As such, “This gametic dimorphism underlies biologists’ reference to sex as a ‘binary.’”

Such a basic biological definition might seem obvious to most people, but Wright explains “the societal and ethical stakes are also significant.” Gender theory has infamously defined male and female away into oblivion. Wright says this is driven by unscientific, ideological dogma. “Proposals to redefine sex in terms of karyotypes, secondary sexual characteristics, behavior, or other correlates are incoherent and invariably presuppose this foundation, because the categories ‘male’ and ‘female’ are intelligible only by reference to sperm and ova.”

Wright is a secular evolutionary biologist. But just as this truth is reflected in science, it is also revealed in the wisdom of Scripture.

“So God created man in his own image, in the image of God he created him; male and female he created them. And God blessed them. And God said to them, “Be fruitful and multiply and fill the earth” (Gen. 1:27-28, ESV).

Scripture tells us humanity is created in two forms – male and female – and each is the unique and deeply consequential image and likeness of God. God created male and female with many essential and distinct qualities, but the first command He gave them was to live out their sex-distinct procreative nature. In this way, we become cooperators with God as life-givers.

And this is precisely why the truth and beauty of male and female are being so viciously attacked today by the evil one. He knows what they mean. Christians must as well.

Related Articles and Resources

How Science and Faith Can Defeat Gender Ideology – Part One

How Science and Faith Can Defeat Gender Ideology – Part Two

How the Binary in ‘LGBTQ+’ Reveals Its Utter Incoherence

Why the ‘LGBT Person’ and ‘LGBT Community’ Don’t Really Exist

Here’s What Happens When Good People Don’t Connect Gay and Trans Ideology

What is ‘Gender Identity’

Transgenderism and Minors: What Does the Research Really Show?

University of California Schools: Students Must Bow to ‘Transgender’ Ideology

University of California schools are using sexual harassment and anti-discrimination training to force students and staff to affirm “transgender” ideology.

Young America’s Foundation first reported that mandatory training at the University of California, San Diego, required students to agree that sexually confused individuals should be allowed to use opposite sex bathrooms based on their “gender identity.”

According to YAF, students must bow down to transgender dogma, or they are blocked from taking classes.

The online program is called SHAPE – Sexual Harassment, Anti-Discrimination, Prevention and Education. It consists of a 60-75 minute training with a quiz at the end of the course.

As YAF explained, UC San Diego students were required “to agree the following scenario constitutes a ‘hostile environment.”

My name is Mona and I am transgender. My classmate Jane continues to call me James, which was my name before I transitioned. Jane refers to me as a man, and complains when I use the women’s restroom. I’ve asked her to stop but she does not. I feel very disrespected and want this to stop. What type of prohibited conduct can this be?

When students choose “Hostile Environment” as the correct answer, SHAPE explains that students must adhere to transgender ideology.

“Hostile Environment may be created when someone demands that others use a particular bathroom that does not correspond to their gender identity or uses the incorrect pronoun.

“Intentionally calling someone their name used prior to transition, as opposed to their lived name, is called dead-naming; and may be a form of sexual harassment.”

In other words, disagreeing with any aspect of transgender ideology creates a hostile environment.

But of course, this is simply speaking biological truth. One would think research universities, with their heavy emphasis on science, would know this.

The UC system violates first amendment rights by forcing students to use speech they disagree with, mandating acquiescence to beliefs that many people of faith reject, and censoring clear scientific thinking about sex and biology.

California Family Council (CFC), a Focus on the Family ally, detailed the origins of the training.

The University of California Office of the President states that SHAPE was “developed by UC Online in partnership with the Systemwide Office of Civil Rights,” and integrates directly with each campus’s online learning system to ensure full participation.

Campuses, including UC San Diego, UC Davis, UC Merced, UC Santa Cruz, UCLA, UC Berkeley, and UC Irvine, have all implemented the program.

CFC described the consequences for students who don’t agree with transgender dogma/

“According to UC Irvine, training is mandatory by the Office for Civil Rights at the University of California, Office of the President, to fulfill state law.

“Every student must earn a 100% score on the final quiz to pass. Failure to complete the program results in a registration hold, preventing enrollment for the next semester.”

Several UC schools, including Santa Cruz and Santa Barbara, use the training to show they are complying with Title IX of the Educational Amendments of 1972.

“No person in the United States shall, on the basis of sex, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any educational program or activity receiving federal financial assistance,” federal law states.

The state of California – and the UC system – make a mockery of Title IX by redefining biological sex to include the spurious concept of “gender identity.” One is an objective fact, the other a baseless belief system.

UC schools allow males to usurp women’s rights, robbing women of educational opportunities, sports victories, scholarships, privacy and safety.

“Once regarded as centers of critical thinking and open debate, these institutions are now conditioning students to affirm a narrow, politicized definition of truth,” CFC opined.

The organization encouraged students to stand up to the UC system’ denial of reality and censorship of opposing voices.

“However, do not let indoctrination training like this silence your voice. Refuse to submit to any authority that demands you compromise biblical conviction or deny biological truth. Instead, stand up and fight alongside the California Family Council.”

Related Articles and Resources

DOJ Lawsuit Describes California Department of Education’s Infuriating Treatment of Girls

Feds Sue California Department of Education, Interscholastic Federation For ‘Illegal Sex Discrimination’

Feds Pressure California After Boy Wins in Girls Track and Field Championship

Focus on the Family Transgender Resources

Shoving Girls Off the Podium: More Male Athletes Participating in Girls Sports

Transgender Ideology is Inherently Destructive

Trump Signs Executive Order Protecting Women’s Sports and Spaces

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Supreme Court Considers Florida Parental Rights Case

On Nov. 7, the U.S. Supreme Court will consider taking up a landmark case that could redefine the meaning of parental rights in public education. The case, Littlejohn v. School Board of Leon County, has the potential to impact every classroom in the United States.

Background

The case involves a middle school student in Florida. Parents allege school officials met privately with their 13-year-old daughter to discuss “gender identity” and created a “gender support plan” against their wishes and without informing them.

According to the lawsuit, staff were allowed to withhold information if a student requested confidentiality. Parents claim the school violated their constitutional right to direct the upbringing of their child under the 14th Amendment.

Legal History

Florida district court and the 11th Circuit Court of Appeals dismissed the case.

Both courts applied the “shock-the-conscience” test – a standard of review that requires proof of school officials acting with the intent to harm in order to find wrongdoing – and held that the school’s actions did not meet that threshold.

The 11th Circuit Court of Appeals reasoned,

Defendants did not act with intent to injure. To the contrary, they sought to help the child. Under these circumstances, even if the Littlejohns felt that Defendants’ efforts to help their child were misguided or wrong, the mere fact that the school officials acted contrary to the Littlejohns’ wishes does not mean that their conduct “shocks the conscience” in a constitutional sense.

In September, the Littlejohns filed their petition with the Supreme Court to review the decision. The Court has scheduled a conference to discuss the case for Friday, Nov. 7.

Constitutional Question

Here’s what at stake: if school officials can infringe on fundamental rights of parents protected in the U.S. Constitution.

The Littejohns argue that parental rights are fundamental and require the Court to apply the highest level of review, strict scrutiny, as it would with other core constitutional rights.

Impact

A ruling in favor of the Littlejohns could solidify constitutional protections for parental rights nationwide on the growing issue of school officials transitioning students without parental involvement.

If the Court decides to take the case this term, there is good reason to believe that the Court would protect parental rights.

As previously reported by the Daily Citizen, the Supreme Court decided not to take a similar Colorado parental rights case. In a short statement, Justice Samuel Alito made it clear that the case raised very serious questions about parental rights.

“The troubling – and tragic – allegations in this case underscore the ‘great and growing national importance’ of the question that these parent petitioners present.”

The Daily Citizen will continue to follow this case.

Related Articles and Resources

Focus on the Family exists to help families, and that includes help navigating the issues of homosexuality and transgenderism. Focus offers a free, one-time counseling consultation with a licensed or pastoral counselor. To request a counseling consultation, call 1-855-771-HELP (4357) or fill out our Counseling Consultation Request Form.

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Exclusive Interview: Colorado Parents Expose ‘Gender Cult’ at Public School in New Documentary

Focus on the Family Urges Congressional Leaders to Respect Parental Rights

Homosexuality Resources

Transgender Resources

Understanding Homosexuality