The U.S. Department of Health and Human Services (HHS) released an important evaluation of the evidence for how best to treat children and adolescents with “gender dysphoria.”
Not surprisingly, the comprehensive review, Treatment for Pediatric Gender Dysphoria Review of Evidence and Best Practices, showed serious problems with treating minors with “gender-affirming care,” which can include body damaging, experimental and risky puberty suppressants, hormones and surgeries.
A news release from HHS clearly explained the troubling paucity of evidence and grave risks for confused children who receive these medical interventions:
This review, informed by an evidence-based medicine approach, reveals serious concerns about medical interventions, such as puberty blockers, cross-sex hormones, and surgeries, that attempt to transition children and adolescents away from their sex.
The review highlights a growing body of evidence pointing to significant risks – including irreversible harms such as infertility – while finding very weak evidence of benefit. That weakness has been a consistent finding of systematic reviews of evidence around the world.
Treatment for Pediatric Gender Dysphoria is 409 pages long and covers everything from the history of transgender medicine to current treatment practices to the effects of harmful medical interventions on minors. It’s release was accompanied by a 173-page appendix which explained the methodology and gave a synthesis of the evidence.
Director of the National Institutes of Health Dr. Jay Bhattacharya emphasized the primary goal in treating children with sexual identity confusion should be to safeguard their health.
He said, “Our duty is to protect our nation’s children – not expose them to unproven and irreversible medical interventions. We must follow the gold standard of science, not activist agendas.”
The report explains that activist agenda comes from groups like the Endocrine Society, the American Academy of Pediatrics, and the World Professional Association for Transgender Health (WPATH). These groups have labeled their treatment “gender-affirming care,” which means affirming a child’s sexual identity confusion and allowing the child to try to live as the opposite sex, or a combination of the two sexes, or no sex, or some self-defined, pseudo “gender.”
These minors are then encouraged to use dangerous and powerful puberty blockers, proceed to body-damaging opposite sex hormones, and then undergo irreversible surgeries. An executive summary of the literature review states the seriousness of these treatments for children who have nothing wrong with their brains or bodies:
Nevertheless, the “gender-affirming” model of care includes irreversible endocrine and surgical interventions on minors with no physical pathology.
These interventions carry risk of significant harms including infertility/sterility, sexual dysfunction, impaired bone density accrual, adverse cognitive impacts, cardiovascular disease and metabolic disorders, psychiatric disorders, surgical complications, and regret.
The executive summary explains that there is little evidence that “gender-affirming” care is even helpful.
“Meanwhile, systematic reviews of the evidence have revealed deep uncertainty about the purported benefits of these interventions.”
One section of the extensive report details the “International Retreat from the ‘Gender-Affirming’ Model,” known as the Dutch Protocol, first published in 2006, which advocated for “gender-affirming care.” This medicalized approach initially expanded, based on two flawed, unreplicated studies with “serious limitations.”
In 2015, the meta-analysis explains, the number of youth identifying as “transgender” surged dramatically, “first gradually, then suddenly,” with a large number of female adolescents wanting to live as boys.
Given its shaky foundation researchers in different countries began conducting their own studies of “gender-affirming care,” and the report details the growing international movement away from using medical interventions to modify children’s bodies:
Finland subsequently became the first country to revise its national guidelines, sharply limiting medical interventions based on the findings of an SR [systematic review]. In the years that followed, other countries began conducting their own evaluations of the evidence and arrived at similar conclusions.
A global trend has since emerged, away from use of PBs [puberty blockers], CSH [cross-sex hormones], and surgeries in youth with GD [gender dysphoria].
Treatment for Pediatric Gender Dysphoria describes England’s review of “pediatric gender medicine” that began in 2020, with the final report, The Cass Review released in 2024. This led to the closing of the country’s Gender Identity Development Service and a move away from puberty blockers, hormones and surgeries for children.
The new HHS report lists other countries that have stopped or limited these harmful, disfiguring treatments, including Denmark, Sweden, and Norway, adding,
“Most recently, hormonal interventions have been restricted in Brazil, Chile, the province of Alberta in Canada, and the state of Queensland in Australia.”
The meta-analysis makes clear that it is not a clinical practice guideline, while emphasizing it “describes the very low-quality evidence underpinning treatment approaches in pediatric gender medicine” and “contains an extensive description of potential or plausible harms associated with certain treatment options (namely, hormonal interventions and surgeries), some of which are significant.”
It concludes that current transgender medical interventions for children and adolescents “are inconsistent with widely endorsed principles of medical ethics.”
There’s much more in Treatment for Pediatric Gender Dysphoria Review of Evidence and Best Practices, and the Daily Citizen will detail these findings in the weeks ahead.
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