Earlier this year the U.S. Department of Health and Human Services (HHS) released guidelines for “Gender-Affirming Care and Young People.” The guidelines state:

Gender-affirming care is a supportive form of healthcare. It consists of an array of services that may include medical, surgical, mental health, and non-medical services for transgender and nonbinary people.

For transgender and nonbinary children and adolescents, early gender-affirming care is crucial to overall health and well-being as it allows the child or adolescent to focus on social transitions and can increase their confidence while navigating the healthcare system.

The advice comes from the HHS Office of Population Affairs, which is under the direction of Assistant Secretary for Health Dr. Rachel Levine, who was born male and identifies as a woman. Levine has been at the forefront of promoting “medical transitioning” for children.

“Gender affirming care” begins with the “social transitioning” of a child to live as the opposite sex. This typically means allowing the child to choose a new name and dress as the opposite sex.

From there, children move to “medical transitioning,” which includes the use of puberty blockers, opposite sex hormones and surgeries to give a child the appearance of the opposite sex.

The document says that “gender diverse children and adolescents” need these medical interventions and that they have “been demonstrated to yield lower rates of adverse mental health outcomes, build self-esteem, and improve overall quality of life for transgender and gender diverse youth.”

But is this true? What does “transgender” research – with minors, especially – actually demonstrate?

The Institute for Research and Evaluation (IRE) published a review of the available medical and psychological literature, “Transgender Research: Five Things Every Parent and Policy-Maker Should Know” (“Transgender Research”).

The institute’s primary focus has been on evaluating sex education programs, but with transgender ideology being taught in many schools, often through Comprehensive Sexuality Education, IRE took time to analyze what the research really says about transgenderism.

IRE notes that this work is especially important given the “exponential rise in the occurrence of gender confusion or gender dysphoria (also called transgender or gender non-conforming) among young people worldwide, especially among teenage girls.”

“Transgender Research” goes on to say:

The distress of these young people is real, and the causes of this unprecedented trend are unclear, raising difficult questions about compassionate, ethical, and effective ways to respond.

IRE explains that the HHS endorsement of gender-affirming care is controversial and that the use of drugs, hormones and surgeries with children “has been the focus of heated debate.”

In evaluating the available research, IRE asks five questions, offering a summary of the evidence, giving highlights from published research, and drawing conclusions about medical transitioning and children’s well-being.

Their conclusions differ markedly from HHS’ recommendations. Here are some of IRE’s findings.

  1. What does research show about the benefits and harms of cross-sex medical treatment for minors?

IRE notes the international movement away from medical treatment for sexually confused minors:

Many scientific agencies- both U.S. and international—-do not recommend medical “transition’ for youth because the research claiming to show positive effects from cross-sex hormones or surgery is methodologically flawed and not scientifically reliable.

The review highlights decisions by Sweden, England and Finland to back off from such treatments because of questions about the reliability of transgender studies.

Sweden’s National Board of Health & Welfare said that the risks of puberty blockers and hormones for adolescents “outweigh the possible benefits” and that there is “continued lack of reliable scientific evidence concerning the efficacy and the safety of both treatments.”

The British Medical Journal published an evidence review which listed concerns about puberty blockers, including how they “threaten the maturation of the adolescent mind” and “are being used in the context of profound scientific ignorance.”

“Transgender Research” lists the shortcomings of many studies that claim there are benefits to medical treatments for minors with sexual identity confusion. These include: “lack of control groups, small sample sizes, recruitment bias, nongeneralizable study populations, short follow-up times, and high numbers lost to follow-up.”

The institute reaches an important conclusion that contradicts HHS recommendations:

Scientific evidence has not shown that cross-sex medical treatments are beneficial to children or adolescents. The research making these claims is not scientifically reliable. In fact, there is evidence of harmful impact. Consequently, a growing number of scientific agencies do not recommend such treatments. Instead, they recommend counseling and watchful waiting for gender-confused youth.

IRE than asks a second important question:

  1. What does research on medical gender transition tell us about preventing suicide in trans youth?

The review explains that parents are often told they “must choose between a ‘live trans son or a dead daughter’ (or vice versa).” But the literature does not support this. The IRE review states:

Widely cited studies claiming that suicidality in gender-confused youth is reduced by cross-sex hormonal and surgical interventions have been found to have significant methodological flaws and therefore should not be relied on. Scientifically sound studies have found either no reduction or an increase in transgender suicidality after youth have received cross-sex medical procedures (emphasis theirs).

“Transgender Research” points to a “landmark 30-year longitudinal study of life after transgender surgery” from Sweden which found:

Ten years after sex reassignment surgery, the transgender patients were 19 times more likely to die from suicide than the typical Swedish population, after accounting for differences in individual mental illness before surgery.

IRE also quotes an article by Dr. Stephen Levine, clinical professor of psychiatry at Case Western Reserve University School of Medicine, who found that “neither hormones nor surgeries have been shown to reduce suicidality in the long-term.”

  1. Is gender dysphoria in children a permanent condition, and one that requires medical treatment?

“Transgender Review” concludes:

Research shows gender dysphoria in children usually goes away on its own by young adulthood, if “transition” is not encouraged. This avoids the harmful effects of cross-sex medical interventions.

IRE reports that, in contrast, with the increasing early social transitioning of children, “the large majority will most likely persist in a ‘trans’ identity” and move on to medical interventions.

But with an approach that entails “watchful waiting” and counseling, most children desist from their belief that they are the opposite sex:

There is strong evidence showing that the vast majority (averaging about 85%) of children who experience gender dysphoria will resolve their gender identity confusion and accept their biological sex by the time they reach young adulthood, that is, if they are not subjected to “social transition” or cross-sex medical intervention.

  1. Can young people be influenced to identify as transgender, or is it all biologically determined?

As the Daily Citizen has previously reported, there has been a huge increase in children – especially adolescent and teen girls – with sexual identity confusion and with the number of clinics and hospitals in the U.S. that use experimental and damaging medical interventions with minors.

“Transgender Research” reports:

A recent U.S. Gallup Poll found that the percent of Generation Z (born 1997 – 2002) who identify as transgender has increased by 900% over the percent of Generation X (born 1965 – 1980), who say they are transgender.

IRE explains that such an increase can’t be accounted for by biological or genetic influences, stating:

Scientific evidence indicates that the causes of gender dysphoria are complex. Social and cultural factors can have a significant influence on whether a young person will identify as transgender.

  1. What does research tell us about teaching sex education and gender ideology to young children?

“Transgender Research” concludes:

There is no scientific evidence showing that young children benefit from being taught in school about sexuality, transgender identity, or homosexuality, or that such teaching reduces child sex abuse.

IRE summarizes the available research:

Studies to date have not produced scientific evidence to back up the claim that teaching sex education to young children in early elementary school, including content about transgender ideology and homosexuality, is beneficial to them or reduces rates of child sex abuse. There are no sound studies on these outcomes. And research has not shown reliable evidence that sex education classes which teach these topics to older youth produce any long-term benefits.

Here are the final takeaways from the report:

1) Research evidence does not support medical intervention for gender-confused minors. 2) Medical transition procedures have not been shown to reduce youth suicides. 3) Childhood gender dysphoria usually dissipates on its own by adulthood. 4) The dramatic increase in gender dysphoria in the past decade is likely being driven by social factors. 5) Sex education for early elementary school children, including content about transgender ideology, has not been shown by scientific research to be beneficial.

School board members and departments of education should know this as they are faced with decisions about curriculum and resources.  State legislators should be aware of these findings and protect children from these harmful medical interventions.

And parents faced with a child, adolescent or teen who claims to be transgender will want to help their child through watchful waiting and counseling – rather than puberty blockers, hormones and surgeries which can cause irreversible, life-long damage to a child’s mind and body.

Related articles and resources:

If you or someone you know is struggling with transgenderism or other sexuality issues, and you don’t know where to turn, Focus on the Family is here to help.

Focus offers a one-time counseling consultation with a licensed or pastoral counselor free of charge thanks to generous donor support. If you would like to request a consultation with Focus’ Counseling Department, call 1-855-771-HELP (4357) weekdays from 6:00 AM to 8:00 PM (Mountain Time) or complete our Counseling Consultation Request Form.

The Institute for Research and Evaluation: Transgender Research: Five Things Every Parent and Policy-Maker Should Know

Focus on the Family: Transgender Resources

American Academy of Pediatrics Captured by Gender Ideology; Mainstream Professionals Are Calling Them Out

Britain’s National Health Service Changes Guidance about Puberty Blockers for Gender-Confused Children

Hospitals and Doctors “Transition” Hundreds of Children with Drugs, Hormones and Surgery

Huge Increase in Sexual Identity Confusion and Body-Mutilating Procedures

Questioning Drugs, Hormones and Surgery for Youth Confused about Their Sexual Identity

Transgender Organization Suggests Hormones and Surgeries Should Start Even Earlier for Gender-Confused Teens