On May 1, the Department of Health and Human Services (HHS) released a comprehensive report addressing gender-affirming care for transgender youth. The document has faced substantial criticism from medical professionals, parents, and LGBTQ+ advocacy groups.

Context and Background

This report follows an executive order from Donald Trump that sought to eliminate gender-affirming medical treatments for children. The order mandated Secretary of Health and Human Services Robert F. Kennedy Jr. to prepare a review of existing literature on best practices in this area within a 90-day timeframe. Although the report does not possess legal authority, it is viewed as a precursor to future policy changes.

Criticism of the Report’s Basis

Medical experts have expressed concern over the report’s reliance on a narrow selection of studies that support specific administration viewpoints while ignoring decades of established research that advocates for gender-affirming care. Critics argue that the proposed alternatives mimic methods akin to conversion therapy, a discredited practice aimed at altering an individual’s gender identity or sexual orientation.

Leading organizations in the medical community, including the American Academy of Pediatrics and the American Medical Association, affirm the importance of gender-affirming care for both children and adults.

Lack of Author Attribution

The report notably omits the names of contributing authors, raising concerns about its credibility within the scientific community. Morissa Ladinsky, MD, a pediatrician specializing in gender-affirming care, has described this lack of transparency as “extremely unorthodox” and “concerning.”

Controversial Recommendations

Among the problematic suggestions in the report is the promotion of “exploratory therapy.” Critics liken this approach to a rebranding of conversion therapy, where therapists may undermine the authenticity of a client’s gender identity. This method is argued to systematically discourage transition and could potentially harm transgender youth’s mental health.

Misrepresentation of Mental Health Care

The HHS report contains claims that mental health assessments are frequently minimized in current care models. However, experts counter that mental health therapy is a foundational element of gender-affirming care, often involving thorough longitudinal assessments before any medical interventions are considered. According to professionals, young individuals are typically under care for significant periods before reaching a point where medical transition is discussed.

Mandy Giles, whose family has navigated the gender-affirming care process, emphasizes that extensive mental health evaluations are prerequisite to any medical interventions, debunking the myth that transgender minors can easily access treatments like puberty blockers and hormones.

Evidence of Impact on Mental Health

Despite claims made in the HHS report, numerous studies have demonstrated the positive effects of gender-affirming care on mental health. A 2022 study published in The Journal of Adolescent Health highlighted a significant correlation between access to hormone therapy and reduced rates of depression and suicidality among transgender and nonbinary youth.

Conclusion

The backlash against the HHS report emphasizes the ongoing discourse surrounding gender-affirming care. While the report seeks to reshape the narrative about transgender youth and their access to healthcare, established medical consensus supports the efficacy and necessity of gender-affirming treatments. Understanding the nuances of these discussions is essential for navigating the complexities surrounding transgender healthcare.