The U.S. Department of Health and Human Services (HHS) under President Donald Trump has released a scathing 410-page report, “Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices,” condemning “gender-affirming care” for children as unscientific and harmful. Published on Wednesday, the peer-reviewed document exposes the risks of puberty blockers, cross-sex hormones, and surgeries, drawing parallels to Britain’s Cass Review and critiquing the World Professional Association of Transgender Health (WPATH) guidelines as ideologically driven rather than evidence-based.
It accuses U.S. medical associations of promoting unproven protocols, ignoring long-term harms, and marginalizing dissent, effectively labeling the practice as malpractice rather than medicine. Key findings reveal that the evidence supporting these interventions is of “very low quality,” with overstated benefits and significant risks including infertility, sexual dysfunction, bone density loss, surgical complications, and heightened chances of heart, metabolic, and psychiatric disorders.
The report highlights publication bias, inadequate tracking of harms, and the fact that gender dysphoria—a mental health condition—often resolves naturally in late teens without intervention, making mental health care the preferred approach. It portrays the industry as a “billion-dollar” enterprise that profits from creating lifelong customers through irreversible procedures, while ethical concerns around informed consent and regret rates are routinely downplayed.
HHS officials and experts hailed the report as a pivotal shift. Assistant Secretary Admiral Brian Christine blamed the previous administration, particularly Rachel Levine, for politicizing children’s health for ideology and profit, stating, “It’s literally a billion-dollar industry… You should treat them with mental health care because we know that if you do, the majority of these kids, by the time they’re in their late teens, are very comfortable in their own skin.” HHS Secretary Robert F. Kennedy Jr. declared, “The American Medical Association and the American Academy of Pediatrics peddled the lie that chemical and surgical sex-rejecting procedures could be good for children… That is not medicine — it’s malpractice.”
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