A report published on the Department of Health and Human Services (HHS) website on Wednesday pushes the dubious claim that gender-affirming care for transgender youth does more harm than good — a statement that flouts years of studies concluding otherwise.
The report, titled “Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices,” derides gender-affirming care by reclassifying it as “pediatric sex-rejecting procedures.” HHS Secretary Robert F. Kennedy Jr. commended the report, dismissing the idea that such treatment could “be good for children.”
“So-called ‘gender-affirming care’ has inflicted lasting physical and psychological damage on vulnerable young people,” Kennedy said, baselessly claiming that it’s “malpractice.”
The report is actually a continuation of a study that was published in May. When that report came out, critics noted that it was deeply flawed, as it failed to even provide a list of contributors’ names.
“The Report fails to clearly articulate how the studies were selected, what criteria governed their inclusion or exclusion, or how their quality was assessed,” an initial peer review statement from the American Psychiatric Association said.
The group added:
There is no indication that key stakeholders — namely, transgender individuals, their families, and clinicians — were consulted or that their perspectives were considered. … While the Report is clear about the potential harms of intervening medically, it does not apply any kind of rational scrutiny to potential harms that have been associated with withholding intervention, including higher rates of depression, anxiety, suicidality, and social withdrawal.
Another peer reviewer of the report noted that it was “stacked with members with an intellectual conflict of interest.”
Indeed, several of the reports’ authors are noted anti-LGBTQ voices and critics of gender-affirming care, with little experience when it comes to providing medical care to transgender youth.
One of the contributors, for example, is Evgenia Abbruzzese, the founder of the so-called Society for Evidence-Based Gender Medicine (EBGM). That organization is listed by the Southern Poverty Law Center (SPLC) as an anti-LGBTQ hate group.
Another contributor is Leor Sapir, a senior fellow at the Manhattan Institute for Policy Research, a right-wing think tank that frequently pushes the debunked “transgender social-contagion” theory. And another participant in the report is Moti Gorin, a philosopher and anti-transgender activist.
The updated paper comes just weeks after news reports indicated that HHS would institute new rules that forbid any medical organization in the U.S. that receives federal funds from providing gender-affirming care to trans youth. The report’s conclusions will undoubtedly be cited when HHS eventually makes those recommendations official.
With the contributors’ names now published, many observers said it was obvious why the initial report in May was against gender-affirming care as a treatment option for trans youth.
“Now that the authors have announced themselves, they can be identified as engineers of a cottage industry that solely exists to dismantle health care for a vulnerable group of people,” said Meredithe McNamara, an adolescent medicine specialist at the Yale School of Medicine. “Transgender identity is real, transgender people of all ages thrive when they have access to the care they need, and politics needs to get out of medicine.”
“Gender-affirming care is not fringe; it’s standard, developmentally appropriate health care. It is individualized, careful and — as every major medical organization has stated and a mounting body of evidence indicates — can be lifesaving,” pediatrician and Physicians for Reproductive Health fellow Bianca Allison said in response to the new report.
In response to Kennedy’s condemnation of medical organizations in support of gender-affirming care, the American Medical Association and the American Academy of Pediatrics issued a joint statement.
The authors of the report “did not engage with anyone with actual clinical expertise in the care of trans youth,” said Kellan Baker, a senior adviser for health policy at the Movement Advancement Project, adding that the contributors are “a very small loop of people who have already been on record…[of being] opponents of care for trans young people.”
“We reject characterizations of our approach to gender-affirming care as negligent or ideologically driven,” the groups said. “These claims, rooted in politics and partisanship, misrepresent the consensus of medical science, undermine the professionalism of physicians, and risk harming vulnerable young people and their families.”
“HHS hid contributors initially. Why? Because they are activists, not independent or neutral experts. … This is effectively ‘institutional capture” of an HHS report by anti-trans groups,” wrote Alejandra Caraballo, a trans rights advocate and clinical instructor at Harvard Law’s Cyberlaw Clinic.
Multiple studies have demonstrated that gender-affirming care is incredibly beneficial for transgender youth.
A study published in JAMA Pediatrics last year found that teenagers who pursued gender-affirming care options, like those panned in the HHS report, are highly satisfied with their outcomes, with the lead author of the study reporting that “regret was very rare.” More than half of the participants in that study rated their care a perfect score, and only 4 percent expressed regret over their treatment.
Among those who did express regret, most said it was over how their care plan was initially mapped out, not because they received the care and didn’t want it later on — for instance, many participants were regretful that they started with puberty blockers instead of receiving hormone treatments right away.
A recent review of dozens of studies performed by Cornell University found that 51 of them showed positive outcomes for trans people receiving gender-affirming care. Indeed, no studies examined by the university concluded that gender transition or affirmation “causes overall harm” to recipients.
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