Disregard transgender treatment guidelines, follow recommendations by unidentified authors, suggests letter from Health and Human Services to health care providers.
The United States Department of Health and Human Services (HHS) has prompted a heated debate with a recent report on the treatment of youth with gender dysphoria, urging healthcare providers to update their treatment protocols based on the controversial review.
On Wednesday, Robert F. Kennedy Jr., the HHS Secretary, penned a letter advocating for such updates, cautioning providers against relying on science-based professional guidelines. Kennedy's letter, shared via HHS's social media, encourages providers to utilize the government document instead, indicating a possible shift in the department's stance.
The HHS report, released May 1st, insists it is not a clinical practice guideline. Nonetheless, Kennedy's letter warns of potential reprisals against providers who do not comply, hinting at new policies and oversight measures to protect children and hold transgressors accountable.
In another development, the Centers for Medicare and Medicaid Services (CMS), a subagency of HHS, announced Wednesday an oversight initiative into hospitals performing "experimental sex trait modification procedures" on children. CMS Administrator Dr. Mehmet Oz expressed concern over the lack of scientific evidence supporting these procedures and any related profits.
Although gender-affirming surgeries are relatively uncommon among transgender or gender-diverse youth in the US, professional medical organizations generally endorse such procedures as part of an individualized care plan. Major medical associations, including the American Medical Association, American Psychiatric Association, Endocrine Society, American Psychological Association, American Academy of Pediatrics, and the American Academy of Child & Adolescent Psychiatry, consider gender-affirming care clinically appropriate and potentially life-saving.
However, the HHS report, initiated by an executive order from President Donald Trump, casts doubts on the safety and efficacy of gender-affirming care for minors. The report questions the evidence base for these treatments—including puberty blockers, hormone therapy, and surgeries—and warns of irreversible effects with little proven benefit. To date, there have been no gender-affirming surgeries reported on transgender youth aged 12 and under, and the rates are low for older teens and adults.
Notably, the HHS refused to disclose who wrote the report, withholding essential transparency. Parts of it were peer-reviewed, but the department remained tight-lipped regarding which sections and who reviewed them. The report avoids issuing legislative or policy recommendations, focusing on evidence, ethical considerations, psychotherapy, and "clinical realities" centered on treatment for gender dysphoria in young people. The review omits an examination of adult treatment.
Critics allege the report is politically driven and misrepresents the current medical consensus, while professional medical organizations maintain that gender-affirming care for transgender adolescents can be both life-saving and evidence-based.
- The recent debate over the treatment of youth with gender dysphoria in the United States has extended to the realm of politics, with the HHS Secretary, Robert F. Kennedy Jr., advocating for updates in healthcare provider treatment protocols based on a controversial report.
- Stewarting against science-based professional guidelines, Kennedy's letter encourages healthcare providers to instead follow the government document, signaling a potential shift in the department's stance towards evidence-based practices.
- In a separate development, the Centers for Medicare and Medicaid Services (CMS), a subagency of HHS, announced an oversight initiative into hospitals performing "experimental sex trait modification procedures" on children, expressing concern over the lack of scientific evidence supporting these procedures and any related profits.
- Amidst the controversy surrounding the HHS report on gender-affirming care, professional medical organizations such as the American Medical Association, American Psychiatric Association, and the American Academy of Pediatrics, among others, remain steadfast in their support for these treatments as clinically appropriate and potentially life-saving.
