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2025 US HHS report attacking gender-affirming care

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On May 1, 2015, The Trump Administration released Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices (aka Gender Dysphoria Report) as a pretext for banning healthcare for trans and gender diverse youth.

Background

As part of the Trump Administration’s attacks on trans rights, President Donald Trump ordered a “review” of healthcare for gender diverse people under age 19 by the end of April 2025. This tactic echoes the transphobic Cass Review published in the UK in 2024.

The haste and unprofessionalism with which the document was cobbled together is evident in the reference section. Work cited includes social media posts, podcasts, and blog posts. The second reference states “404 Not Found,” suggesting it was put together using AI.

Reception

The report was criticized by scientific organizations and medical professional associations, including:

Several human rights organizations criticized the report, including:

The report was praised and publicized by anti-trans activists and conservative organizations, including:

Authorship

Anti-trans activist Jesse Singal has deep ties with anti-trans extremists involved with the document and was given an advance copy as a reward. Singal, whose own anti-trans propaganda is cited throughout the report, knew who the anonymous authors were but failed to disclose them, writing:

“I was shocked when I found out who was on the team of external experts commissioned by the HHS to write the report.”

A journalist with such information would have included that information in their report. Journalism is what people don’t want published. Everything else is public relations.

The published documents revealed three people involved in compiling the information:

Cited works

The references mention many leading lights in anti-trans activism, including:

  • Tamara Pietzke
  • FAIR in Medicine
  • Cass Review
  • LOTL / Buck Angel
  • SEGM [11 articles]
  • Transparency podcast
  • The Economist [2 anonymous articles]
  • Foundation Against Intolerance & Racism Open Letter re: Archives of Sexual Behavior.
  • Adkins, D. (2016, May 13). Carcaño v. McCrory, No. 1:16-cv-00236.
  • Andrews, J. C., SchĂŒnemann, H. J., Oxman, A. D., Pottie, K., Meerpohl, J. J., Coello, P. A., Rind, D., Montori, V. M., Brito, J. P., Norris, S., Elbarbary, M., Post, P., Nasser, M., Shukla, V., Jaeschke, R., Brozek, J., Djulbegovic, B., & Guyatt, G. H.
  • Andrews, J., Guyatt, G. H., Oxman, A. D., Alderson, P., Dahm, P., Falck-Ytter, Y., Nasser, M., Meerpohl, J., Post, P. N., Kunz, R., Brozek, J., Vist, G., Rind, D., Akl, E. A., & SchĂŒnemann, H. J.
  • Baldinger-Melich, P., Urquijo Castro, M. F., Seiger, R., Ruef, A., Dwyer, D. B., Kranz, G. S., Klöbl, M., Kambeitz, J., Kaufmann, U., & Windischberger, C.
  • Baron, T., & Dierckxsens, G.
  • Cass Review:
    • Camilla C Kingdon
    • Jo Taylor, Ruth Hall, Trilby Langton, Lorna Fraser, Catherine Elizabeth Hewitt
    • Jo Taylor, Alex Mitchell, Ruth Hall, Claire Heathcote, Trilby Langton, Lorna Fraser, Catherine Elizabeth Hewitt
    • Ruth Hall, Jo Taylor, Catherine Elizabeth Hewitt, Claire Heathcote, Stuart William Jarvis, Trilby Langton, Lorna Fraser
    • Jo Taylor, Alex Mitchell, Ruth Hall, Trilby Langton, Lorna Fraser, Catherine Elizabeth Hewitt
    • Claire Heathcote, Jo Taylor, Ruth Hall, Stuart William Jarvis, Trilby Langton, Catherine Elizabeth Hewitt, Lorna Fraser
    • Jo Taylor, Ruth Hall, Trilby Langton, Lorna Fraser, Catherine Elizabeth Hewitt
    • Catherine Elizabeth Hewitt, Jo Taylor, Ruth Hall, Claire Heathcote, Trilby Langton, Lorna Fraser
    • Jo Taylor, Ruth Hall, Claire Heathcote, Catherine Elizabeth Hewitt, Trilby Langton, Lorna Fraser
    • Ruth Hall, Jo Taylor, Claire Heathcote, Trilby Langton, Catherine Elizabeth Hewitt, Lorna Fraser

  • ABC News
  • Aetna
  • ACLU
  • Achille, C., Taggart, T., Eaton, N. R., Osipoff, J., Tafuri, K., Lane, A., & Wilson, T. A.
  • Actavis Pharma, Inc.
  • Afonso, J., Ramirez-Campillo, R., Clemente, F. M., BĂŒttner, F. C., & Andrade, R
  • AFP
  • Agarwal, A., Hunt, B. J., Stegemann, M., Rochwerg, B., Lamontagne, F., Siemieniuk, R.
    A., Agoritsas, T., Askie, L., Lytvyn, L., Leo, Y.-S., Macdonald, H., Zeng, L.,
    Alhadyan, A., Muna, A.-M., Amin, W., Da Silva, A. R. A., Aryal, D., Barragan, F. A.
    J., Bausch, F. J., 
 Vandvik, P. O.
  • Akobeng, A. K.
  • Steve Alder HIPAA Journal
  • Alfonseca, K., & Geho, L.
  • Allen, L. R., Watson, L. B., Egan, A. M., & Moser, C. N.
  • American Academy of Child and Adolescent Psychiatry, American Academy of
    Pediatrics, & Children’s Hospital Association.
  • American Board of Internal Medicine Foundation
  • American Board of Pediatrics
  • American Medical Association
  • American Psychiatric Association
  • American Psychological Association
  • American Society of Plastic Surgeons
  • Anthem
  • Antommaria, A. H. M.
  • Appleby, L.
  • Arnoldussen, M., Hooijman, E. C., Kreukels, B. P., & de Vries, A. L.
  • Alex Arsenych
  • Ascha, M., Sasson, D. C., Sood, R., Cornelius, J. W., Schauer, J. M., Runge, A., Muldoon, A. L.
  • Florence Ashley
  • Ashley, F., Parsa, N., Kus, T., Leveille, L., Schevers, K., & Rider, G. N.
  • Ashley, F., Parsa, N., Kus, T., & MacKinnon, K. R.
  • Ashley, F., Tordoff, D. M., Olson-Kennedy, J., & Restar, A. J.
  • Asseler, J. D., de Nie, I., Van Rooij, F. B., Steensma, T. D., Mosterd, D., Verhoeven, M. O., Goddijn, M., Huirne, J. A. F., & van Mello, N. M. (
  • Austin, A., Craig, S. L., & D’Souza, S. A.
  • Australian Associated Press
  • Australian Government National Health and Medical Research Council.
  • Bachmann, C. J., Golub, Y., Holstiege, J., & Hoffmann, F.
  • Baker, K. E., Wilson, L. M., Sharma, R., Dukhanin, V., McArthur, K., & Robinson, K. A.
  • Baker, K., & Restar, A
  • Bakker, A.
  • Bakker, J.
  • Carolyn Ells
  • WPATH

References

Lazine, Mira (May 8, 2025). Roundup: Experts Condemn Trump Pseudoscientific Anti-Trans “Report.” Erin in the Morning https://www.erininthemorning.com/p/roundup-experts-condemn-trump-pseudoscientific

Dawson, Lindsey (May 6, 2025). U.S. Department of Health and Human Services Report on Pediatric Gender Dysphoria and Gender Conversion Efforts. KFF https://www.kff.org/mental-health/issue-brief/u-s-department-of-health-and-human-services-report-on-pediatric-gender-dysphoria-and-gender-conversion-efforts/

Vogel, Susanna (May 2, 2025). Trump HHS tiptoes around endorsing conversion therapy for transgender minors. Healthcare Dive https://www.healthcaredive.com/news/trump-hhs-transgender-gender-affirming-care-youths-report/746923/

Jacobs, Phie (May 2, 2025). Researchers slam HHS report on gender-affirming care for youth. Science https://www.science.org/content/article/researchers-slam-hhs-report-gender-affirming-care-youth

Trans Journalists Association (May 2, 2025). The Trans Journalists Association urges caution in covering the HHS report on gender care. https://www.transjournalists.org/2025-hhs-report/

WPATH & USPATH (May 2, 2025). WPATH & USPATH Joint Response to HHS Report on Gender Dysphoria. https://wpath.org/wp-content/uploads/2025/05/WPATH-USPATH-Response-to-HHS-Report-02May2025-2.pdf

The Trevor Project (May 1, 2025). New HHS Report on Health Care for Transgender Youth Includes Dangerous Misinformation, Encourages Conversion Therapy. https://www.thetrevorproject.org/blog/new-hhs-report-on-health-care-for-transgender-youth-includes-dangerous-misinformation-encourages-conversion-therapy/

Yurcaba, Jo (May 1, 2025). HHS breaks with major U.S. medical groups in review of pediatric gender care. NBC News https://www.nbcnews.com/nbc-out/out-health-and-wellness/hhs-breaks-major-us-medical-groups-review-pediatric-gender-care-rcna204185

Riedel, Samantha (May 1, 2025). HHS Report on Trans Youth Relies on Junk Science and Endorses Conversion Therapy. them https://www.them.us/story/hhs-report-trans-youth-gender-affirming-care-brian-christine-conversion-therapy

Do No Harm (May 1, 2025). Do No Harm Issues Statement Supporting HHS Review of Sex Change Interventions for Children. https://donoharmmedicine.org/2025/05/01/do-no-harm-issues-statement-supporting-hhs-review-of-sex-change-interventions-for-children/

GLAAD (May 1, 2025). GLAAD statement on new HHS report on transgender health care. https://glaad.org/releases/glaad-statement-on-new-hhs-report-on-transgender-health-care/

Autistic Self Advocacy Network (May 1, 2025). ASAN Condemns Transphobic HHS Report. https://autisticadvocacy.org/2025/05/asan-condemns-transphobic-hhs-report/

Lambda Legal (May 1, 2025). Lambda Legal Responds to Trump’s HHS Report: A Biased Effort to Eradicate Medical Care for Children and Youth. https://lambdalegal.org/newsroom/us_20250501_ll-responds-to-trump-hhs-report-biased-effort-to-eradicate-medical-care-for-children-youth/

Carnell, Henry; Pauly, Madison (May 1, 2025). “An Anti-Trans Fever Dream”: HHS Publishes Attack on Gender-Affirming Youth Care. Mother Jones https://www.motherjones.com/politics/2025/05/hhs-trans-youth-gender-care-report/

Rodriguez, Adrianna (May 1, 2025). RFK Jr.’s HHS releases controversial report on gender-affirming care. Here’s what it says. USA Today https://www.usatoday.com/story/news/health/2025/05/01/rfk-hhs-transgender-youth/83385405007/

Simmons-Duffin, Selena (May 1, 2025). Health care for transgender children questioned in 400-page Trump administration report. NPR https://www.npr.org/sections/shots-health-news/2025/05/01/nx-s1-5383599/transgender-gender-affirming-care-trump-hhs

Christensen, Jen; Gumbrecht, Jamie (May 1, 2025). Trump administration releases 400-page review of gender dysphoria treatment for youths but won’t say who wrote it. CNN https://www.cnn.com/2025/05/01/health/gender-affirming-care-trump-review

Reed, Erin (May 1, 2025). Fact Check: Trump’s HHS Review On Trans Care Filled with Pseudoscience, Pushes Conversion Therapy. Erin in the Morning https://www.erininthemorning.com/p/fact-check-trumps-hhs-review-on-trans

Nirappil, Fenit (May 1, 2025). Youth gender transition care criticized in HHS report that conceals authors. Washington Post https://www.washingtonpost.com/health/2025/05/01/trump-transition-care-trans-youth-hhs/

Staff report (May 1, 2025). Inside the HHS Review on Trans Youth: Facts, Fears, Fallout. TransVitae https://www.transvitae.com/inside-the-hhs-review-on-trans-youth-facts-fears-fallout/

Ewall-Wice, Sarah (May 1, 2025). RFK Jr. Accused of Pushing ‘Conversion Therapy’ for Trans Kids. The Daily Beast https://www.thedailybeast.com/rfk-jr-accused-of-pushing-conversion-therapy-for-trans-kids/

Wiggins, Christopher (May 1, 2025). BREAKING: Trump HHS posts ‘so-called report’ pushing conversion therapy & discrediting gender-affirming care. The Advocate https://www.advocate.com/politics/trump-gender-affirming-care-report

Schneid, Rebecca; Burga, SolcyrĂ© (May 1, 2025). New HHS Report Urges “Exploratory Therapy” for Transgender Youth. Time Magazine https://time.com/7281894/new-hhs-report-exploratory-therapy-transgender-youth/

Glenza, Jessica (May 1, 2025). US health agency’s ‘review’ advocates for therapy for youth gender dysphoria. The Guardian https://www.theguardian.com/us-news/2025/may/01/gender-dysphoria-report-review-nih

Goldman, Maya (May 1, 2025). HHS report questions evidence for youth gender care. Axios https://www.axios.com/2025/05/01/hhs-report-gender-care-risk

King, Ryan (May 1, 2025). Gender dysphoria should be treated with therapy instead of transition treatments, massive Trump-ordered HHS report urges. New York Post https://nypost.com/2025/05/01/us-news/gender-dysphoria-should-be-treated-with-therapy-instead-of-transition-treatments-massive-trump-ordered-hhs-report-urges/

Kressly, Susan J. (May 1, 2025). AAP Statement on HHS Report Treatment for Pediatric Gender Dysphoria. American Academy of Pediatricians https://www.aap.org/en/news-room/news-releases/aap/2025/aap-statement-on-hhs-report-treatment-for-pediatric-gender-dysphoria/

Mulvihill, Geoff; Johnson, Carka K; Seitz, Amanda (May 1, 2025). Trump’s HHS urges therapy for transgender youth, departing from broader gender-affirming health care. PBS News https://www.pbs.org/newshour/health/trumps-hhs-urges-therapy-for-transgender-youth-departing-from-broader-gender-affirming-health-care alternate text/url: https://abcnews.go.com/US/wireStory/trumps-health-agency-urges-therapy-transgender-youth-broader-121354865

Singal, Jesse (May 1, 2015). HHS Releases Landmark Review on Youth Gender Medicine. The Dispatch https://thedispatch.com/article/transgender-youth-hhs-report/

Miller, Zeke; Mulvihill, Geoff, Shoenbaum, Hannah (January 28, 2025). Trump order aims to end federal support for gender transitions for those under 19. AP News https://apnews.com/article/trump-transgender-transition-executive-order-301e4130233b411311978f66f455f1c4

Anti-trans coverage

Ghorayshi, Azeen; Harmon, Amy (May 1, 2025). Federal Report Denounces Gender Treatments for Adolescents. New York Times https://www.nytimes.com/2025/05/01/health/federal-report-denounces-gender-treatments-for-adolescents.html

Goldfarb, Stanley; Eappen, Roy (May 1, 2025). Sanity returns as feds condemn transgender treatments for kids. New York Post https://nypost.com/2025/05/01/opinion/sanity-returns-as-feds-condemn-trans-treatments-for-kids/

Anthony, Abigail (May 1, 2025). HHS Report Finds No Strong Evidence Supporting ‘Gender-Affirming Care’ Effectiveness. National Review https://www.nationalreview.com/2025/05/hhs-report-finds-no-strong-evidence-supporting-gender-affirming-care-effectiveness/

Resources

Wikipedia (en.wikipedia.org)

US Department of Health and Human Services, Office of Population Affairs (opa.hhs.gov)

  • Foreword & Executive Summary
  • opa.hhs.gov/sites/default/files/2025-05/gender-dysphoria-report-exec-summary.pdf
  • Full Report
  • opa.hhs.gov/sites/default/files/2025-05/gender-dysphoria-report.pdf
  • Appendix
  • opa.hhs.gov/sites/default/files/2025-05/gender-dysphoria-report-appendix.pdf

Trump. Donald (January 28, 2025). Executive Order 14187: Protecting children from chemical and surgical mutilation. https://www.whitehouse.gov/presidential-actions/2025/01/protecting-children-from-chemical-and-surgical-mutilation/