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2025 US HHS report attacking gender-affirming care

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On May 1, 2025, The Trump Administration’s Department of Health and Human Services (HHS) released an anonymously authored document titled 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.

On November 19, they released an updated version that named the nine contributors, all of whom are prominent anti-transgender activists:

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 anti-trans 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.

Criticism of the May report

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

Several human rights organizations criticized the report, including:

Praise of the May report

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

  • Erica Anderson (described as a “whistleblower”) stated “I am glad that authorities in the United States are finally taking into account what’s been going on in Europe in recent years,” 
  • Azeen Ghorayshi (cited 6 times) noted the report’s “sober tone”
  • Helen Lewis claimed it is a “balanced, well-evidenced report suggesting caution in child gender medicine.”
  • Jamie Reed (described as a “whistleblower”)
  • Benjamin Ryan (cited 4 times)
  • Jesse Singal (cited 4 times and embedded with the authors) praised it as “the most comprehensive guidelines ever compiled on the subject by a U.S. government agency” and “a clear and nuanced overview”
  • Do No Harm [statement] “we are grateful and encouraged HHS is bringing needed scrutiny to the gender industry”
  • Heritage Foundation
  • The Blaze heralded it as “the return of common sense”

“Peer reviews” and replies

The November version included several responses to the May draft. Two of the most prominent critical responses are mentioned but not quoted or summarized:

Nadia Dowshen, Kellan Baker, Robert Garofalo, Diane Chen, David J. Inwards-Breland, Gina Sequeira, Jamie E. Mehringer, and Meredithe McNamara (2025). A critical scientific appraisal of the Health and Human Services report on pediatric gender dysphoria. Journal of Adolescent Health, 77(3), 342–345. https://www.jahonline.org/article/S1054-139X(25)00246-0/fulltext

G. Nic Rider, Ben C. D. Weideman, Diane Ehrensaft, Kriti Choudhary, Jennifer Jo Connor, Jamie Feldman, Michael Gendernalik, Steven A. John, Carrie Link, Leonor de Oliveira, Elizabeth Panetta, Jonathan Poquiz, Sara B. Pournoor, Katherine G. Spencer and Dianne Berg (2025). Scientific integrity and pediatric gender healthcare: Disputing the HHS Review. Sexuality Research and Social Policy, 1–6. https://doi.org/10.1007/s13178-025-01221-5

The fullt text of several other responses are included, mostly by anti-trans activists who agree with the authors:

  • American Psychiatric Association: “the Report’s claims fall short of the standard of methodological rigor that should be considered a prerequisite for policy guidance in clinical care.”
  • Trudy Bekkering and Patrik Vankrunkelsven: “We have no major remarks on the study design, nor on the conclusions.”
  • Johan C. Bester: “Thorough, compelling, and well done.”
  • Karleen Gribble: “it would be worthwhile to add text on the risks of using terminology suggesting that people can change their sex.”
  • Richard J. Santen: “whether or not gender affirming hormone therapy is experimental or not is the most important issue underlining all of the current controversy.”
  • Jilles Smids: “The question of why one would cooperate with the production of a report commissioned by the Trump administration that had just characterized pediatric medical gender care as ‘child mutilation’ may, to a lesser extent, also be asked to me. […] It was always better if a good quality analysis would be produced instead of a document written in the same style as the earlier executive order. […] It is clearly not a neutral report in the sense of merely providing the relevant considerations for and against the current gender affirmative treatment model in the US. It decidedly argues against early medical intervention for GD in minors. However, it does so transparently on the basis of established principles of evidence based medicine, responsible clinical practice, and medical ethics.”
  • Lane Strathearn: “This Review provides a valuable and much needed contribution to this important field of practice.”

Authorship

Anti-trans activist Jesse Singal has deep ties with the 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 reporting. Journalism is what people don’t want published. Everything else is public relations.

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

On May 27, 2025, The Center for Constitutional Rights joined the organizations and individuals who each requested documentation related to the report under the Freedom of Information Act.

The published documents in November revealed the nine contributors’ identities:

Cited works

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

  • 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

Fiore, Kristina (November 19, 2025). HHS Names Authors of Its Gender Dysphoria Report. MedPage Today https://www.medpagetoday.com/washington-watch/washington-watch/118601

Manto, Margaret (June 10, 2025). An HHS Report on Transgender Care Cites a Retracted Study. NOTUS https://www.notus.org/health-science/maha-trans-report-citations

Park, Jaeyoon (June 9, 2025). The “Science” Behind Trump’s Anti-Trans War Is Incredibly Weak. The Nation https://www.thenation.com/article/society/trump-hhs-trans-care-report/

Jackson, Janine (June 4, 2025). ‘The HHS Report was put out to give cover to oppose transgender healthcare.’ MR https://mronline.org/2025/06/04/the-hhs-report-was-put-out-to-give-cover-to-oppose-transgender-healthcare/

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

Davis, Lisa Selin (November 19, 2025). A chance to depoliticize gender-affirming care. Boston Globe https://www.bostonglobe.com/2025/11/19/opinion/gender-affirming-care-report-trump-hhs/

Davis, Lisa Selin (November 19, 2025). Revised HHS trans report exposes moral failures in gender medicine. UnHerd https://unherd.com/newsroom/revised-hhs-trans-report-exposes-moral-failures-in-gender-medicine/

Ryan, Benjamin (November 19, 2025). Unmasked At Last: The 9 Authors of the Trump Administration Report On Pediatric Gender Medicine. So Who Are They? Hazard Ratio https://benryan.substack.com/p/unmasked-at-last-the-9-authors-of

Editorial Board (November 19, 2025). What we still don’t know about pediatric medical transition. Washington Post https://www.washingtonpost.com/opinions/2025/11/19/transgender-pediatric-medical-transition-hhs-report/

Oliveira, Alex (November 19, 2025). Scientists okay Trump-ordered report that found almost nothing to support ‘gender-affirming care’ for kids. New York Post https://nypost.com/2025/11/19/us-news/trump-ordered-report-that-found-almost-no-evidence-to-support-gender-affirming-care-for-kids-gets-scientific-seal-of-approval/

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)

  • November 2025 report
    • Foreword & Executive Summary
    • opa.hhs.gov/sites/default/files/2025-11/gender-dysphoria-report-exec-summary.pdf
    • Full Report
    • opa.hhs.gov/sites/default/files/2025-11/gender-dysphoria-report.pdf
    • Peer Review Supplement
    • opa.hhs.gov/sites/default/files/2025-11/gender-dysphoria-report-supplement.pdf
    • Appendix
    • opa.hhs.gov/sites/default/files/2025-11/gender-dysphoria-report-appendix.pdf
    • Errata
    • opa.hhs.gov/sites/default/files/2025-11/gender-dysphoria-report-errata.pdf
  • May 2025 report
    • 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/