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2025 Utah HHS report on gender-affirming care for minors

In May 2025, the Utah Department of Health and Human Services released a report commissioned by the Utah Legislature regarding medical transition options for trans and gender diverse minors.

The report found that “overall, there were positive mental health and psychosocial functioning outcomes” from gender-affirming care. They also found that “patients that were seen at the gender clinic before the age of 18 had a lower risk of suicide compared to those referred as an adult.”

The report contradicted the 2025 federal HHS report attacking gender-affirming care for minors.

Background

In 2023, Utah lawmakers banned gender-affirming care for minors. As part of the ban, they ordered a systematic review of the medical literature on that care.

The report was prepared via the University of Utah College of Pharmacy Drug Regimen Review Center (DRRC). The authors spent two and a half years putting together a 1051-page systematic review.

The authors of the 16-page report are:

  • William Francis, DO: advisor representing the Utah Osteopathic Physician and Surgeon’s Licensing Board
  • Angelo Giardino, MD, PhD, MPH: advisor representing Intermountain Primary Children’s 
  • Michelle Hofmann MD, MPH, MHCDS, FAAP: Medical Director, Utah Department of Health and Human Services 
  • Brooks Keeshin, MD: pediatrician and advisor representing the University of Utah
  • Yoon Kim-Butterfield, MD: endocrinologist and former Medical Director of Utah Medicaid  
  • Nikki Mihalopoulos, MD, MPH: advisor representing the University of Utah. 
  • Katherine Smith, PharmD: advisor representing Roseman University of Health Sciences
  • Alan Smith, MD: advisor representing Utah Physicians Licensing Board 
  • Jennifer Strohecker, PharmD, BCPS: Medicaid Director and Director, Division of Integrated Healthcare 

The authors of the full 1051-page systematic review are:

  • Valerie Gonzales, PharmD: Clinical Pharmacist, DRRC
  • Tami Haines, RPh: Clinical Pharmacist
  • Lauren Heath, PharmD, MS, BCACP: Clinical Pharmacist, DRRC
  • Rebecca Henkels, PharmD candidate: Pharmacist Intern
  • Kristin Knippenberg, MFA: Project Administrator
  • Joanne LaFleur, PharmD, MSPH: Director, DRRC [submitter]
  • Xi Liang, PharmD, PhD candidate: Graduate Research Assistant
  • Monet Luloh, PharmD: Clinical Pharmacist, DRRC
  • Danielle Nguyen, PharmD, PhD candidate: Graduate Research Assistant
  • Ary Vadipour, PharmD candidate: Pharmacist Intern

Conclusions

  • “The conventional wisdom among non-experts has long been that there are limited data on the use of GAHT in pediatric patients with GD. However, results from our exhaustive literature searches have led us to the opposite conclusion.”
  • “Tthe consensus of the evidence supports that the treatments are effective in terms of mental health, psychosocial outcomes, and the induction of body changes consistent with the affirmed gender in pediatric GD patients. The evidence also supports that the treatments are safe in terms of changes to bone density, cardiovascular risk factors, metabolic changes, and cancer.”
  • “We found (based on the N=32 studies that addressed it) that there is virtually no regret associated with receiving the treatments, even in the very small percentages of patients who ultimately discontinued them. Reasons for discontinuing GAHT are varied, but changed minds about gender identities is only a very minor proportion overall.”
  • “It is our expert opinion that policies to prevent access to and use of GAHT for treatment of GD in pediatric patients cannot be justified based on the quantity or quality of medical science findings or concerns about potential regret in the future, and that high-quality guidelines are available to guide qualified providers in treating pediatric patients who meet diagnostic criteria.”

Recommendations

While the report says “DHHS takes no position on whether the Legislature should lift the moratorium,” they make four recommendations in the event it is lifted:

  • Create a hormonal transgender treatment board managed by DHHS, in partnership with the Department of Commerce, that advises on certification, continuing education, minimum standards of care, and consent procedures
  • Limit providers who can deliver care to demonstrated experts.
  • Limit care to a comprehensive interdisciplinary care team model that provides integrated physical and mental health care using evidence-based protocols, evaluates its outcomes, and reports regularly to the Utah Legislature. 
  • Institute an enhanced and explicit informed consent and assent process. 

References

Stern, Emily Anderson (May 22, 2025). Utah lawmakers’ own study found gender-affirming care benefits trans youth. Will they lift the treatment ban? Salt Lake Tribune https://www.sltrib.com/news/politics/2025/05/22/utah-lawmakers-own-study-found/

Resources

Utah State Legislature (le.utah.gov)