HHS Review Questions Evidence for Gender-Affirming Care in Minors

In an op-ed for the Washington Post, a contributor to the anonymous Department of Human Health Services (HHS) review published in May expressed their concerns over the findings related to “gender affirmation” procedures for minors. The report indicated that the basis for such procedures was “very weak evidence.”

The HHS review highlighted a deficiency in scientific backing for “gender-affirming” care aimed at minors experiencing gender dysphoria, which is essentially a psychological discomfort related to one’s gender identity. Alex Byrne, a philosophy professor at MIT, weighed in on this topic, emphasizing that the review was authored not by outside skeptics, but by a group predominantly composed of liberals.

Byrne noted that the review was initiated by a Presidential Order signed by Donald Trump, which established a deadline of May 1st for completion. He expressed initial concerns that the White House might interfere with the review’s direction or its public release; however, those worries turned out to be unfounded.

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In the op-ed, Byrne shared that after thoroughly reviewing the existing evidence, he and his co-authors—who mainly identify as liberal—concluded that medical interventions for minors seeking to transition are “not empirically or ethically justified.”

This HHS review builds upon the work of Hilary Cass, a respected British pediatrician, who noted a similar lack of robust evidence in this area. Following her report, the UK government imposed an indefinite ban on adolescent hormone blockers for treating gender dysphoria, except for those involved in clinical trials. The health secretary is now contemplating extending similar restrictions on cross-sex hormones for patients under 18.

Data from the Stop the Harm database shows that from 2019 to 2023, nearly 14,000 minors in the United States received treatments related to gender transitioning.

In his comments, Byrne pointed out that the “gender-positive care” model endorsed by entities like the American Medical Association is built on flimsy evidence. He emphasized that all medical interventions come with risks, and current reliable research does not demonstrate that these treatments improve mental health outcomes for children.

Byrne emphasized the importance of maintaining a scientific mindset—one that involves questioning assumptions and seeking out new evidence—within the ongoing discussion around gender medicine for youth. He noted that this critical approach seemed to be lacking in much of the public debate, suggesting that more individuals within liberal circles should prioritize evidence over loyalty to group think or fear of backlash.