Gender-affirming care for minors under fire

Jamie Reed, a former case manager at the Washington University Transgender Center, alleged that children were being rushed into medical transition without adequate psychological screening. Her testimony led to a state investigation and Senate hearing.

Clinical psychologist Erica Anderson, a transgender woman and former president of the US Professional Association for Transgender Health, has repeatedly raised concerns about the haste with which children are put on medical pathways.

Dr Eithan Haim, a surgeon in Texas, is now facing prosecution after revealing details about paediatric gender surgeries at a children's hospital.

Rather than sparking debate, these whistleblowers have faced vilification, career damage, and in some cases legal consequences. The HHS suggests this culture of fear has stifled the scientific inquiry necessary for sound medicine.

Psychotherapy as an alternative

Instead of defaulting to hormones or surgery, the report urges a return to psychotherapy. Gender-related distress, it notes, often overlaps with broader psychological challenges that can be addressed non-invasively.

"There is no evidence that pediatric medical transition reduces the incidence of suicide, which remains, fortunately, very low," the report finds.

Psychotherapy carries no documented harms and offers space for resolution and support. The HHS calls for greater investment in "psychotherapeutic management" as a safer and more ethical approach.

Restoring scientific integrity

Commissioned under President Trump's Executive Order Defending Children's Innocence by Ending Ideological Medical Interventions, the report responds to growing alarm over the medicalisation of minors.

Trump's Executive Order directed federal agencies to evaluate practices to help "minors with gender dysphoria, rapid-onset gender dysphoria, or other identity-based confusion, or who otherwise seek chemical or surgical mutilation."

It explicitly criticised "junk science" promoted by groups such as the World Professional Association for Transgender Health (WPATH), calling for a return to evidence-based standards and scientific discipline.

Rather than imposing new mandates, the HHS report focuses on delivering "the most accurate and current information available" to clinicians, families, and policymakers-urging caution and restraint.

"Our duty is to protect our nation's children-not expose them to unproven and irreversible medical interventions," said NIH Director Dr Jay Bhattacharya. "We must follow the gold standard of science, not activist agendas."