Gender-affirming care for minors under fire

Reform already underway

The HHS report lands amid a wave of legal reforms.

As of this year, 27 states have passed laws restricting or banning gender-affirming care for minors. These range from full bans on hormones and surgery to tighter consent requirements.

Nineteen of those laws were passed in 2023 alone, according to the Kaiser Family Foundation.

Over half of states have enacted laws/policies limiting youth access to gender affirming care

Though many face court challenges, the trend reflects mounting public concern over the medicalisation of gender-distressed youth. The HHS findings are expected to accelerate further scrutiny and legislative action.

Global shifts

The HHS review is part of a broader international movement to re-examine paediatric gender medicine.

In 2024, the UK's Cass Review, led by paediatrician Dr Hilary Cass, delivered a landmark critique of NHS gender services. Cass concluded that the model had been adopted prematurely "based on a single Dutch study," and lacked sufficient evidence.

In response, the UK banned the routine use of puberty blockers and began closing the Tavistock gender clinic, replacing it with regional centres focused on holistic mental health care.

In Australia, the Queensland government took similar steps earlier this year, pausing all prescriptions of puberty blockers and cross-sex hormones for minors pending further review.

The move followed the suspension of Dr Jillian Spencer, a senior psychiatrist, from her clinical duties at Queensland Children's Hospital after she raised concerns about the gender care protocols being used.

Her case has since become a focal point in Australia's national debate on youth gender medicine.