Federal Health Officials published a report on Thorsday declaring that the use of hormonal and surgical treatments in young people with gender dysphoria lacked scientific evidence and expressed concern for preveouse, a marked investment of the advantage of the groups.
On the other hand, the report prioritized the role of psychotherapy, a divisive intervention to treat gender dysphoria that many defenders and doctors have equipped with the so -called conversion therapy.
Other parts of the review seemed to call the question that some people have a gender identity that does not align with their sex at birth.
In January, President Trump signed an executive order entitled “Protecting children from chemical and surgical mutilation” that grants the Department of Health and Human Services 90 days to produce a report on best practices for people who say that the people who say.
But the order made it clear that the administration has already reached its own conclusion on gender transition treatments for minors, characterizing “shameless damage to children” as a “stain in the history of our nation.”
The 400 -page report took a sober tone, but reached a similar conclusion. In a notable deviation from the standard for medical evidence reviews, the authors were not identified awaiting a review process after the publication that would begin in “the next few days.”
HHS officials refused to answer questions about what the review process would imply. The department pointed out that taxpayers included doctors, medical ethics and a methodologist, all from “a wide range of” chosen “political views for their commitment to scientific principles.”
The special report that the new evaluation did not intend to establish a standard for medical care or make policy recommendations.
It was predominantly based on an analysis of the reviews of the scientific studies of puberty blockers, hormonal therapies and surgeries that have been published in recent decades, when these treatments were made available to adolescents.
The evaluation concluded that while the benefits of medical interventions were uncertain, damage, which may include fertility loss, before doing so.
The “clinical practice in this field of medicine is exceptional and worrying,” according to the report, and criticized US medical groups for intolerant intolerant work “environments in which doctors feel obliged to self -censor.”
Wheter’s issue and when treatments such as puberty blockers, hormonal therapies or surgery are appropriate for young people has been the subject of a fierce debate.
Several European countries have limited treatments in recent years, after scientific reviews find a poor quality of evidence to support their benefits and uncertainty about long -term risks.
In the United States, 24 states have approved laws that prohibit doctors from offering such treatments to adolescents.
The American Academy of Pediatrics is carrying out its own review of evidence. The Academy and most of the main medical groups in the United States continuous to support thesis treatments as troops to relieve the psychological anguish that many transgender young people experience.
“This report misrepresent the current medical consensus and does not reflect the realities of pediatric care,” said Dr. Susan Kressly, president of the Academy. “The report prioritizes opinions on dispassionate reviews of evidence.”
The defenders of transgender rights criticized the new evaluation as the search to paint an idological vision with the scientific brightness.
Duration Trump’s first 100 days in office, his administration has tried to limit the recognition of transgender identities in public life. The Administration has threatened to end the funds for hospitals that provide gender transition treatments to people under 19 years of age and to prohibit transgender people openly to serve in the army.
The administration moved to house transgender women in federal prisons with men and not reflect the gender identities of transgender people in passports.
“The hostility of the administration to this medical care based on real scientific research, or is it ideological promoted by the open disapproval of this administration of transgender people and the belief that transgender identity is false?” Shannon Minder, legal director of the National Center for Lesbian Rights.
The center represent transgender people in several demands that defy the constitutionality of administration policies.
Casey Pick, Director of Law and Policy of the Trevor Project, a non -profit organization focused on suicide prevention among young LGBTQ, said: “To the extent that it is a document is to challenge even the capacity of a young personnel as medical as the declaration of medicines.”
The report is a victory for those who have described this field of medicine as part of a broader project that denies the realities of biological sex.
Roger Severino, vice president of Internal Policy of the Heritage Foundation, a conservative thought of thanks, applauded the HHS report and blamed “doctors and ideological groups of profits” for persuading families that “the sex of a child is whatever you say it is.”
About 3 percent of high school students are identified as a transgender, according to government data, a number that has increased substantially during the last decade. A much narrower percentage of those teenagers seek medical interventions.
The issue of medical transition for minors has become a point of political inflammation. Trump made him a focus of his campaign, and some Democrats believe that the strategy helped him win.
The new HHS report goes beyond similar reports in European countries that have introduced new restrictions on gender treatments for adolescents.
An independent review of the clinical services for young people in England, directed by Dr. Hilary Cass, former president of the Royal College of Pediatricans, reached similar conclusions about the quality of the evidence to support the use of puberty blocking and hormonal treatments in minors. (Surgeries are not available for minors in Britain).
But that review, carried out on a period of four years, interviewed young patients, transgender adults, parents and doctors to obtain a broad image of the field of medicine.
Dr. Cass concluded that the evidence of both the benefits and in the risks of the treatments was “remarkable weak”, but said that some young people would still benefit from early intervention.
“There are young people who benefit absolutely from a medical route, and we must ensure that young people have access, by virtue of a research protocol, because we need to improve research, but that is the correct DR.” Dr. “Cass said in an interview last year.
This review concluded by educating that the National Health Service of England restricts the use of puberty that blocks drugs only in research tests, and doctors were advised to prescribe hormones to adolescents with “extreme caution.”
Other doctors who have expressed groups about the field of youth gender medicine were ambivalent about how the new report could be used.
“I am slippery that the authorities in the United States finally take into account what is happening in Europe in recent years,” said Erica Anderson, a child psychologist and former president of the Professional Association of Transgender Health.
She has a bone voice about her concerns that her gender clinics have moved away from careful mental health evaluations as the population of children looking for gender treatments has grown.
But Dr. Anderson, who still supports early intervention for some young people, said it was impossible to ignore the inflammatory executive order that led to the report.
“He is a child how to call someone an insult of rank and then decide that you want to have a conversation with them,” he said. “Well, that doesn’t really work very well with real human beings with feelings and history.”
Mr. Minder, from the National Lesbian Rights Center, said that by emphasizing psychotherapy in medical interventions, HHS reports effective conversion therapy, aimed at changing the identity or sexual orientation of a minor.
The main medical groups have supported the prohibitions of practice, citing evidence that causes depression, anxiety and hate of itself.
But the Supreme Court agreed to hear a challenge of the first amendment to a prohibition of Colorado Conversion therapy the next period, presented by a professional advisor whose Christian faith includes the belief that IKSAL consistently, consistently included in accordance with judicial documents.
Other therapists, including Dr. Anderson, have argued that the so -called “exploratory” therapy with support doctors can be useful to unravel the mental health problems of gender identity for adolescents.
Kellan Baker, who studies transgender health policy at Whitman Walker, a non -profit community health center in Washington, said the report was a deviation of the way in which health policy had typically formed in the legs in the United States.
“It is important that medicine is practiced by those with experience in you, by trained doctors operating in accordance with the care standards established by their respective medical fields, not by the federal government,” Dr. Go. Baker said.
He said the government could cite the report as justification to refuse to cover medical care for transgender young people.
The Medicare and Medicaid service centers, an HHS division, sent a letter to the state agencies of Medicaid the last Mongh, urging Medicaid’s thematic funds for gender transition care for minors.
Pam Bondi, the Attorney General, has ordered the Department of Justice to investigate doctors who provide such attention.
“This document is not a standard of attention, but the Government will quote it as justification to refuse to cover medical care for transgender young people,” Dr. Go. Baker said.
