RFK Jr's New Anti-Trans HHS "Review" Is F*cked!

Photo by Ehimetalor Akhere Unuabona on Unsplash

Thursday, May 1, 2025, Robert F. Kennedy Junior's Department of Health & Human Services released a nearly 300-page report entitled, "Treatment For Pediatric Gender Dysphoria: Review of Evidence and Best Practices".

Reading through this document illustrates just exactly how easy scientific research can be deliberately manipulated to favor the "consensus" of religious zealots rather than engaging the expertise of scientists, physicians, and psychologists among dominant worldwide professional medical and psychological societies that create the guidelines for healthcare professionals providing gender-affirming care.

Medicine as with science is driven by expert consensus. This means that once enough scientific evidence accumulates in a particular area of science or medicine, that accumulation of evidence begins pointing to similar truths, understandings, or outcomes. In other words, it leads scientists to particular conclusions based upon that totality of existing evidence. This is no less true in gender medicine.

Before explaining specific issues within the HHS report, I'll provide several areas of necessary context. The first outlines concerns of misinformation and the various methodologies that scientists use to reduce human bias in scientific research; the second area outlines historical issues concerning "gender ideology" over the last half-century to provide context for the modern debate about gender, gender dysphoria, and the medical treatment of transgender people.

Misinformation & Scientific Methodologies

What tends to happen among people who do their own research and are not trained scientists themselves is multifactorial but may include:

Misunderstanding the conclusions of particular studies
Expressing data from a study that is incongruent with the findings of the study
Deliberately misconstruing findings in a study altogether because they have no training in reading scientific research, or...
They overestimate the conclusions of a study without having looked at the totality of evidence on the topic

The overall trend seen in the mirky world of false information is that...

Misinformation purveyor's commonly seek evidence that confirms their already existing beliefs.

According to Psychologists, this is called confirmation bias.

Some of the methodologies scientists use to reduce bias in research studies include:

Randomizing treatment & control groups
Blinding physicians & participants to treatment interventions
Having control groups (those not receiving the tested treatment)
Using complex statistical methods and analyses
Replication of studies and peer review
Transparent reporting standards
Reporting conflicts of interest
Inclusion of diverse research teams

As you can see, many of the areas that seek to prevent bias among trained scientists are areas that can easily be manipulated or misunderstood by those that are not formally trained in science, medicine, or psychology.

Professionals in these fields dedicate their entire lives to studying particular areas of science; in other words, people form relationships with the area of which they research throughout their career. They are committed to better understanding and improving the skillset of their profession just like an electrician, plumber, or car mechanic is invested in improving their understanding and skillset throughout the trajectory of their working life.

Sadly, as is revealed in this new report by HHS, people with absolutely no scientific background providing their opinions on matters of which they are not fully informed given their lack of expertise and training is outright dangerous.

It might be helpful to frame this argument from this perspective...

Would you take your car in to be fixed by a Cardiologist?

Would you ask for your wedding cake to be made by an Electrical Engineer?

Would you ask for interior design help from a Veterinarian?

Currently, what the United States Congress has done is green-light the Department of Health & Human Services to be run by RFK Jr., an Environmental Lawyer. His training as such is in law, not in science, health, medicine, or psychology.

Make it make sense.

With this awareness, it's easy to comprehend how biased this HHS report is, especially given that it's simply an extension of Trump's Executive Order (EO) that was instituted within days of entering office which federally codified the existence of only two genders, male and female.

Gender & Society

It is indisputable biological and scientific fact that there are more than two sexes, male, female, and intersex. Not only does Trump's EO dismiss the existence of intersex people but it conflates gender being equivalent to one's birth sex. The fundamental misunderstanding here is that...

Gender is socially constructed whereas birth sex is biologically constructed.

The conflation of gender and birth sex is what has created the conditions for massive societal upheaval and debate on these topics in recent years.

Sadly, this current societal debate about gender has historical precedent within the LGBTQIA+ movement as outlined in a recent article in Slate published by Zein Murib an associate professor of political science at Fordham University. Their article, "Why Are Trans People Such an Easy Political Target? This Crisis was Decades in the Making," is an incredible piece that is highly recommended.

In this article, Murib explains that after the Stonewall Riots of the 1970s, many among the gender and sexually expansive community (LGBTQIA+) wanted to come together and advocate for societal acceptance.

Incidentally, you can listen to some of this history that I present in Episode 11 of Queer Story Time The Podcast entitled, Stonewall, Nazis, And The Global March for Queer & Trans Liberation.

Within the first years of the community working toward progress and acceptance, there started to be an internal fracturing.

Gay & lesbian folks started to feel like their cause was different from trans people. So whereas they focused their advocacy efforts around their sexuality; they left gender advocacy to trans people, a much smaller portion of the population within the broader community.

This was the singular fatal flaw of the entire LGBTQIA+ rights movement in the last 50+ years.

Whereas it is true that gender and sexuality are two separate societal constructs, in reality, there is also interconnection among them. Despite this, gays and lesbians of the 70s only saw one minor difference between themselves and heterosexuals, that difference was that they're homosexual. Thus, their advocacy centered this truth and so too did the entire queer rights movement throughout the mid to late 20th century and early 21st century.

The major flaw in their advocacy as detailed in Murib's article was seeing themselves as sexually expansive and not as gender expansive.

By now, you might be thinking, "What's wrong with this approach?"

The massive oversight from a historical perspective is that LGBTQIA+ people as a group regardless of their identity inherently subvert pervasive societal norms of gender and sexuality according to Eurocentric Colonial views which expect conformity to the gender binary and monogamous heterosexual relationships. In fact, this was one of the many ways in which Indigenous cultures globally were controlled by European colonizers throughout the history of colonization.

So, regardless of whether gays and lesbians are indeed cis-gender people, being in a same-sex relationship contrasts the expectations of Eurocentric Colonial views of gender and sexuality.

Therefore, if the dominant LGBTQIA+ rights movement would have centered its advocacy around this truth from the very beginning, perhaps we would not be arguing about gender in 2025 because from this perspective, the entire LGBTQIA+ community is gender (and sexually) expansive.

With these historical, political, and sociological insights, let's move on to discuss the harmful impact of this new HHS report and some of the misinformation it promotes.

HHS Report On Treatment of Pediatric Gender Dysphoria

First, there are two areas of concern upon initial observation of this new HHS report.

It is quite striking that overall this HHS report is a 300-page document of supposed evidence defending practices that are not accepted by the dominant consensus among professional societies within the worlds of medicine and psychology.

WPATH, the legitimate organization known as the World Professional Association of Transgender Health that does set professional guidelines for gender-affirming care once every decade; released the updated version of their Standards of Care Version 8 in September 2022. What is most striking to me is that these WPATH guidelines are approximately 300-pages, too.

Did the HHS authors write this report in order to compete with WPATH so that people perceive that it is equally valid research? It certainly appears so.

There is one other remarkably curious observation here. When you compare the citations of evidence used to support the WPATH guidelines, every single citation referenced within these guidelines is from a scientific study published in a peer-reviewed medical journal.

In contrast, when you look at the Bibliography of the HHS report, you find a mixture of research articles, news articles from New York Times and MSN News among others, references to random medical and LGBTQIA+ websites, policy documents, archived open letters, references to the defunct U.K. Cass Review; reference to the autobiography of Christine Jorgensen who received wide-spread public attention in the 1950s due to her pursuing medical transition as a former Private in the U.S. Army, among many other questionable references that would never be found in peer-reviewed medical research.

No elite or self-respectable scientific journal, editor, professional medical or psychological society would ever allow such a paper to be published within their journal if these were its citations; it would never get past peer-review.

Very clearly, this "Review of Evidence and Best Practices" is nothing short of cherry-picked misinformation to support their already existing belief that transgender people are not "natural" or worse yet that "Transgenderism must be eradicated from public life entirely," as stated by Michael Knowles at a 2023 CPAC conference.

Beyond these dubious references, misinterpretation of research, lack of peer review, and evident confirmation bias, this HHS report makes many claims that persist among anti-trans politicians and activists. Here are five of these top claims found in the HHS report:

Claim #1: Gender-affirming medical interventions for minors are experimental and lack sufficient evidence of long-term benefits.

A study entitled, "Mental Health Outcomes in Transgender and Nonbinary Youths Receiving Gender-Affirming Care" published in JAMA Network Open in 2022 found that among 104 transgender youth that "gender-affirming medical interventions were associated with lower odds of depression and suicidality over 12 months."

Secondarily, in a 2023 article published in the New England Journal of Medicine entitled, "Psychosocial Functioning in Transgender Youth after 2 Years of Hormones," they studied 315 transgender youth between the ages of 12-20 years old and tracked them at 6-month intervals for a total of 24-months (2 years). The outcomes of this study reveal increased appearance congruence which is a measurement of the degree to which individuals feel their external appearance aligns with their gender identity. Additionally, psychological function testing revealed positive affect among this cohort along with improved life satisfaction with an overall decrease in symptoms related to depression and anxiety.

There are innumerable studies that come to similar conclusions as the two mentioned above.

Claim #2: Psychotherapy should be the primary treatment for gender dysphoria in youth, rather than medical interventions.

As an established Anti-Conversion Therapy advocate myself, I am keenly aware of the fact that anytime Pro-Conversion Therapy advocates make mention of "Psychotherapy," what they're actually referring to is the pseudoscientific and pseudo-psychological practices of Conversion Therapy which have been condemned by every major reputable and professional medical/psychological society globally.

No matter what it's called, whether Conversion Therapy, Reparative Therapy, Gender-Exploratory Therapy, Restorative Therapy, Spiritual Counseling, and many others; it's all pseudo-psychotherapy that is downright abusive mentally, physically, and often sexually. Those abused by these practices commonly experience a lifetime struggle with Complex Post-Traumatic Stress and other psychological disorders.

Conversion Therapy for nearly a half century has been promoted by organizations like Focus On The Family co-founded by James Dobson who also founded Alliance Defending Freedom, the organization that has created many of the anti-LGBTQIA+ laws within the last 5 years. They work synergistically with The Heritage Foundation of whom wrote the nearly 1,000 page document named Project 2025 of which outlines policy decisions for turning the U.S. into a Christian Theocracy that has influenced many if not all of Trump's initial EOs and policies within his first 100 days in office.

This is quite damning.

Even as the HHS report cites WPATH in several instances, clearly it was an oversight on their behalf that WPATH does indeed recommend legitimate psychotherapy for transgender minors as a part of the gender-affirming care they receive. However, this version of psychotherapy is not meant to change their gender identity unlike Conversion Therapy; it's simply meant to be an environment where children and youth are allowed to explore gender and have conversations about what they're feeling without condemnation, judgement, or the pretense of Conversion Therapy. These sessions are also used to assess whether an "Adolescent demonstrates the emotional and cognitive maturity required to provide informed consent/assent for the treatment (WPATH, Statement 6.12.c)." Professionals also assess for any mental health concerns that may interfere with consent (WPATH, Statement 6.12.d). There are many other guidelines of which you can read for yourself found within the Standards of Care Version 8 by WPATH.

Claim #3: Puberty blockers and hormone therapy pose significant health risks.

Dr. Jack Turban, MD a very well-regarded gay Psychiatrist and researcher published a first of its kind article in February 2020 in the journal Pediatrics entitled, "Pubertal Suppression for Transgender Youth and Risk of Suicidal Ideation." Astonishingly, this study surveyed a cohort of nearly twenty-one thousand transgender adults aged 18-36 years, and examined their self-reported history of pubertal suppression during adolescence. Of this cohort, 2.5% received pubertal suppression in their youth which amounts to approximately 500 patients.

Researchers then compared those within the full cohort that received pubertal suppression in their youth versus those that desired pubertal suppression but did not receive it. It's important to note, the study accounted for demographic variables and level of family support for gender identity. When comparing these two groups, the group that received pubertal suppression had a lower odds of lifetime suicidal ideation in turn showing an association between pubertal suppression treatment during adolescence and lifetime suicidal ideation among transgender adults who never received such treatment. On the level of mental health, this is a favorable outcome.

To address physical health concerns, I'll reference the article "Puberty suppression in transgender children and adolescents" originally published in 2017 which outlines the historical reasoning for suspending puberty in this population to prevent the dissonance between one's birth sex and gender identity.

To be clear, puberty blockers as recommended by WPATH are not recommended until one has undergone psychiatric assessment and until they have reached Tanner Stage II of puberty. Therefore, it is a patent falsehood based on conservative propaganda to say that transgender children are being placed on puberty blockers or receiving gender-affirming surgeries. There's zero evidence of this other than conjecture and hyperbole.

Tanner staging is a standardized way for Physicians to track physical development during puberty. Tanner Stage II is referring to pubertal onset of which marks the beginning of sexual maturation and development of secondary sex characteristics. Those assigned female begin developing breasts, pubic hair, and the ovaries begin producing estrogen. In those assigned male, testicular enlargement occurs along with increased testosterone production, pubic hair develops, and emergence of increased muscle mass to name a few.

It is important to note that puberty blocker treatment is already the recommended treatment in cases of precocious puberty which is a condition that causes early onset of puberty. According to a 2024 study in the Frontiers of Endocrinology, the incidence of this condition is approximately 1 in 5,000 to 1 in 10,000 children of which is 10-25 times more common in those assigned female at birth (AFAB) than those assigned male at birth (AMAB). In the same way that puberty blocking medications are used to treat children with diagnosed precocious puberty; so too are these puberty blocking medications recommended to transgender adolescents when medically and psychologically appropriate according to WPATH standards.

Whereas there are risks associated with any medical treatment whether natural, pharmaceutical, or surgical; these risks must be addressed from a holistic perspective as it is disingenuous to outline risks of a treatment without considering the benefits of that same treatment. Herein lies the complexity of medicine. Risk/benefit analyses occur daily in healthcare.

As witnessed in the study by Dr. Jack Turban, access to puberty blocking medication in adolescence reduces the incidence of lifetime suicidal ideation; therefore, in a risk/benefit analysis of trans youth seeking pubertal suppressants, we are weighing the risk of suicide due to gender incongruence against the medical risks associated with puberty blocking medication. Some of the risks associated with these medications include concerns of bone mineral density, cognitive functioning, compromised fertility, delayed growth, and mood changes; these are the same risks associated with treatment in precocious puberty.

Professional medical societies within North America and beyond including the American Academy of Pediatrics, WPATH, the Endocrine Society among many others who have thoroughly reviewed the totality of evidence regarding pubertal suppressants support the use of these medication for transgender youth of whom note that the benefits in reducing gender dysphoria, anxiety, depression, and suicidal ideation often outweighs the potential risks described above, especially with close monitoring by a Physician.

As a part of this risk/benefit, it should be understood that pubertal suppressants are reversible. This means that the effects of the medication will stop upon discontinuation of the medication. Thus, suppression of sex hormones by these medications would no longer occur and development of secondary sex characteristics resumes. The other scenario is that trans youth, in concert with their parents, Physician, and Psychologist can make the decision to pursue cross-sex hormone treatment which in large part helps negate much of the risk associated with puberty blocking medication treatment given the introduction of cross-sex hormone medication. Testosterone in those AFAB and estrogen in those AMAB.

From the start, much of this "debate" about puberty blocking medication is disingenuous considering that from a physiological perspective, regardless of birth sex, those AFAB and those AMAB produce both estrogen and testosterone, just in different proportions.

Typically about 25% of what is produced in male testes is estrogen. Additionally, about 25% of what is produced in female ovaries is testosterone. Read that again carefully.

In perhaps clearer words, both sexes produce both sex hormones.

This seems to be an inconvenient truth for those who believe transgender medicine involves the mutilation of children when in reality it involves adjusting the ratio of sex hormones that their body already produces which in turn helps to feminize or masculinize the body.

Much like other areas of medicine, this is an area that is pursuing ongoing research and investigation; however, to state that there is no evidence to support puberty suppressing medications in transgender youth is irresponsible and often favors one's own biases than it does existing scientific literature supported by dominant medical and psychological societies.

Claim #4: Medical organizations like WPATH have suppressed unfavorable evidence and removed age minimums for treatment under political pressure.

This is yet another lie. If you've reached this point in this article, you've already read about 3,000 words which means, there are layers upon layers of complexity to these topics; thus, there is more to this claim than as expressed in the new HHS report.

It's utter foolishness to think that a medical organization like WPATH can "suppress unfavorable evidence." WPATH as an organization does not produce all of the scientific literature on gender-affirming care itself, it only consolidates the best literature available on gender-affirming care to use that evidence as a guide in creating the updated standards of care once every decade. Medical societies that create guidelines for healthcare professionals do not have control over what completely separate medical journals decide to publish. This is a bizarre and unsubstantiated claim much like everything within the HHS report as a whole.

The second half of this claim regarding removal of age minimums is a half-truth at best. Here's the nuance, whereas the WPATH Standards of Care Version 7 that was originally published in 2012 did recommend an age limit of 16 year old for hormone therapy at the time; these guidelines were updated in the 2022 Standards of Care Version 8 to prioritize a patient's unique circumstances including their physical and psychological maturity rather than adhering to strict age criteria. Additionally, as mentioned in the section addressing puberty blockers above, WPATH still recommends not beginning treatment until the patient reaches Tanner Stage II (onset of puberty) which commonly begins between 10-12 years of age. This should not be interpreted as all trans children receive access to puberty blockers the day they hit puberty. As has been outlined here, gender-affirming care involves various stages and ongoing assessments by Physicians & Psychologists to assess readiness and consent to care.

Claim #5: Gender-affirming surgeries are commonly performed on minors.

Much like all of these claims, this claim incites fear mongering rather than actual evidence as accepted by dominant medical and psychological societies.

As is addressed in a study entitled, "Prevalence of Gender-Affirming Surgical Procedures Among Minors and Adults in the US," by the Harvard T.H. Chan School of Public Health published in June 2024...

This study found zero evidence of surgical procedures among transgender and gender-diverse minors ages 12 years old or younger.

Contrary to popular belief, cis-gender minors had greater utilization of gender-affirming surgeries than their trans-gender counterparts. Let me break this down.

This study included cohorts of over 47-million insured U.S. adults along with nearly 23-million insured U.S. minors between the ages of 13-14, 15-17, and 12 years of age and younger. Whereas gender-affirming surgeries among children less than 12 years of age was not expected due to international medical guidelines that explicitly do not recommend surgical interventions prior to puberty; they did find that teens 15-17 and adults 18 years or older who elected to undergo gender-affirming surgery did so at a rate of 2.1 per 100, 000 in the youth population and 5.3 per 100,000 in the adult population. The vast majority of these surgeries were chest surgeries. In accounting for cis-gender males needing breast reductions due to a medical condition called gynecomastia, the study noted that 80% of these surgeries occurred among cis-gender male adults and 97% occurred among cis-gender male teenagers. So no, "genital mutilation" is not occurring in children or youth, anyone looking at this data should easily concede this fact.

This study is unequivocal in its findings, yet, bias and fear-mongering persists which says a whole lot more about those that believe these fallacies than it does the existing research base on these topics.

Conclusion

As you can see outlined within the entirety of this article, there are not only massive concerns regarding the validity and integrity of the newly published review by RFK Jr's Department of Health & Human Services but there is ample scientific evidence to support the care of gender-expansive children and youth, only a fraction of which has been provided here.

Sadly, it has to be stated that expertise should matter; however, in an environment where wannabe fascist dictators seek to further marginalize trans people and twist scientific findings in their favor; my sincere hope is that those of sound mind can be guided not only by expertise but by a sincere love for humanity that recognizes every single one of us has the desire to live in authenticity, integrity, and truthfulness. This is all that trans people were ever asking for; we never sought to be the pawn in a modern day culture war. Alas, science is on our side!

For press inquiries, you can reach Stevie Inghram at futuredrstevie@gmail.com.