The Department of Health and Human Services released a review Thursday that found the quality of evidence about the impact of minors on transition-related care is “very low”, and as a result, many American doctors have managed to inadvertently “fail patients” by providing them with such care.

The 409-page report states: “A core theme of this review is that many American medical professionals and associations do not fulfil the health benefits of young patients who prioritize them.”

The HHS review found limited evidence on the “psychological outcomes, quality of life, regret or long-term health” of the gender-irritated youth. Meanwhile, it found that “evidence on hazards related to the transition to pediatric medical care in a systematic review” is “sparse”, but said “the finding should be interpreted with caution” because there is no study tracking and reporting on hazards.

It also severely criticized the World Transgender Health Association, Nonprofit organizations are made up of medical professionals This is a guide on trans health care, which considers its guidelines to be biased and politically motivated. The HHS report said WPATH has affected the American Medical Association, which has reached a consensus on transitional care for minors, despite the relatively small number of people who are concerned about whistleblowers and critics, or who no longer agree with the transgender or regret transitional care they receive.

The review also has a growing number of studies in recent years that found significant independent associations between gender irritability and suicide, as well as studies linking transitional care to improving youth mental health outcomes.

The HHS review ultimately calls for psychotherapy as a “noninvasive alternative to endocrine and surgical interventions for the treatment of gender dysphoria in children” to allow for more research on the impact of sexual psychotherapy on minors with gender dysphagia.

The report marks the latest escalation in the Trump administration’s efforts to gradually gain transition-related care and other transgender rights. Donald Trump issued several executive orders for transgender people in the first few weeks of his tenure, including one who declared only two unchanged genders, only two genders at birth, another who prohibited transgender people from serving or enlisting in the military, and one prohibited the federal government from providing transitional care to minors.

The order signed on January 28 on transgender care for minors requires HHS to publish a review of existing literature on “Best Practices for Promoting Children’s Health that Protects Gender Irritable,” a medical term for pain caused by someone’s birth and gender identity. The HHS commented that this is not a “clinical practice guide” and aims to help clinicians and patients make decisions about care, “and do not issue legislation or policy recommendations.” However, the review may still affect transitional care for minors nationwide by adding fuel to surrounding political fires.

The findings of the review mark a significant disruption between the federal government and the stance of major American medical associations, including the American Medical Association, the American Academy of Pediatrics and the American Psychological Association, which supports access to transition-related care for minors and opposes restrictions on them.

As a result, the review was immediately opposed by the Medical Association and transgender activists who criticized its approach and lack of transparency. Most notably, HHS lists any commentary authors in the seemingly breakthrough with the protocol, as the author's name is usually required to be included in any scientific publication.

“Although this is a systematic review of the literature on the subject performed by experts in the field, the credibility of the report is in the minds of many in the scientific and medical community because these experts are not named anywhere,” said Dr. Morissa Ladinsky, a clinical professor at Stanford University School of Medicine.

She added that such scientific reports also often list the names of peer-reviewed experts, which this review does not.

It is not clear whether the entire report is peer reviewed or only part of it. "The chapters for this review were peer reviewed before this publication, and after publication, peer review will begin in the coming days, involving stakeholders with different perspectives," the HHS press release issued Thursday.

This is unique, Latinsky says, and post-publication peer review usually only occurs when there is a “serious suspicion” of the findings of a study or report.

HHS did not return a comment request for the author's name that was excluded from the report or peer review process.

Susan J. Kressly, president of the American Academy of Pediatrics, said the organization was "deeply shocked" by the report.

“For a credible analysis, it must consider the total number of available data and the full range of clinical outcomes, rather than relying on selected perspectives and narrow data sets,” Cresley said in a statement. “This report distorts current medical consensus and fails to reflect the reality of pediatric care.”

The review also facilitates “exploratory psychotherapy”, which review uses conversational therapy as an alternative to pubertal blockers or hormone therapy. According to the comments, therapists in this therapy try to help young people “to make an agreement with their bodies” or accept their birth.

Some of the largest LGBTQ advocacy groups in the United States, including GLAAD, LGBTQ media advocacy and Trevor Project, Trevor Project, an LGBTQ youth prevention and crisis crisis intervention organization, and medical experts, who specialize in research on LGBTQ youth, often "exploratory psychotherapy", a habit of another habit. Sexual orientation or gender identity.

"This is an argument they have used for decades and it is indeed the light of transformational therapy," said Doug Haldeman, psychologist and professor of clinical psychology at John F. Kennedy University. "We are in an era where governments have made it clear from day one that their desire is to eliminate trans identities altogether."

Haldeman, also author of "the case against the conversion of 'therapeutics': evidence, ethics and alternatives," said years of research showing that trying to get trans people to "accept" their birth gender has negative mental health outcomes.

The HHS review gradually equates “exploratory” therapy with so-called transformational therapy, considering that all psychotherapy is “definitionally”.

The comment also mentions multiple “whistleblowers” ​​or people who have previously provided care to trans-young people condemn this care. It mentions Jamie Reed, a former case worker at the Transgender Center at St. Louis Children's Hospital, accusing children of frequently prescribed pubertal blockers or hormone treatments without "appropriate or accurate" mental health assessments. Her allegations were used by state lawmakers, supporting legislation that ultimately prohibited gender-prudent care for minors in Missouri.

The review said the whistleblower’s concern was “discounted, fired or ignored by prominent advocates and practitioners of the transition to pediatric medical care.”

"As the whistleblower designated in the report, as a lesbian himself, I agree wholeheartedly with the conclusion of the comments about the internal knowledge of this field," Reed said.

"Gender medicine has always been a homosexual translational therapy," Reed said in a statement to NBC News. "The HHS comments share history and concluded that this practice raises "serious justice-related issues" because of excessive representation of LGB youth among patients. As a lifelong Democrat, I believe it's time for bipartisan support to acknowledge the report's findings."

Ladinsky previously worked as a pediatrician in Birmingham, Alabama for 10 years, where she treated hundreds of transteens until the state passed a ban on transitional care in 2022. The state is one of the 25 countries that have enacted such restrictions.

"We're all on the frontline to tell you that in the 25 states where the elements of care are prohibited, we haven't learned about a young man who is no longer transsexual," Ladinsky said.