The U.S. Department of Health and Human Services (HHS) has issued a thorough review confirming what skeptics and concerned citizens have argued for years: that the medical transition of children is based on weak evidence, suppresses opposing findings, and involves professional corruption that has put vulnerable young people across America at risk.

Released on November 19, 2025, the 300-page HHS report provides the most comprehensive federal review of so-called “gender-affirming care” for minors. Its findings are devastating to those who have claimed this experimental approach is “settled science” or “lifesaving medicine.”

It is neither.

The report’s central finding should shock the conscience. Systematic reviews of existing research reveal “very low” quality evidence of any benefits from puberty blockers, cross-sex hormones, or surgeries performed on children and adolescents with gender dysphoria. This means the beneficial effects touted in medical literature are likely to differ substantially from the actual effects.

Let that sink in.

Thousands of American children have undergone irreversible medical procedures—chemical castration with puberty blockers, sterilization via hormones, surgical removal of healthy breasts and genitals—all based on research so flawed that health authorities can have very little confidence in its conclusions.

The report explains how this fragile house of cards was constructed. Studies claiming positive results had major methodological flaws. They featured short follow-up times, high patient dropout rates, failure to systematically monitor harms, and in some cases, outright manipulation of findings.

The often-cited Chen study, published in the New England Journal of Medicine, illustrates this corruption. Two patients committed suicide during the study period, yet the authors concealed this fact while adjusting their original hypothesis to focus on “appearance congruence” instead of the reduction in suicidality they initially intended to measure.

Perhaps most damning is the report’s documentation of systematic suppression of evidence by the World Professional Association for Transgender Health (WPATH)—the organization whose guidelines have shaped American clinical practice. Court disclosures revealed that WPATH suppressed publication of reviews on at least 10 of 13 topics related to adolescent treatment, including reviews examining fertility impacts, cardiovascular risks, and metabolic complications.

When a commissioned systematic review found only “low and insufficient” evidence for mental health benefits from hormonal interventions, WPATH leadership stepped in to ensure the published conclusion still claimed these treatments were “likely associated with improvements” and considered “an essential component of care.” The evidence said one thing. WPATH’s politically motivated conclusion said another.

The report also exposes how WPATH’s Standards of Care Version 8 (SOC8) was created in violation of conflict-of-interest management rules, removed age minimums for medical procedures due to political pressure, and suppressed systematic reviews that leaders feared would “undermine its favored treatment approach.” (SOC8 is a comprehensive set of clinical guidelines published in 2022 by WPATH. It details what they consider best practices for healthcare providers treating transgender and gender-diverse individuals, including recommendations for social, medical, and surgical transition support.)

While evidence of benefits remains unclear, the biological and physiological evidence of harms is unmistakable. The report highlights risks that any reasonable person would consider catastrophic: permanent infertility when puberty blockers are followed by cross-sex hormones, sexual dysfunction, decreased bone density leading to osteoporosis and fractures, negative effects on brain development during critical adolescent periods, cardiovascular disease, metabolic disorders, and deep regret.

Males given estrogen experience testicular atrophy and irreversible breast growth. Females given testosterone suffer permanent voice changes, facial hair, clitoral enlargement, and male-pattern baldness. Both lose their fertility—often before they are cognitively mature enough to understand what reproduction means, much less give consent to its permanent loss.

The report states that puberty blockers, when used to treat actual precocious puberty in young children, are discontinued so normal puberty can occur at the appropriate age. However, in gender medicine, these same drugs are used to halt normal puberty indefinitely, leading to a condition known as hypogonadotropic hypogonadism—a medically recognized issue with serious health risks. This is not genuine treatment; it essentially creates illness in previously healthy children.

Advocates have used suicide statistics as a weapon to silence opposition, claiming that not affirming children’s transgender identities and providing immediate medical care amounts to a death sentence. The report counters this emotional manipulation with clear facts.

First, suicide rates among gender-dysphoric youth remain very low, even without medical intervention.

Second, there is “no independent association between gender dysphoria and suicidality”—the higher rates of suicidal thoughts are linked to the high rates of co-occurring mental health conditions in this group, not to gender dysphoria itself.

Third, and most importantly, “there is no evidence that pediatric medical transition reduces the incidence of suicide.” In fact, multiple studies show higher suicide rates among those who have undergone medical transition compared to the general population—including the Chen study, where two patients died by suicide and “suicidal ideation” was the most common adverse event during treatment.

The United States is increasingly isolated in its support of pediatric gender medicine. The report shows how health authorities in the United Kingdom, Sweden, Finland, and Norway have significantly restricted or effectively banned these interventions for minors after reviewing their own evidence.

The U.K.’s comprehensive Cass Review found this to be “an area of remarkably weak evidence” where “results of studies are exaggerated or misrepresented by people on all sides of the debate.” England’s National Health Service has prohibited routine use of puberty blockers for gender dysphoria. Sweden and Finland now recommend psychotherapy rather than medical intervention as the primary treatment, limiting hormones and surgeries to research protocols only.

These countries have functional national health systems with fewer financial incentives to promote costly medical procedures. They can follow the evidence. America’s privatized, profit-driven healthcare system has economic motives to keep treating children as customers for lifelong medical dependencies.

The report shows how American gender clinics have dropped even the basic safeguards initially suggested in the Dutch Protocol. Thorough mental health assessments have been replaced by quick evaluations—in some top pediatric gender clinics, assessments are done in just one two-hour session.

The approach has become explicitly child-led, with the patient’s self-reported “embodiment goals” guiding treatment decisions, and clinicians see their role as enabling access rather than exercising medical judgment. Planned Parenthood locations prescribe cross-sex hormones using an informed-consent model with minimal assessment, treating powerful endocrine disruptors like contraceptives available on demand.

Whistleblowers inside gender clinics, including clinicians who initially supported this approach, have tried to sound alarms about the falling standards. Their warnings have been “discounted, dismissed, or ignored by prominent advocates and practitioners.” Some, like Dr. Eithan Haim, who exposed Texas Children’s Hospital‘s secret continuation of child transitions, have faced federal prosecution for their efforts to protect children.

The report highlights how pediatric gender medicine is unusual in ways that should have prompted much greater scrutiny. The diagnosis depends entirely on subjective self-reports with no objective physical markers. The natural course of the condition shows that most cases resolve without intervention—medical professionals cannot predict which adolescents will continue in transgender identification and which will desist.

Yet despite this diagnostic uncertainty and the condition’s tendency to resolve naturally, the medical establishment promotes invasive, irreversible interventions with significant known harms and uncertain benefits. This reverses the usual medical approach, where treatments are proven safe and effective in adults before being used in children. In this case, the pediatric protocol was developed precisely because outcomes in adults were so disappointing.

As the report points out, medicine includes examples of uncertain diagnoses, self-limiting conditions, and risky treatments— but “what makes PGM [pediatric gender medicine] exceptional is not any one of these features, but their combination.”

The report’s ethics section eviscerates the claim that “gender-affirming care” respects patient autonomy. While patients have the right to refuse medical treatments, they do not have a comparable right to receive treatments that are not beneficial. Respect for autonomy does not eliminate physicians’ professional and ethical duties to protect patients from harm.

When evidence for benefit is very uncertain while evidence for harm is less uncertain, healthcare providers have a moral obligation to decline offering such interventions, “even when they are preferred, requested, or demanded by patients.” Failing to do so “reduces medicine to consumerism, threatening the integrity of the profession and undermining trust in medical authority.”

The report also questions whether it would be ethical to conduct randomized controlled trials on puberty suppression, considering what is already known about the interventions’ mechanisms and risks. The lack of such trials is not just an evidence gap—it might also reflect the impossibility of ethically conducting research that intentionally harms children.

Major medical associations—the American Medical Association, American Academy of Pediatrics, Endocrine Society—played crucial roles in creating an illusion of professional consensus supporting pediatric medical transition. The report shows that this “consensus” was driven by small, specialized committees heavily influenced by WPATH, and that “it is not clear that the official views of these associations are shared by the wider medical community, or even by most of their members.”

Evidence suggests these associations “suppressed dissent and stifled debate about this issue among their members.” Physicians who questioned the evidence or raised concerns about patient welfare faced professional ostracism. The toxic environment made “name-calling echoes the worst bullying behaviour” the norm, with “few other areas of healthcare where professionals are so afraid to openly discuss their views.”

The report focuses heavily on how manipulated language has hidden medical truths and prevented ethical discussions. Terms like “gender-affirming care,” “top surgery,” and “assigned sex at birth” are not neutral medical terms — they are loaded phrases meant to make experimental treatments sound normal and caring.

Calling a double mastectomy on a healthy 15-year-old girl “gender-affirming chest surgery” disguises what is really happening: the surgical removal of healthy organs from a minor. The phrase “assigned sex at birth” implies arbitrary decision-making rather than acknowledging the biological reality that existed long before birth.

Even more perniciously, the framework of “transgender children” versus “cisgender children” assumes that gender identity is an unchangeable trait identifiable in childhood—precisely the claim that lacks scientific backing. This terminology trap makes exploring underlying causes through therapy sound like coercive indoctrination rather than responsible mental health care.

This federal report marks a significant milestone. It offers authoritative evidence of what concerned parents, detransitioners, and skeptical clinicians have been saying, despite being vilified as bigots: pediatric gender medicine is not based on solid evidence but is instead ideological experimentation on vulnerable children.

The report was commissioned by executive order and reflects a federal government finally willing to examine this issue honestly. It does not issue legislative recommendations—it leaves those decisions to policymakers. But it provides policymakers, along with parents, physicians, and courts, with a comprehensive synthesis of evidence that makes clear the current approach is indefensible.

For years, we have been told to “trust the science” and rely on medical expertise. This report reveals how that expertise was corrupted, how evidence was hidden, how professional associations were taken over, and how financial and ideological motives overshadowed patient care. The supposed consensus was created through institutional pressure and intimidation rather than careful evaluation of evidence.

Thousands of American children have been sterilized, made unable to experience sexual pleasure, deprived of healthy body parts, and put on a path toward lifelong medical dependency—all in the name of “affirming” feelings that research shows would likely have resolved with time and proper psychological support.

The institutions that enabled this—medical associations, professional organizations, gender clinics, complicit media, government officials, educational authorities, and especially church leaders who have an affirmative duty to speak out against evil—bear responsibility for the greatest medical scandal of our time.

This report provides the evidence needed to hold them accountable and, more importantly, to prevent further harm to the vulnerable young people in their care.

Faith without works is dead. Do something now.