On November 19, 2025, Robert F. Kennedy Jr., the Secretary of Health and Human Services (HHS), released a report that sharply criticizes gender-affirming medical care for transgender minors. This new report updates and expands upon a similar but widely condemned HHS study published earlier in May, which had drawn intense scrutiny for lacking transparency about its authorship and promoting controversial psychological treatments. The renewed publication has reignited debates surrounding the medical care of transgender and gender-diverse youth, raising questions about scientific consensus, medical ethics, and political influence in healthcare.
The practice of gender-affirming care, supported by the American Medical Association (AMA) and many other leading medical organizations, involves psychological and medical treatments designed to help transgender children live in accordance with their gender identity. These treatments can include puberty blockers—which pause the physical changes of puberty and are considered reversible—and hormone therapies such as testosterone or estrogen, which produce more lasting bodily changes. Estimates suggest that between 2.5 and 8.4 percent of children identify as transgender or gender-diverse, meaning their gender identity or expression differs from societal expectations based on their sex assigned at birth.
In stark contrast to the broad medical consensus, the new HHS report claims that gender-affirming care is harmful. According to a press release from HHS, the report asserts that “the harms from sex-rejecting procedures—including puberty blockers, cross-sex hormones, and surgical operations—are significant, long term, and too often ignored or inadequately tracked.” Secretary Kennedy stated that such care has “inflicted lasting physical and psychological damage on vulnerable young people.” These assertions represent a notable shift from prevailing medical perspectives, which generally view gender-affirming care as an important, evidence-based component of healthcare for transgender youth.
The May report from HHS had already attracted widespread criticism for its opaque authorship and its advocacy of unproven psychotherapeutic methods for transgender and gender-diverse minors—a group known to face heightened risks of suicide and mental health challenges. This earlier study’s lack of transparency made it difficult for experts to assess its validity. The new report attempts to address this by revealing its nine authors, most of whom are known critics of gender-affirming care. However, this disclosure has itself generated controversy, as critics argue that the authors are part of a “cottage industry” focused on undermining healthcare access for transgender youth.
Meredithe McNamara, an adolescent medicine specialist at Yale School of Medicine and co-author of a critique of the U.K.’s 2024 Cass Review on gender-affirming care, condemned the report’s authorship and conclusions. McNamara emphasized that “transgender identity is real,” and that “transgender people of all ages thrive when they have access to the care they need.” She called for the separation of politics from medicine, highlighting the risks that politicized reports pose to vulnerable populations.
In response to accusations that the report is politically motivated, HHS press secretary Emily Hilliard defended the study’s scientific integrity, stating, “We will continue to follow the science wherever it leads, even when the findings challenge entrenched interests or preferred narratives.” Co-author Evgenia Abbruzzese echoed this sentiment in a statement, emphasizing that the research group included clinicians and researchers from across the political spectrum and was granted full independence to pursue evidence-based conclusions. Abbruzzese described the reassessment of gender-affirming care as part of a “familiar medical pattern” in which initial, well-intentioned innovations are later refined or corrected based on emerging evidence.
Despite these defenses, the report’s methodology has come under fire. The American Psychiatric Association (APA), in one of the peer reviews published alongside the report, criticized it for lacking sufficient transparency and clarity, cautioning that its findings should not be accepted at face value. The APA has maintained this critical stance even after the report’s authors rejected their feedback. Meanwhile, the American Academy of Pediatrics (AAP) and the Endocrine Society, two major organizations deeply involved in the care of transgender youth, declined to review the report, signaling their reservations or possible disagreement with its conclusions.
Medical professionals who support gender-affirming care have voiced strong opposition to the report’s claims. Pediatrician Bianca Allison, a fellow with Physicians for Reproductive Health, described gender-affirming care as “standard, developmentally appropriate health care.” She emphasized that such care is individualized and carefully administered and that “