Concerns after HHS advocate reports for therapy for trans children on treats that strengthen gender

The Ministry of Health and Humanitarian Services (HHS) released what he called A “Comprehensive review“Transgender care for children and adolescents on Thursday, calls for a broader use of psychotherapy for young people with gender dysforia than gender care.

Details of more than 400 pages alleged losses from medical interventions for young people, including the use of puberty blockers, and alleged risks, such as infertility.

“Review of the Best Evidence and Practice Report” is a response to January Executive command Issued by President Donald Trump, said the federal government would not “fund, sponsor, promote, help or support” transition treatments for those aged under 19.

“Our task is to protect our children – not expose them in medical interventions that are not proven and cannot be changed,” Dr. Jay Bhattacharya, Director of the National Institutes of Health, said in a statement on Thursday. “We must follow the gold standard of science, not an activist agenda.”

Treatment that strengthens gender is supported by many large medical organizations. This can range from allowing children to choose pronouns to treatments that are usually prescribed for older teens. The study of treatment is Generally safe And treatment has a positive impact on mental health, which cannot be given by psychotherapy, experts said.

“Need someone [go] Through the therapy course specified can be misused by the government to try to block access to treatment, “Dr. and Karasic, Professor of Psychiatric Emeritus at the University of California San Francisco Weill Institute for Neurosciences, told ABC News.” There is no evidence that the psychotherapy of gender response. “

Safety puberty blockers, hormone therapy

One of the most common treatments in the treatment that strengthens gender is the use of puberty blockers, which are used to delay the emergence of puberty among transgender and gender youths.

The report claimed his review of the study found low evidence that the puberty blocker was safe or that they improved mental health between children and gender dysforia, and “high certainty evidence” that they often cause infertility.

What was reported also stated, “Low certainty evidence shows that puberty blockers can endanger bone health.”

However, The study has shown That adults who use puberty blockers in the past experience a menstrual cycle, childbirth and miscarriage at the same level as the general population.

Dr. Morissa Ladinsky, a clinical professor in the field of pediatrics at Stanford University in California, said that puberty blockers have been used as treatment for more than 30 years, especially for a condition called CPP, or puberty prematurely, namely the puberty period began too early.

“These drugs are very well studied,” he told ABC News. “The long-term effect of puberty drugs, when used in children, for a temporary period of time, functions as a gap button that can be fully reversed.”

He said the side effects associated with sexual function or bone density are usually seen among adults, who may take medicine for prostate cancer to reduce testosterone, or endometriosis.

The HHS report also discusses cross -sex hormones, better known as hormone therapy, claiming there is a “high certainty evidence” that hormone therapy has “physiological effects” and that many studies “are not specifically designed to capture various long -term results.”

Although hormones can bring side effects, like any medicine, they can greatly improve mental health Of those who suffer from gender dysforia, research shows.

Ladinsky said hormone therapy is often used with older teenagers who have experienced gender dysphoria for a long time.

Hormone therapy “is all used and has been used in children’s and adolescent medicine, for a very, old, old time,” he said. “Everyone who has used family planning kbobination pills has taken oral estrogen. So, not because these drugs are unique, experimental, attracting shelves. They are standard pharmacologies in medical practice.”

Controversy about operations

The review said he found three studies of operations for children or teenagers with gender dysforia “with most of the mastectomy.”

Mastectomy that strengthens gender, which is known everyday as “top surgery,” is a surgical procedure that removes breast tissue to make the chest that looks more masculine.

The report said the author found a low certainty of the evidence of the effects of operations that strengthen gender in adolescents including suicide, depression, asexual function, quality of life and regret.

Ladinsky said there was no genital operation that strengthened gender that occurs in minors and there is no other gender reduction operation performed on small children.

“There is a group of older-older teenagers who are older, which means 17-Ish, 18, which-in the standard of treatment driven by our evidence allows a small group of older Trans-Maskulin teenagers with extraordinary and sustainable chest surgery to undergo masculinization chest surgery,” he said.

Ladinsky continued, “That is very, very rare and the procedure can only be carried out in the long run of supervision around the gender dysforia with doctors, very large parents’ approval and professional support by those who care for the young man.”

HHS supporters for psychotherapy

The HHS report recommends the use of psychotherapy as a treatment for children and adolescents with gender dysforia.

“Psychotherapy is a noninvasive alternative for endocrine and surgery interventions for the treatment of child gender dysforia,” the report said. “Systematic Evidence Review does not find evidence of the side effects of psychotherapy in this context.”

Carasic says certain types of psychotherapy can be used to treat the symptoms of anxiety and depression between cisgender and transgender individuals, but psychotherapy should not be considered as a substitute for gender care.

“There is absolutely no evidence that psychotherapy is a substitute for people who need medical treatment,” he told ABC News. “There is substantial evidence for its benefits [gender-affirming] Caring for minors, and that is why all the main medical and mental health groups support this versus there is no evidence of psychotherapy to be a substitute. “

Karasic says psychotherapy is not bad, but has a place and, very often, children and adolescents receive psychotherapy together with medical intervention.

“If people propose the availability of therapy for people who need it, I think everyone will agree with that,” he said. “But when people say that medical intervention should not be provided because therapy can be used instead, it’s wrong. There is no evidence to support it.”

Response from the medical community

American Academy of Pediatrics released a statement On Thursday said it was “very worried” by the HHS report.

“For such analysis to bring credibility, it must consider the totality of available data and a full spectrum of clinical results rather than relying on certain perspectives and a series of narrow data,” the statement said in part. “This report is wrongly describing the current medical consensus and fails to reflect the reality of children’s care.”

AAP also released A statement With several groups, including the American Academy of Family Physicians, American College of Obstetricians and Gynecologists, American College of Physicians, American Osteopathic Association and American Psychiatric Association.

“Our organization consistently opposes the laws, regulations, or executive actions that interfere with the secret relationship between patients and their doctors or damage the provision of evidence based on patient care and doctor’s training and education,” the statement, which was released on Thursday, was read. “Patients must be able to discuss health problems with their trusted doctors to determine together what care is best for them.”

More than 500 anti-LGBTQ+ bills have been introduced throughout the 2024 legislative session, according to American Civil Freedom Association.

Ladinsky said the bill was dangerous and they did not complete the gender dysforia for anyone.

“If the information approved by the government, striking information is used to make policy decisions that affect millions of Americans, we open the Pandora box to greatly reduce the health of everyone, rather than lifting it,” he said. “Another important thing is that we know from the 25 states that have provided illegal elements of this treatment, it does not make the children of Trans identity no longer trans.”