All children and youth should have the opportunity to live and grow in communities with supportive adults who care for them, learn in environments that promote their growth and development, and access quality and affirming health care. The current administration is undermining these essentials and has deployed a range of tactics, including Executive Orders, guidance to administrative agencies, and the cancellation of existing grants and contracts to instill fear, cause chaos, and directly harm the health and wellbeing of children.
The latest attacks in this onslaught come from the Department of Health and Human Services (HHS), which released today a report that falsely claims medical transition is harmful and unproven, and promotes “exploratory therapy”—a rebranded version of conversion practices widely condemned by major medical associations; and from Attorney General Bondi, who issued a memo directing the Department of Justice to eliminate access to gender-affirming care for young people and prosecute those who provide it. Both the report and memo fly in the face of recommendations by medical professionals and decades of scientific research that highlight the benefits of responsive and affirming care. These statements threaten the health and wellbeing of children, and must be retracted immediately.
Importantly, neither the report nor the memo change existing law. Rather, they are intended to cause fear and create chaos for medical providers, insurance and pharmaceutical companies, and families. As stated in the memo, by “putting medical practitioners, hospitals, and clinics on notice” and pushing a false narrative that medical providers submit fraudulent claims to help patients access care, for example, “performing surgical procedures to remove or modify a child’s sex organs while billing Medicaid for an entirely different procedure”, this administration is signaling and threatening prosecution of anyone who helps a young person access gender-affirming care. Both the report and the memo grossly and erroneous misrepresent gender-affirming care, with the memo mischaracterizing it as female genital mutilation; create confusion for pharmaceutical companies over how drugs are labeled; and misrepresent and ignore scientific evidence and studies in peer reviewed journals. Rather, the report explicitly pushes conversion practices through “gender exploratory therapy”, despite the clear evidence that these practices cause significant harm to children and youth. Currently, 23 states and the District of Columbia have state-wide bans on conversion therapy for minors.
We owe young people so much better. All children and youth deserve gender-affirming care, which at its most basic, is health care that recognizes and affirms someone’s gender identity. Doctors have embraced gender-affirming care for decades, and major medical organizations—including the American Medical Association, the American Academy of Pediatrics, and the World Health Organization— deem it medically necessary. Gender-affirming care goes beyond hormones and surgeries for those who identify as transgender. For example, for cisgender people, it can include reconstructive mastectomy, hair removal, hormone replacement therapy, and breast reduction surgery to alleviate the social and mental health challenges of unwanted breasts in cisgender men and boys. Access to gender-affirming care has also been shown to decrease the risk of depression and suicide for youth, and is a crucial support for young people as they pursue their goals and dreams. Put simply, gender-affirming care is health care that is responsive, affirming, and appropriate and it is the sort of dignified health care that every person deserves.
This memo and report follow explicit attacks by the administration targeting LGBTQIA+ individuals, and specifically transgender young people, including a January Executive Order to restrict access to gender-affirming care for minors, the White House’s proclamation threatening caregivers who support transgender youth as perpetrating child abuse, and a recent push by the Center for Medicare and Medicaid Services for states to not use Medicaid funds for gender-affirming care for minors.
This administration continues to make it clear that it does not value the health and wellbeing of all children, and it has repeatedly used its resources to go after providers who do value all children. The actions of this administration are already having the intended chilling effect. In response to the January Executive Order, some hospitals who provided gender-affirming care have stopped doing so, despite what medical guidance dictates is in the best interest of patients. Even when these hospitals and providers have been given the “all clear” to resume the provision of services, many have not reinstated care and/or are not accepting new patients for fear of retribution from this administration. This report and memo will only lead to more fear among medical providers, and the broader medical community, and will likely not only result in fewer providers who are willing to provide gender-affirming care for children but also increase the prevalence of damaging conversion practices, harming more children and families.
The administration’s consistent and increasing attacks on the health and wellbeing of children and their families, and the health care professionals that support them, are patently wrong and incredibly dangerous. We must reverse course immediately and ensure that all children and youth are protected from harmful conversion practices and have access to health care that affirms and supports their whole-identities.
