The U.S. Department of Health and Human Services (HHS) has released a peer-reviewed study highlighting serious, long-term risks associated with medical interventions that alter a child’s biological sex.
The report, Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices, published through the Office of the Assistant Secretary for Health, concludes that procedures such as puberty blockers, cross-sex hormones and surgeries have consequences that are often inadequately tracked or acknowledged.
HHS Secretary Robert F. Kennedy Jr. framed the study as a challenge to the prevailing medical establishment.
“The American Medical Association and the American Academy of Pediatrics peddled the lie that chemical and surgical sex-rejecting procedures could be good for children,” Kennedy said in a press release.
“They betrayed their oath to first do no harm … their so-called ‘gender-affirming care’ has inflicted lasting physical and psychological damage on vulnerable young people. That is not medicine—it’s malpractice.”
The study identifies a range of potential harms, including infertility, weakened bone density, metabolic complications, cognitive impacts and psychiatric issues.
HHS officials argue that these findings reinforce earlier warnings from the Trump-era Make America Healthy Again Commission, which cautioned against the overmedicalization of minors.
The report comes amid growing debate in the U.S. over pediatric “gender-affirming care,” with some states enacting or proposing restrictions on interventions for minors due to concerns over safety and long-term effects.
International experience also informs the conversation.
England’s Cass Review recently found that early hormonal treatments for children show uncertain benefits, prompting the National Health Service to limit prescriptions for puberty blockers.
Experts point to this as evidence that caution is warranted when considering irreversible interventions for youth.
National Institutes of Health Director Jay Bhattacharya, MD, PhD, praised the study for its scientific rigor.
“The evidence in it meticulously documents the risks the profession has imposed on vulnerable children,” he said. “We must ensure science, not ideology, guides America’s medical research.”
Assistant Secretary for Health Brian Christine, MD, described the report as “an urgent wake-up call” to parents and healthcare providers.
“What are we going to tell the young people who can’t have children because the medical profession stole that from them?” Christine asked.
HHS commissioned the study with contributions from experts spanning medicine, bioethics, psychology and philosophy, including Evgenia Abbruzzese of the Society for Evidence-Based Gender Medicine, Farr Curlin, MD, of Duke University and Alex Byrne, PhD, of MIT.
While the American Academy of Pediatrics and the Endocrine Society declined to participate, the report highlights the importance of evidence-driven guidance in areas with lasting consequences for children.
By framing medical decisions around documented outcomes rather than ideological trends, the report aims to provide parents, providers and policymakers with guidance on navigating one of the most controversial areas in modern pediatric medicine.
The study’s authors and HHS officials alike stress that careful consideration, parental involvement and robust scientific evidence are critical before pursuing interventions that can permanently alter a child’s body and future fertility.
