USA Govt Publishes Final Peer-Reviewed Puberty Blockers Report

[UtopiaPlanitia]

Admiral Brian Christine, who replaced Admiral Rachel Levine as Assistant Secretary for Health, announced the publication of the final, peer-reviewed version of the HHS report on "paediatric gender dysphoria".

https://x.com/ADM_Christine/status/1991176470723518638?s=20

"Today, we released a report exposing the truth: pediatric sex-rejecting procedures are not evidence-based. They are dangerous. Enough is enough. Read it for yourself. Protecting children should not be controversial, it is our duty. The tide is turning."

How many more national level review teams around the world have to find the same thing for people to start thinking that these reviews are not 'biased' and if a country's administration finds the same result, then it is likely that 18 months on from the Cass Report, there STILL is no evidence to support the use of these drugs?

Considering the Cass report was launched in 2020, shouldn't some evidence have been undertaken by a treatment supportive national level team in those FIVE years that would counter all the other country's health team reviews?

Considering we have national teams from Sweden, UK, (Finland I believe), France, Canada, Germany, NZ and the Australia and NZ College of Psychiatrists all finding that there is low evidence to support these drugs being used....

I would love to have that man be accountable for abolishing the age restriction at the very least.

Having read a few of those peer reviews (not all 200+ pages) the authors seem to be broadly agreeing with the conclusions with some greater or lesser nitpicking as to methodology as you would expect.

They seem to be fairly united in criticising the lack of transparency as to authorship which I think is fair given there are so many strong views and conflicts of interest on this topic.

The American Psychiatric Association seems to be more critical than most and suggests a list of studies that should also be included. I don't know if the APA has a policy position on child gender treatment or of the strength of the studies they list.

I picked one at random that they suggested: https://pubmed.ncbi.nlm.nih.gov/20646177/
This study is for 70 children. No control group. All went onto cross sex hormones following puberty blockers. They checked behaviour, anger/anxiety and gender dysphoria before starting puberty blockers and again before starting cross sex hormones. Behaviour improved apparently but anxiety/anger and gender dysphoria did not.

Not a great study methodologically and doesn't show great outcomes!

The de Vries et al paper is the original Dutch research. The full report did reference this paper multiple times. The APA’s peer review is bizarre in claiming those papers weren’t looked at. Of course they were looked at. The “reply to review” on the supplement clearly puts the APA in its place by pointing this out.

Yes the peer reviews are broadly supportive. It is like they couldn't find anything to dismiss the conclusions with.

I also understand why they hid the author's names until it was peer reviewed, although not sure it was a sound ethical decision. However, considering the attack that these authors will now face, it was a protective move.

I noticed that. Maybe the APA needed to hear it from de Vries about the weaknesses of that study. They should have watched this.

A documentary on the Dutch Protocol

There are currently almost 3,000 young people on the waiting list for gender care in the Netherlands. They are vulnerable adolescents who are frequently subjected to discrimination. Many of them suffer severe mental distress. Doctors at the gender clinic in Amsterdam are pioneers in care for transgender young people. The treatment developed here years ago is now used worldwide. Now, criticism is growing. International experts are questioning the scientific evidence put forward by the clinicians in Amsterdam. Zembla investigates the Dutch transgender protocol.

What this covers is that no gender clinic has been able to replicate the results of the Dutch paper. One patient of the group died due to the surgery complications of gender surgery and even de Vries questioned why no one seemed interested in that patient while accepting the study. Dr Riittakerttu Kaltiala (Professor of Pschyiatry, Tampere and who set up gender clinics) and Mikael Landen (Professor of Pscyhiatry, Gotenberg) and Dr Angela Samfjord (Head of Child and Adolescent Psychiatry at the University of Gotenberg ) all are interviewed about the quality of the study behind the protocol and its flaws that became apparent later. Ie. The 55 patients is so small and de Vries acknowledges that they are not really similar to todays cohort of adolescent transitioners. That only 32 filled in the survey with positive results. The others were not chased up and one died.

Gerard van Breukelen, a professor of Methodology at Maastricht university goes on record to say that the methodology of that initial study was weak. There was no control group so the conclusions should not have been considered as strong as the gender clinicians claimed. Other academics declined to be interviewed due to fear for their employment as it is such a contentious issue. When talking to de Vries, she mentions that many more studies have been done by other countries now. And the doco makers mention that all those studies de Vries refer to have stated that the evidence is low quality. A Swedish team led by Landen was asked to do a full review by the Swedish government and he confirms that the evidence was just not there. Hence the Swedish government withdrew treatment.

Great news. The tide is indeed turning.

What now needs to happen is an enquiry into how these untested treatment approaches were pushed onto confused kids willy-nilly, without any proper research studies being done to determine effectiveness and harms.

It should have been obvious to medical authorities that using ND kids and kids with mental health issues as guinea pigs for medical interventions that amount to extreme interference with the natural developmental process of puberty is - at best - highly unethical, and - at worst - actively harmful across the child's whole lifespan.

This is medical ethics 101 - it doesn't pass the Beauchamp and Childress framework. Yet nobody stopped the juggernaut.

It seems really clear, as we all knew \i think, that there was never any evidence for these treatments.

But it seems to me that what is really needed now is not so much a study of proposed treatments, but a deep examination of the diagnosis they are giving these children. And the adults as well.

There seems to be something very wrong with the way this disorder, and maybe other disorders, are being defined, or the idea of the "trans person" in need of treatment.

So long as the diagnosis is off base, any studies of treatments are likely to be skewed.

Did RJK Jr have anything to do with writing the report itself?

No, then what's the price of potatoes got to do with flying kites. 🤯

I'm just scunnered that nobody appears to be in prison for having harmed many thousands of children.

I very much suspect he's never had anything to do with looking at puberty blocker use and side effects for precicious puberty where there's years of scientific knowledge which seems to get shredded the second you whispher 'gender identity'....

Lisa Selin Davis comments on the HHS report:

https://unherd.com/newsroom/revised-hhs-trans-report-exposes-moral-failures-in-gender-medicine/

"The report also made the case that youth gender medicine does not meet the basic moral principles of ethical healthcare. With no clear benefit, and some known bodily harms from blockers, hormones, and surgeries, the field promised neither non-malfeasance — the obligation to avoid harm — nor beneficence. The report authors think that because of this, there is no ethical way to even conduct further research on young people.

Rather than offer a defence of continuing to socially and medically transition young people, and a basis for continuing research, the AAP and other medical groups simply stuck to insisting that they must operate “free from political interference” and thus condemned the report. These medical groups don’t seem to realise their own hypocrisy, or how they project politics onto science, just as they accuse others of doing.

The AAP and other proponents of gender-affirming care should actually read the report and engage with its ideas and suggestions, rather than projecting onto it the sins they’re guilty of themselves. They are the ones who’ve misrepresented the medical consensus, and prioritised opinions over dispassionate reviews of evidence. With the names revealed, and the peer reviews in place, they no longer have reason to ignore this report."

No doubt there's some reason for this in Murican administrative law and how it affects the federal government, but I always scratch my head that Rachel Levine got to be an admiral, while L Ron Hubbard was only ever a commodore.

Good summary of the failures of the APA’s attempt at peer review.

https://www.realityslaststand.com/p/eager-to-affirm-yet-unwilling-to-e79

I was one of the peer reviewers of this research review report. Perhaps of particular interest to Mumsnetters, I commented on the need to make clear the impact of chest masculinisation surgery on breastfeeding and to consider breast binding as a physical intervention unlike other aspects of what is described as social transition- my review can be found at p18 https://opa.hhs.gov/sites/default/files/2025-11/gender-dysphoria-report-supplement.pdf?fbclid=IwY2xjawON1alleHRuA2FlbQIxMQBzcnRjBmFwcF9pZBAyMjIwMzkxNzg4MjAwODkyAAEev98DhSv2dO6SOh28ajDKYBob1ymKJfClYmMwcXi3YFkjsGtJhWqYKV-HxyU_aem_PhwjdU9thB8fxGOvfIscXA

If only.

Not as far as I know. I hope I'm wrong!

Thank you, Karleen! ❤️

and to consider breast binding as a physical intervention

I would go further.

Breast Ironing/Flattening is specifically cited in the UK as Child Abuse and is criminalised:

www.met.police.uk/advice/advice-and-information/caa/child-abuse/breast-ironing-flattening/

I cannot see any reason why the facilitation of Breast Binding children by adults should not also be criminalised, given the injuries that it can cause and the lack of medical need.

The only reason for the distinction IMHO is racism which, ironically, favours the protection of children who are usually born into families from Sub-Saharan Africa.

"In some families, large stones, a hammer or a spatula heated over scorching coals are used to compress the breast tissue. Other families may opt for an elastic belt or binder to press the breasts and prevent them from growing.
Breast flattening usually starts with the first signs of puberty, which can occur as young as nine years old, and is usually carried out by female relatives.

It is important to note that some adolescent girls and boys may choose to bind their breasts using constrictive material due to gender transformation or identity, and this may also cause health problems.

Breast flattening can happen anywhere in the world. The map below represents the countries where research has been conducted. Just because a country is not highlighted doesn’t mean it doesn’t happen; it simply means there is no research available in that area."

nationalfgmcentre.org.uk/breast-flattening/

Breast Ironing/Flattening and Breast Binding are both cultural practices that harm girls.

Breast Binding is tolerated, even celebrated by those who participate in the ideology of transgenderism, as a "Western" cultural practice that harms girls - and is being exported globally.

As such, the children currently affected are primarily white "Western" girls and they are denied protection from this form of child abuse.

However, this also provides a loophole for parents to use breast binders and claim the excuse of "gender identity affirmation" when what they are actually doing is subjecting their daughters to the cultural practice of Breast Ironing/Flattening.

It makes no sense to permit Breast Binding for "gender identity affirmation" while criminalising it as a Breast Ironing/Flattening practice that harms the child.

Therefore, Breast Binders should be banned for all purposes and the adults involved should be prosecuted for child abuse.

I live in the USA and this report isn't getting much general publicity, if I didn't read the feminism boards on Mumsnet I wouldn't know about it. I live in a West Coast Democrat dominated city and the local newspaper hasn't mentioned it as far as I have found. I only see it in newspapers in Republican dominated states such as Tennessee. This is how even intelligent and well educated people are so uninformed about the effects of Gender Ideology, as there will be a silence in the "progressive" Left media whenever information that conflicts with the party line is disseminated. Of course most people aren't getting their news from newspapers and TV anyway but the legacy media will ignore these stories if possible.

Thank you very much for giving us your impression of how the HHS report is being reported in the US.

It reminds me of the recent clips I've seen of Bill Maher trying to talk to Patton Oswalt about this issue and Oswalt knows nothing about any of the stories that Maher brings up as evidence for his argument because, to quote Maher, Oswalt lives in that Blue Bubble.

Newsweek published an article by two Biden staffers regarding the HHS report:
https://www.newsweek.com/bad-medicine-how-secretary-kennedy-is-jeopardizing-lgbtq-lives-opinion-11182985

Benjamin Ryan, journalist, has tweeted about it today:
https://x.com/benryanwriter/status/1999162208454947300?s=20

"This @Newsweek editorial, written by two Biden admin ex-HHS officials, is an example of what philosopher Dan Williams calls "highbrow misinformation." It relies on a litany of misleading or incorrect stats to back up its claim that the recent HHS report on pediatric gender medicine is bunk.

This includes:

• Deriding the HHS report as being "peer reviewed" in scare quotes, as if the peer review is illegitimate, and then citing one of the peer reviewers, the APA, to further disparage the report.

• ^Falsely claiming that all major medical organizations have endorsed pediatric gender transition treatment (the American Society of Plastic Surgeons has not; I wrote about that here: https://benryan.substack.com/p/top-plastic-surgeon-wont-commit-to^

• ^Credulously citing Tordoff et al's unsubstantiated claim that gender-transition treatment is linked to 60% lower depression and 73% reduction in suicidality. @JesseSingal has thoroughly deconstructed that very weak and flawed paper: https://jessesingal.substack.com/p/researchersfound-puberty-blockers^

• ^Credulously citing the Harvard research letter that published misleading claims about pediatric gender surgeries. (I wrote about that here: https://benryan.substack.com/p/how-harvard-teed-up-the-false-claim^

• Falsely claiming that we know what the regret rates are for pediatric gender-transition surgeries. The 1% regret rate they cite refers to a study of adults. And even that study is unreliable due in part to loss to follow-up.

• Falsely claiming the HHS report relies on "outdated studies," when in fact, the report relied on an umbrella review of all available systematic literature reviews, which included the Tordoff study from 2022 that the Newsweek writers then cite as a current study.

• Not substantiating the claim that the HHS report relies on conspiracy theories, a statement that itself has the air of a conspiracy theory.

• ^Falsely claiming that HHS has not released the names of the HHS report authors, which were released weeks ago with the peer-reviewed version of the report that the Newsweek writers are criticizing. (I wrote about them here: https://benryan.substack.com/p/unmasked-at-last-the-9-authors-of^

• Falsely claiming that the HHS report authors only agreed to have it peer reviewed after people complained about the first version. It was always the plan to peer review it.

• Citing the APA's criticisms of the report but not citing the authors' response to those criticisms, in which they suggested that the authors of the APA critique hadn't even read the entire report.

• Falsely claiming that 1.7% of people are intersex. (The true figure is about 0.02%.)

• Deriding the updated HHS report for only including minimal changes and thus suggesting that this was egregious on the HHS authors' part as opposed to evidence, following peer review, that few changes were actually needed.

• Not citing that the AAP and Endocrine Society declined the opportunity to peer review the report."

"highbrow misinformation" , I'm going to be using that in the future. 😁
It's sounds like the same sort of twaddle that greeted the Cass report, I'm glad they're going straight on the attack to counter the false narrative the genderwangers are attempting to create. 👍