The American Psychiatric Association tried and failed to discredit the Department of Health and Human Services’ (HHS) report showing sex-rejecting procedures harm minors.
HHS commended the association last week for for peer-reviewing Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices, which the department first published in May. The American Academy of Pediatrics and Endocrine Society refused HHS’ invitation to review, though both support subjecting wrong-sex-identified children to surgical procedures, so-called puberty blockers and [wrong]-sex hormones.
Though the American Psychiatric Association agreed to review Treatment for Pediatric Gender Dysphoria, it did not do so carefully or in good faith. Its criticisms rely on half-truths, manipulations and outright falsehoods, demonstrating how little evidence “gender-affirming” organizations have to support procedures they call “evidence-based.”
Below are five of the America Psychiatric Association’s failed critiques of HHS’ Treatment for Pediatric Gender Dysphoria.
Failure to Read
The American Psychiatric Association recommended HHS review 16 additional studies for the final version of Treatment for Pediatric Gender Dysphoria.
The original report had already addressed twelve of them.
Two other recommended studies examined the effect of sex-rejecting procedures on the wrong population (adults, not minors). Another did not investigate sex-rejecting procedures at all.
HHS found only one of the American Psychiatric Association’s recommended studies “potentially relevant.” Importantly, it came out after the department published Treatment for Pediatric Gender Dysphoria on May 1, 2025.
In its response to the association’s review, HHS speculates its “unfounded” criticisms “could have resulted from a failure to read core parts of the review.
Making Assumptions
The American Psychiatric Association argued Treatment for Pediatric Gender Dysphoria failed to consider the risk of allowing children struggling with wrong-sex identification to go through puberty.
This critique reflects a common lie that sex-rejecting procedures stop wrong-sex-identified children from committing suicide or experiencing other debilitating mental illnesses.
More importantly, it subtly reveals the American Psychiatric Association changes its conception and treatment of puberty based on the feelings of the developing child.
The association evidently considers puberty a natural and necessary process only when the child accepts it. Conversely, when puberty causes a child distress, the association considers it a sickness to be stopped and reversed.
HHS correctly recognizes puberty as a natural, necessary part of human life — regardless of the developing person’s feelings about growing up. Treatment for Pediatric Gender Dysphoria investigates the effects of disrupting this natural physical development with wrong-sex hormones, drugs that “block” puberty and sex-rejecting surgeries.
Cherry Picking
Treatment for Pediatric Gender Dysphoria references many findings and conclusions from The 2024 Cass Review — a comprehensive report on transgender medical interventions which prompted the UK to ban puberty blockers and prohibit the administration of wrong-sex hormones to minors outside experimental research.
The American Psychiatric Association criticized HHS for cherry picking favorable portions of the Cass Review and ignoring lines like, “For some, the best outcome will be transition…”
Ironically, the association cherry picked this phrase from a larger paragraph, not on the benefit of sex-rejecting procedures, but on the UK National Health Service’s obligation to children struggling with wrong-sex identification:
For some, the best outcome will be transition, whereas others may resolve their distress in other ways. Some may transition and then de/retransition and/or experience regret. The NHS needs to care for all those seeking support.
The American Psychiatric Association selected this paragraph out of context to suggest the Cass Review equivocates on the benefits of sex-rejecting procedures. It doesn’t. The review clearly concludes evidence for sex-rejecting procedures is weak and, further, that doctors can’t know whether children will grow out of their wrong-sex identification and regret harming their bodies.
“Any reasonable interpretation of The Cass Review’s statements … must grapple with its findings about lack of evidence for benefit and deep uncertainties about diagnoses,” HHS writes. “Unfortunately, the [American Psychiatric Association] fails to do so.”
Unsupported Conclusions
The American Psychiatric Association criticized HHS for obfuscating how it chose and evaluated evidence in Treatment for Pediatric Gender Dysphoria.
Most other peer reviewers praised the report for its transparency and methodological rigor.
HHS highlights a positive peer review from two methodologists at the Belgian Centre for Evidence-Based Medicine. The scientists commended the reports’ methodology and described the results as “[written] transparently” and “easy to follow.”
Misapplication of Scientific Norms
Healthcare “stakeholders” refer to any population or entity impacted by changes to the medical system, including patients.
The American Psychiatric Association argued HHS improperly excluded stakeholder perspectives, particularly those of “transgender individuals and their families,” from Treatment for Pediatric Gender Dysphoria.
But scientists don’t need patients’ input to write reliable evidentiary reviews.
HHS suspects the association confused its report with a clinical practice guide, which dictates how doctors should diagnose and treat medical conditions. Clinical practice guides generally require feedback from patients who will be impacted by the recommendations.
Treatment for Pediatric Gender Dysphoria does not weigh in on diagnoses and treatment; it compiles and evaluates all evidence on the effects of sex-rejecting procedures on minors. The perspectives of patients and other stakeholders do not — and should not — affect its scientific conclusions.
Ironically, HHS notes, the current “gender affirming” clinical practice guides for wrong-sex-identified children score low on stakeholder involvement.
Why It Matters
Treatment for Pediatric Gender Dysphoria suggests the American medical system performed sex-rejecting procedures on wrong-sex-identified children with no evidence of those procedures’ benefits and every evidence of their harms.
HHS gave standard-bearers like the American Psychiatric Association the opportunity to respond to this serious implication. They either refused or presented weak, deceptive arguments devoid of evidence.
That’s unacceptable. Protecting children from sex-rejecting procedures requires illuminating these cop-outs and pursuing justice for families and children harmed by these unconscionable practices.
Additional Articles and Resources
Counseling Consultation & Referrals
Resources for families struggling with wrong-sex identification
HHS Finalizes Report Finding Sex-Rejecting Procedures Harm Minors
HHS Releases Report on Harms of ‘Transgender’ Medical Interventions for Minors
FTC Begins Investigating ‘Gender-Affirming’ Medical Community for Deception, False Advertising
The Shifting Ground of ‘Gender-Affirming Care’
Don’t Fall for the ‘Affirm Them or They Will Die’ Lie
Transgenderism and Minors: What Does the Research Really Show?
UK Bans Puberty Blockers for ‘Transgender’ Minors
U.K.’s Review of Child Gender Policy Reveals Profound Failures That U.S. Still Defends
England’s NHS Stops Dispensing Puberty Blockers for Children — Not Safe or Effective
Addressing Gender Identity with Honesty and Compassion
Newsom Signs Bill Connecting Students to ‘LGBT Hotline’ and Unsafe Chatrooms
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