Trump’s health agency urges therapy for transgender youth, not broader gender-affirming health care

President Donald Trump’s administration released a lengthy review of transgender health care on Thursday that advocates for a greater reliance on behavioral therapy rather than broad gender-affirming medical care for youths with gender dysphoria.

The 409-page Health and Human Services report questions standards for the treatment of transgender youth issued by the World Professional Association for Transgender Health and is likely to be used to bolster the government’s abrupt shift in how to care for a subset of the population that has become a political lightning rod.

Major medical groups and those who treat transgender young people sharply criticized the new report as inaccurate.

This “best practices” report is in response to an executive order Trump issued days into his second term that says the federal government must not support gender transitions for anyone under age 19.

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The report accuses transgender care specialists of disregarding psychotherapy that might challenge preconceptions, partly because of a “mischaracterization of such approaches as ‘conversion therapy,’” a discredited practice that seeks to change patients’ sexual orientation or gender identification. About half the states have banned conversion therapy for minors.

The American Academy of Child & Adolescent Psychiatry has said evidence shows conversion therapies inflict harm on young people, including elevated rates of suicidal thoughts.

HHS said its report does not address treatment for adults, is not clinical guidance and does not make any policy recommendations. However, it also says the review “is intended for policymakers, clinicians, therapists, medical organizations, and importantly, patients and their families,” and it declares that medical professionals involved in transgender care have failed their young patients.

The report could create fear for families seeking care and for medical providers, said Shannon Minter, the legal director at the National Center for Lesbian Rights. “It’s very chilling to see the federal government injecting politics and ideology into medical science,” Minter said.