Gender transition procedures on minors face intensifying scrutiny as the transgender-friendly Biden administration prepares to step down, with Republican lawmakers demanding a federal health agency reveal the scientific evidence justifying such treatments.
In a letter sent to the Inspector General (OIG) of the U.S. Department of Health and Human Services, members of the GOP-led House Committee on Energy and Commerce dubbed the HHS a “global outlier” for its promotion of puberty blockers and reconstructive surgeries for children.
The lawmakers cited European studies and restrictions that apparently contradict the HHS’ assertions that such procedures are beneficial.
“[A]ll of HHS’s medical treatment recommendations, especially medical treatment recommendations for children, should be based on rigorous and well-established research,” the lawmakers wrote. “Accordingly, the Committee requests that the OIG investigate this matter to ensure American children receive evidence-based, high-quality, and safe medical care.”
The committee’s letter came about a week after the House passed the 2025 National Defense Authorization Act, which included a last-minute GOP addition banning military health insurance from covering procedures on minors that “may result in sterilization.”
The HHS has defended its support of what it calls “gender-affirming care” for minors, claiming that scientific data and medical experts back treatments like hormones and surgeries on children.
“At HHS, we listen to medical experts and doctors, and they agree with us, that access to affirming care for transgender youth is essential and can be life-saving,” HHS Secretary Xavier Becerra said in March 2022.
But as recently as October 2024, new research suggests that gender transition procedures on minors may not deliver the benefits promised.
The $10 million study involving Children’s Hospital Los Angeles, the second-largest provider of child medical gender reassignment interventions, is currently being withheld from publication due to the author’s fear its results could be “weaponized” against the practice of giving children puberty blocker hormones.
Some medical organizations in the U.S. had expressed caution even before the study was finished, most notably the American Society of Plastic Surgeons.
“ASPS currently understands that there is considerable uncertainty as to the long-term efficacy for the use of chest and genital surgical interventions for the treatment of adolescents with gender dysphoria, and the existing evidence base is viewed as low quality/low certainty. This patient population requires specific considerations,” the organization said in April.
Yet, as warning signs grow, the number of gender transition procedures on minors in America has risen significantly over the past five years.
According to medical nonprofit group Do No Harm, between 2019 and 2023, there were at least 13,394 gender reassignment procedures on individuals 17.5 years old or younger nationwide, with the youngest seven years old.
“Procedures” are defined as either the use of puberty or hormone blockers, or gender reassignment surgeries such as mastectomies and penile reconstruction. The organization reports that of those, there were 4,160 breast removal procedures and 660 phalloplasty procedures on minors.
Some states have begun enacting restrictions on what gender dysphoria treatments minors may receive, prompting a slew of lawsuits.
One case challenging the constitutionality of Tennessee’s ban on transgender-identifying children receiving sex surgeries, hormones, and puberty blockers is currently being heard by the U.S. Supreme Court.
The court is set to rule on whether state-level bans are constitutional in 2025.