Tag: Harm

  • HHS Condemns Gender-Affirming Care in Report That Finds ‘Sparse’ Evidence of Harm – The 74

    HHS Condemns Gender-Affirming Care in Report That Finds ‘Sparse’ Evidence of Harm – The 74


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    This story was originally reported by Orion Rummler of The 19th. Meet Orion and read more of his reporting on gender, politics and policy.

    On Thursday, the Department of Health and Human Services (HHS) published a 400-page analysis of research on gender-affirming care for transgender youth, as directed by President Donald Trump. The agency used the release of the report to declare that available science does not support providing gender-affirming care to trans youth. LGBTQ+ advocacy groups worry the report will be used to further restrict gender-affirming care and to change medical guidelines in ways that harm trans youth.

    The president mandated the report in an executive order condemning the medical treatment — without evidence — as a form of mutilation, amid a broader push by the administration to exclude trans people from public life. Trump’s order asked the health agency to review the “best practices for promoting the health of children who assert gender dysphoria,” while pressuring youth clinics to halt treatment or lose federal funding.

    Now, the HHS has produced that report. The agency combed through research on the outcomes of puberty blockers, hormone replacement therapy, social transition, psychotherapy, and the rare cases of surgeries on adolescents and young adults diagnosed with gender dysphoria. 

    Gender dysphoria, the reason that most trans people undergo gender-affirming care, is a strong and persistent distress felt when one’s body is out of sync with their gender identity. Without treatment, gender dysphoria can lead to severe negative impacts in day-to-day life. 

    The agency states in its executive summary of the report that the document is not meant to provide clinical practice guidelines or issue legislative or policy recommendations. However, the report does imply that health care providers should refuse to offer gender-affirming care to adolescents and young adults on the basis that such care comes with the potential for risk — despite little evidence for that risk actually being found in the report. 

    “The evidence for benefit of pediatric medical transition is very uncertain, while the evidence for harm is less uncertain,” the executive summary states. “When medical interventions pose unnecessary, disproportionate risks of harm, healthcare providers should refuse to offer them even when they are preferred, requested, or demanded by patients.”

    In its research review, the HHS determined that evidence measuring the effects of gender-affirming care on psychological outcomes, quality of life, regret and long-term health is of “very low” quality. This conclusion ignores decades of research, as well as a recent survey of more than 90,000 transgender people in the United States that found an overwhelming majority report more life satisfaction after having transitioned. Access to gender-affirming care has been linked to lower odds of suicidality and depression in trans youth, while gender-affirming surgeries have been found to lower psychological distress for adults.

    Even when analyzing research that the administration deemed low-bias, the HHS found “sparse” to no evidence of harm from gender-affirming care. What’s more, the report frequently found evidence demonstrating the benefits of gender-affirming care — though it ultimately downplays those findings as not significant. 

    Available research on puberty blockers found high satisfaction ratings and low rates of regret. A systematic review of hormone replacement therapy described improved gender dysphoria and body satisfaction. Another found that hormone treatment leads to improved mental health. Two before-and-after studies reported reduced treatment needs or lower levels of suicidality and self-harm after hormone treatment. When measuring safety outcomes of hormone treatment, side effects did not have a major impact on treatment and complications were limited. 

    Despite these findings, the Department of Health and Human Services advertised the report in a Thursday news release as one that “highlights a growing body of evidence pointing to significant risks” of gender-affirming care. At the White House briefing room Thursday, deputy chief of staff for policy Stephen Miller touted the new report and attributed the idea of being transgender as part of a “cancerous communist woke culture” that is “destroying this country.” 

    There are side effects to many of the medications that transgender people — and cisgender people — take to receive gender-affirming care, as is the case with most medical treatments. These side effects, like the risk of decreased bone density when taking puberty blockers, are closely monitored and treated by doctors and communicated to patients.

    LGBTQ+ advocacy organizations denounced the report as a political attack on transgender youth. Multiple groups said that the report’s endorsement of psychotherapy as a “noninvasive alternative” to puberty blockers and hormone treatment amounts to an endorsement of conversion therapy — a practice wherein mental health professionals try to change a youth’s sexual orientation or gender identity.

    “It is already clear that this report is a willful distortion of the evidence intended to stoke fear about a field of safe and effective medicine that has existed for decades, in order to justify dangerous practices which amount to conversion therapy,” said Sinead Murano Kinney, health policy analyst at Advocates for Trans Equality. 

    The Human Rights Campaign, the country’s largest LGBTQ+ rights organization, accused the HHS of producing a report that is attempting to lay the groundwork to replace medical care for trans and nonbinary people with conversion therapy. 

    “Trans people are who we are. We’re born this way. And we deserve to live our best lives and have a fair shot and equal opportunity at living a good life,” said Jay Brown, chief of staff at the Human Rights Campaign. “This report … lays the groundwork to push parents and doctors aside and allow politicians to subject our kids to the debunked practice of conversion therapy.” 

    No authors or contributors are named in the report or in its executive summary. The agency says these names are being initially withheld to “maintain the integrity of this process,” and states that chapters of the document were subject to peer review.


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  • Dismantling Ed Dept. Will Harm More Than 26 Million Kids — and America’s Future – The 74

    Dismantling Ed Dept. Will Harm More Than 26 Million Kids — and America’s Future – The 74


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    The layoffs of half of the employees of the U.S. Department of Education clearly demonstrate the Trump administration’s follow-through on one of Project 2025’s mandates, which intends to eliminate the resources, protections and opportunities that millions of children and families across this nation rely on.

    It is evident that the White House will not stop until it wipes out the most basic protections and supports for the American people, including the youngest children. The first step was the attempt to defund Head Start and Early Head Start, impacting 800,000 young children across the nation. This order was halted by a federal judge in Washington, thanks to the lawsuits filed by Democracy Forward and attorneys general from 23 states. 

    The mass layoffs will severely hamper the department’s ability to execute on its core responsibilities. This move is a direct assault on millions of students, teachers and families. It is clearly a precursor to dismantling the department without congressional consent, which would have an even more devastating impact. The department serves and protects the most vulnerable children and young adults, ensuring that they have equal access to education. This includes:

    • 26 million students from low-income backgrounds — more than half of all K-12 students — who rely on the department for reasonable class sizes; school meals; tutoring; afterschool and summer programs; school supplies such as laptops and books; parent engagement programs; and, in some cases, transportation
    • 9.8 million students enrolled in rural schools
    • 7.4. million students with disabilities
    • 5 million English learners
    • 1.1 million students experiencing homelessness
    • 87 million college students who receive Pell Grants and student loans 

    The department was created in 1980 with a single, crucial purpose: to ensure equal access to education and to promote educational excellence throughout the nation. Its creation followed decades of systemic inequities that left children in disadvantaged communities without the same learning opportunities as their more privileged peers. The department’s work has been a critical safeguard against discrimination in schools, whether on the basis of race, disability, gender or income. 

    Without the federal government’s intervention and oversight, the more than 13 million children who live in poverty would be even more vulnerable to systemic inequities. The department ensures that federal dollars are distributed to those students most in need, ensuring that underserved children have the same opportunities for success as their wealthier peers. Without the federal oversight and the department’s support, these students will fall even further behind, and the national achievement gap will grow wider.

    The federal government is the only entity that can ensure a baseline level of educational equity across the entire nation. The department holds states accountable for ensuring that all children, regardless of where they live or what their socioeconomic status may be, receive a quality education. If this accountability is removed, the children most at risk — those in underfunded schools, children of color, children with disabilities, English learners and those experiencing homelessness — will be the first to suffer. These children would be denied the critical services and protections they need to succeed in school and in life.

    Moreover, the president’s plan to turn education policy over to the states would completely dismantle the federal safety net that ensures that the most vulnerable children are not left behind. Each of the 50 states has different priorities, resources and political climates. While some might be able to provide excellent educational opportunities, others will leave children behind, particularly in rural or economically disadvantaged areas. Inequities between states could widen to an intolerable degree, and the resulting lack of uniform educational standards would only further disadvantage the children who need the most help.

    To be clear, the department cannot be dissolved at the whim of a sitting president. Under the Constitution, only an act of Congress can create or dismantle a federal agency. The president does not have the unilateral power to eliminate an entire federal institution that serves the educational needs of millions of children across this country. Attempting to do so would not only undermine the law, but also inflict tremendous harm to the very foundation of America’s educational system.

    The idea that dismantling the department could somehow improve that system is not only misguided, but dangerously naïve.

    It’s vital that we, as a nation, recognize the long-term damage this action would cause. The attempt to dismantle the Department of Education is not just an attack on a government agency — it is an attack on the future of America’s children.

    To parents across the country: This policy is not only unconstitutional — it is a grave threat to your children’s future. Whether your child is in a classroom in New York, Los Angeles or a small town in the Midwest, the U.S. Department of Education has worked to ensure that their educational opportunities are protected, funded and regulated. A president who seeks to eliminate this essential agency is jeopardizing the future of every single student in America.

    This is why we must all rise up and make our voices heard. We must demand that our leaders stop this dangerous plan in its tracks, that they fix what isn’t working and that they use this opportunity to reimagine public education and invest in a more effective, equitable system that gives all children the opportunity to succeed.


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