As a lawyer who represents detransitioners like Chloe Cole in medical malpractice cases and parents fighting for the right to notice and consent before public schools may socially transition their children, I am all too familiar with how bad science gets laundered in pediatric gender medicine. For the record, a detransitioner is an individual who medically transitioned but now identifies and presents as their natal sex.
Activists take over medical associations (most notably, the World Professional Association for Transgender Health or WPATH) and use the imprimatur of those organizations to justify providing children with puberty blockers, cross-sex hormones, and even irreversible surgeries. The unreliability of much of the medical literature on pediatric gender medicine makes the U.S. Department of Health and Human Services’ recent report, Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices, a necessary development in the field.
Here are ten key takeaways from the review.
Children who receive puberty blockers to keep them in a pre-pubescent state longer have marked deterioration of bone health. One-third of patients’ bone density scores exhibit osteoporosis of the hip, while one-fourth have osteoporosis of the spine. A scientific review shows that the effect of puberty blockers on neurocognitive development is unknown, but there is “some evidence” that puberty blockers suppress children’s IQ scores. Females who receive testosterone experience vaginal atrophy and other concerning medical symptoms, including one study showing “100% of vaginectomy specimens contained abnormal prostatic tissue growth.” There is moderate and high certainty evidence of some incidence of “cardiovascular events” in women under twenty-six who received testosterone. If a male starts puberty blockers at Tanner Stage 2 (the initial stage of puberty) and goes on to take estrogen, he will almost always have the genitalia of a pre-pubescent or early puberty male. A Swedish study from 2011 found that adults who had medically and surgically transitioned had 19 times the rate of suicide deaths and nearly three times the rate of all-cause mortality and inpatient psychiatric care compared to peers of the same sex and age group. While the precise detransition rate is not known, a British study revealed that one-fifth of patients stopped hormone treatment within five years and that half experienced detransition or regret. American, British, Dutch, and Swedish researchers each examined the mortality rates among trans-identified individuals relative to the general population, and while the rates varied, each study found significant increases in mortality among trans-identifying people, with the Swedish study showing that a transgender individual faced a 2.8 times higher risk of death than their age- and sex-matched peers. The report concludes that it would be unethical to conduct a study on the effect of puberty blockers and cross-sex hormones on fertility because the “mechanism [of how this treatment interferes with fertility] is well-understood” and does not have to be established in a clinical trial. A 2025 JAMA Pediatrics study showed that between 2018 and 2022, one in one thousand (0.1%) of American seventeen-year-olds received cross-sex hormones. While this may seem like a small percentage, it is, in absolute terms, a large number of children.The review’s key points put the risks children face when undergoing transgender medical interventions in sharp focus. Do doctors explain to their minor patients that they may experience significant negative health outcomes years or even decades in the future? When children are warned, are they mature enough to appreciate the risk of long-term consequences? Are children asked to consider the possibility that they may not identify as transgender in the future? Are children led to examine how they might feel about the interventions they received if they do indeed detransition? (My work as a lawyer in detransition cases tells me the answer to all these questions is often “no.”)
Debates about pediatric transgender interventions have largely been framed in terms of politics (what are the major parties’ stances?), law (does the Constitution permit states to prohibit transgender interventions for children?), and even philosophy (what is a woman?). But the central question we all should be asking is whether these interventions work. HHS’s exhaustive review of the medical literature makes a compelling case that the medical risk to minors posed by puberty blockers, cross-sex hormones, and surgeries significantly outweighs any benefits these interventions might confer.
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Jesse Franklin-Murdock is the Miles Visiting Fellow at the Center for American Liberty and a counsel at Dhillon Law Group Inc., where his practice areas include political law and civil rights.
The views expressed in this piece are those of the author and do not necessarily represent those of The Daily Wire.
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