On 1 May 2025, the US Department of Health and Human Services (HHS) released their report on trans youth treatment, as mandated by US President Donald Trump’s 28 January 2025 Executive Order “Protecting Children from Chemical and Surgical Mutilation” (link goes to archive.org mirror from the same day). The report has already been critiqued in detail by Erin Reed at Erin in the Morning and Evan Urquhart at Assigned Media. The report is noted as being filled with inaccuracies, substituting opinion and supposition for research and evidence. This is besides the numerous apparent editing and spelling errors throughout, speaking to the speed and potentially haphazard nature with which it was compiled.
The authors of the reports are as yet unknown, similar to how the UK Cass report was released without a list of authors (although the authors of one appendix were uncovered later by WTT). Quickly after the report was released, however, Florence Ashley, a jurist, bioethicist, and associate professor at University of Alberta, Canada, revealed on their BlueSky account that the names of Alex Byrne, Blake Sanchez, and John Koenig can be found within the XML metadata for “creator” for each of the three files of the report. Details on these individuals, as well as their involvement with the documents, are as of yet unclear.
Within 48 hours of the HHS report being released, several medical organizations released their responses to it. A joint response from six major US physician groups, while released due to the HHS report, addresses broader issues with how medical care is being treated under the current US administration. In contrast, the American Academy of Pediatrics and USPATH/WPATH reponses address the report directly, citing specific issues.
Joint Statement by US Medical Bodies
To begin with, on 1 May, the American Academy of Family Physicians, American Academy of Pediatrics, American College of Obstetricians and Gynecologists, American College of Physicians, American Osteopathic Association, and American Psychiatric Association released a joint statement entitled “Leading Physician Groups Oppose Infringements on Medical Care, Patient-Physician Relationship”. The response opens with the following paragraph:
“Our organizations, representing nearly 600,000 physicians and medical students, firmly believe the trusted relationship between a physician and their patient should never be jeopardized by the actions of policymakers, that physicians should not be criminalized or penalized for providing care and that medical standards of care and physician training and education must remain evidence-based and free from political interference.”
The statement continues by pointing out that the organizations have continued to oppose governmental actions that would interfere with the patient-physician relationship, or jeopardize access to evidence-based medical care, training, and education. They further object to the politicization of medical care, while voicing their support for their members.
WTT reached out to and received responses from several of the organizations involved in the statement and were told that the statement itself, while written to apply more broadly to recent government actions, was indeed triggered by the HHS report, despite not naming the report directly.
American Academy of Pediatrics Statement
On the same day, the American Academy of Pediatrics (AAP) issued their own response in addition to coauthoring the statement above. In their individual release, they specifically address the HHS report and its potential impact.
Entitled “AAP Statement on HHS Report Treatment for Pediatric Gender Dysphoria” and authored by AAP president Dr. Susan J. Kressly, the statement notes that the HHS report “misrepresents the current medical consensus and fails to reflect the realities of pediatric care.”
Drawing a comparison with recent moves away from encouraging immunizations, it notes that the report is “bypassing medical expertise and scientific evidence” which can have “real consequences for the health of America’s children”. The statement also reveals that the AAP “was not consulted in the development of this report, yet our policy and intentions behind our recommendations were cited throughout in inaccurate and misleading ways.” It goes on to state that the report “prioritizes opinions over dispassionate reviews of evidence,” and like the joint statement asserts that decisions about patient care are best left to patients, families, and physicians, “not politicians or government officials”.
WPATH/USPATH Statement
On 2 May, WPATH/USWPATH issued their statement (PDF), entitled “WPATH and USPATH Response to the HHS Report on Gender Dysphoria”. Like other statements, it notes that the HHS report “misrepresents existing research and disregards the expertise of professionals who have been working with transgender and gender-diverse youth for decades” and “fails to meet established scientific standards”. It goes on to say that “the report dismisses multiple international clinical guidelines and disregards the prevailing medical consensus on gender-affirming care.”
Regarding gender-affirming care in general, the statement explains that it “is backed by rigorous research, expert consensus, and patient-centered values” and that ”[s]tudies consistently show its positive impact, including improved mental health and overall quality of life.”
While the statement rejects the HHS report’s assertion that psychotherapy is the only treatment option that should be considered for youth with gender dysphoria, it also takes issue with the report’s claim that WPATH sees psychotherapy as being conversion therapy outright. It corrects this by stating that WPATH “supports a comprehensive, multidisciplinary assessment,
ensuring that mental health professionals evaluate and address any co-occurring mental
health conditions in youth who are exploring their gender identity and options for
treatment.” It then goes on to reaffirm the importance of clinical guidelines such as those outlined in WPATH’s Standards of Care Version 8 while cautioning about the damage that halting research funding and banning gender-affirming interventions can have.
HHS Report’s Focus on “Exploratory Psychotherapy”
As discussed by Erin Reed, the HHS report advocates for “exploratory psychotherapy”. This practice is noted for keeping any form of transition care out of reach while continually “exploring” potential causes for the patient’s transness rather than taking it as a given (see Florence Ashley’s 2023 article for more information). While promoters deny that it is conversion therapy and claim the method has “no fixed outcomes”, Reed notes how groups that promote it also consistently oppose bans on conversion therapy while taking other actions that undermine their assertions of outcome neutrality. Casey Pick of the Trevor Project, quoted in a Time Magazine article on the HHS report, also stated that “[d]espite the report’s claims, this is, in fact, the same harmful practice of conversion therapy, just using friendlier language.” Advocating for so-called exploratory therapy is a stance shared with, or perhaps even borrowed from, the UK Cass Review, which similarly advocates for an “exploratory” approach before other treatment options are considered (see this Trans Safety Network article for more analysis).
If, as critics have expressed, so-called “exploratory” therapies are tantamount to conversion practices, the impact this could have on trans youth is likely to be large. A 2020 study in the American Journal of Public Health linked experience with conversion practices to increases in suicidality among LGBTQ youth. Another more recent study released on 6 May 2025 on JAMA Open Network shows a potential link between conversion therapy exposure and cardiovascular disease risk. This should come as no surprise, given the known impacts of minority stress on individuals. However, evidence specifically linking conversion practices to both physical and mental health issues continues to emerge.
(Photo by Tim Mossholder on Unsplash)
