Health
Federal Report Denounces Gender Treatments for Adolescents
Federal health officials published a report on Thursday declaring that the use of hormonal and surgical treatments in young people with gender dysphoria lacked scientific evidence and expressing concern about long-term harms, a stark reversal from previous agency recommendations and the advice of top U.S. medical groups.
The report instead prioritized the role of psychotherapy, a divisive intervention to treat gender dysphoria that many advocates and physicians have equated with so-called conversion therapy.
Other parts of the review seemed to call into question the very notion that some people have a gender identity that does not align with their sex at birth.
In January, President Trump signed an executive order titled “Protecting Children From Chemical and Surgical Mutilation” giving the Department of Health and Human Services 90 days to produce a report on the best practices for treating young people who say their gender does not align with their birth sex.
But the order made it clear that the administration had already reached its own conclusion about gender transition treatments for minors, characterizing the “blatant harm done to children” as a “stain on our nation’s history.”
The 400-page report took a more sober tone but reached a similar conclusion. In a remarkable departure from the standard for medical evidence reviews, the authors were not identified pending a post-publication review process that would begin in “the coming days.”
H.H.S. officials declined to answer questions about what the review process would entail. The department noted that the contributors included doctors, medical ethicists and a methodologist, all from “a wide range of political viewpoints” who were chosen “for their commitment to scientific principles.”
The report specified that the new assessment was not intended to set a standard for medical care or to make policy recommendations.
It relied predominantly on an analysis of reviews of the scientific studies of puberty blockers, hormone therapies and surgeries that have been published in the last few decades, when these treatments were first made available to adolescents.
The assessment concluded that while the benefits of medical interventions were uncertain, the harms, which can include loss of fertility, were less so.
The “clinical practice in this field of medicine is exceptional and concerning,” the report said, and it criticized American medical groups for fostering intolerant work “environments in which clinicians feel compelled to self-censor.”
The question of whether and when treatments like puberty blockers, hormone therapies or surgery are appropriate for young people has been the subject of fierce debate.
Several European countries have limited the treatments in recent years, after scientific reviews finding poor quality of evidence to support their benefits and uncertainty about long-term risks.
In the United States, 24 states have passed laws barring physicians from offering such treatments to adolescents.
The American Academy of Pediatrics is conducting its own review of the evidence. The academy and most major medical groups in the United States continue to endorse these treatments as effective in relieving the psychological distress many transgender youths experience.
“This report misrepresents the current medical consensus and fails to reflect the realities of pediatric care,” said Dr. Susan Kressly, president of the academy. “The report prioritizes opinions over dispassionate reviews of evidence.”
Transgender rights advocates criticized the new assessment as seeking to paint over an ideological view with scientific gloss.
During Mr. Trump’s first 100 days in office, his administration has sought to limit recognition of transgender identities in public life. The administration has threatened to end funding for hospitals that provide gender-transition treatments to people under 19 and to bar openly transgender people from serving in the military.
The administration has moved to house transgender women in federal prisons with men and to no longer reflect the gender identities of transgender people on passports.
“Is the administration’s hostility to this medical care based on actual scientific research, or is it ideologically driven by this administration’s open disapproval of transgender people and belief that transgender identity is false?” said Shannon Minter, legal director at the National Center for Lesbian Rights.
The center represents transgender individuals in several lawsuits challenging the constitutionality of the administration’s policies.
Casey Pick, director of law and policy at the Trevor Project, a nonprofit organization focused on suicide prevention among L.G.B.T.Q. young people, said, “To the extent that this is a document that is challenging even the ability of a young person to identify as transgender, that is an ideological statement — that is not a medical statement.”
The report is a victory for those who have described this field of medicine as part of a broader project that denies the realities of biological sex.
Roger Severino, vice president for domestic policy at the Heritage Foundation, a conservative think thank, applauded the H.H.S. report and blamed “profit-seeking doctors and ideological groups” for persuading families that “a child’s sex is whatever they say it is.”
About 3 percent of high school students identify as transgender, according to government data, a number that has risen substantially over the last decade. A much smaller percentage of those adolescents seek medical interventions.
The issue of medical transition for minors has nonetheless become a political flashpoint. Mr. Trump made it a focus of his campaign, and some Democrats believe the strategy helped him win.
The new H.H.S. report goes further than similar reports in European countries that have introduced new restrictions on gender treatments for adolescents.
An independent review of clinical services for young people in England, led by Dr. Hilary Cass, former president of the Royal College of Pediatricians, reached similar conclusions about the quality of evidence to support the use of puberty blocking and hormonal treatments in minors. (Surgeries are not available for minors in Britain.)
But that review, conducted over a four-year period, interviewed young patients, transgender adults, parents and clinicians to gain a broad picture of the medical field.
Dr. Cass concluded that the evidence on both the benefits and the risks of the treatments was “remarkably weak” but said that some young people were still likely to benefit from early intervention.
“There are young people who absolutely benefit from a medical pathway, and we need to make sure that those young people have access — under a research protocol, because we need to improve the research — but not assume that that’s the right pathway for everyone,” Dr. Cass said in an interview last year.
That review concluded by recommending that England’s National Health Service restrict the use of puberty blocking drugs to research trials only, and clinicians were advised to prescribe hormones to teenagers with “extreme caution.”
Other clinicians who have voiced concerns about the field of youth gender medicine were ambivalent about how the new report might be used.
“I am glad that authorities in the United States are finally taking into account what’s been going on in Europe in recent years,” said Erica Anderson, a child psychologist and former president of the U.S. Professional Association of Transgender Health.
She has been vocal about her concerns that youth gender clinics have moved away from careful mental health assessments as the population of children seeking gender treatments has grown.
But Dr. Anderson, who still supports early intervention for some young people, noted that it was impossible to ignore the inflammatory executive order that led to the report.
“It’s kind of like calling out to someone a rank insult and then deciding you want to have a conversation with them,” she said. “Well, that doesn’t really work very well with actual human beings with feelings and histories.”
Mr. Minter, of the National Center for Lesbian Rights, said that by emphasizing psychotherapy over medical interventions, the H.H.S. report effectively endorsed conversion therapy, intended to change a minor’s gender identity or sexual orientation.
Leading medical groups have supported bans on the practice, citing evidence that it causes depression, anxiety and self-hatred.
But the Supreme Court has agreed to hear a First Amendment challenge to a Colorado ban on conversion therapy next term, brought by a licensed professional counselor whose Christian faith includes the belief that “people flourish when they live consistently with God’s design, including their biological sex,” according to court documents.
Other therapists, including Dr. Anderson, have argued that so-called “exploratory” therapy with supportive clinicians can be helpful for helping to disentangle mental health issues from gender identity for adolescents.
Kellan Baker, who studies transgender health policy at Whitman Walker, a nonprofit community health center in Washington, said the report was a departure from how health policy had typically been shaped in the United States.
“It is important that medicine be practiced by those with expertise in it, by trained clinicians operating according to standards of care that are set out by their respective medical fields — not by the federal government,” Dr. Baker said.
He said he worried that the report might be cited by the government as justification for refusing to cover medical care for transgender young people.
The Centers for Medicare and Medicaid Services, a division of H.H.S., sent a letter to state Medicaid agencies last month urging them not use Medicaid funds for gender-transition care for minors.
Pam Bondi, the attorney general, has directed the Justice Department to investigate doctors who provide such care.
“This document is not a standard of care, but it’s going to be cited by the government as justification for refusing to cover medical care for transgender young people,” Dr. Baker said.
new video loaded: Trump Pushes Unproven Link Between Tylenol and Autism
By Azeen Ghorayshi, Claire Hogan, Theodore Tae and June Kim•
Top U.S. health officials urged pregnant women not to use acetaminophen, the active ingredient in Tylenol, claiming it could cause autism, though studies have been inconclusive. Azeen Ghorayshi, a science reporter for The New York Times, explains.
NEWYou can now listen to Fox News articles!
Monday’s sweeping autism announcements have sparked deeper conversations about the widespread neurological disorder.
Health officials spoke during a press conference in Washington, D.C., about possible causes, vaccine guidance and the potential for a cancer drug to double as an autism therapy.
Autism diagnoses have been steadily rising in recent decades, according to the Centers for Disease Control and Prevention.
AUTISM SPECTRUM IN ADULTS HAS COMMONLY OVERLOOKED SYMPTOMS, EXPERTS WARN
“In the 1970s, autism was considered rare, perhaps 1 in 5,000 to 10,000 children,” Steven Quay, M.D., Ph.D., a physician-scientist and founder of Atossa Therapeutics in Seattle, Washington, told Fox News Digital.
In the year 2000, an estimated one in 150 children aged 8 had the disorder. By 2010, that number had risen to one in 68 — and by 2022, one in 31 children were diagnosed.
Autism diagnoses have been steadily rising in recent decades, according to the Centers for Disease Control and Prevention. (iStock)
“Autism is no longer an uncommon condition tucked away in psychiatric textbooks,” said Quay. “It is part of the daily fabric of schools, clinics and families everywhere.”
Dr. Aggie Papazyan, a Los Angeles-based psychologist specializing in autism spectrum disorder, noted that autism prevalence has also increased globally.
CANCER DRUG COULD DOUBLE AS AUTISM THERAPY, AND IS POISED FOR FDA APPROVAL
“These rates vary by region,” she told Fox News Digital. “In many places, especially in higher-income settings with more robust diagnostic and health resources, prevalence estimates have gone up.”
She added, “However, it’s important to note that how autism is measured makes a big difference.”
Awareness vs. epidemic
The CDC has noted that improved identification of autism could be part of the increase, but that other factors could also come into play.
Decades ago, many autistic people were “missed, misdiagnosed or labeled differently,” said Papazyan.
“There doesn’t seem to be a sudden surge in biological incidence.”
“Over time, as awareness has grown, diagnostic definitions expanded and screening became a bit more routine — so it’s not a surprise to see more autism diagnoses,” she said.
“The biggest misconception is that rising numbers mean autism itself is suddenly becoming more common,” the expert went on. “That’s scary to some people, but there’s no new autism ‘epidemic.’”
Experts say more funding is needed for early intervention programs, such as speech, occupational and behavioral therapies. (iStock)
Most of the increase, according to Papazyan, is due to earlier intervention, broader diagnostic criteria and improved access to services.
“There doesn’t seem to be a sudden surge in biological incidence,” she added. “There may still be a true rise, but it’s not as dramatic as many people want to think.”
Quay said it would be “naïve” to assume that the rise is due only to better detection, and said that environmental change also plays a role.
“Fifty years ago, many individuals on the spectrum were mislabeled — sometimes as intellectually disabled, sometimes as ‘eccentric’ or ‘odd,’ but I do not believe this accounts for the entire increase,” he said.
To counter the rising autism diagnoses, experts call for increasing awareness and acceptance while reducing stigma. (iStock)
“Environmental influences, from prenatal exposures to changes in maternal health to shifts in early childhood experiences, likely play some role.”
‘Urgent need’
To counter the rising autism diagnoses, Papazyan is calling for increasing awareness and acceptance while reducing stigma, as this affects how resources are allocated.
“Beyond that, we need to expand diagnostic and assessment services, especially in underserved communities, so that people are properly diagnosed and given the care they need,” she said.
Papazyan said more funding is also needed for early intervention programs, such as speech, occupational and behavioral therapies.
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The experts also agreed that support is needed for autistic people as they get older, including mental health services, financial assistance and life skills development.
“Interventions are needed that go beyond childhood, because autistic adults will spend most of their lives outside the school system, yet services for them are almost nonexistent,” said Quay.
“Fifty years ago, many individuals on the spectrum were mislabeled.”
Looking ahead, Papazyan predicts that autism prevalence will continue to increase over the next few years before it slows down and eventually hits a plateau.
Quay also expects that prevalence will continue to rise in the near term, largely due to improvements in detection and “societal willingness to diagnose.”
For more Health articles, visit www.foxnews.com/health
“Whether there is a biological plateau remains to be seen,” he said. “If environmental contributors are identified and mitigated, we could see stabilization.”
For decades, as an activist, Robert F. Kennedy Jr. resisted the scientific consensus that vaccines are safe and necessary to prevent serious disease. Now at the helm of the nation’s health department, he has begun to put his extreme views into practice, ousting veteran scientists and installing allies across the nation’s health agencies to enact major shifts in vaccine policy.
Some of Mr. Kennedy’s hires are activists who have worked for years alongside him. Others are scientists who say they broadly support vaccines but publicly criticized Covid shots or mandates during the pandemic. Many of these scientists have begun to question the safety or value of other shots, reflecting the views of Mr. Kennedy. The following account is based on previous statements made by these officials and on interviews with current and former health agency leaders.
F.D.A. chief medical and scientific officer
Critical of Covid boosters and shots for healthy kids
F.D.A. commissioner
Skeptical of certain vaccines
Dr. Vinay Prasad
Dr. Marty Makary
The agency’s new vaccine lead and chief medical officer, Dr. Vinay Prasad, has called himself an “extreme pro-vaccine person,” and Dr. Marty Makary, the agency’s commissioner, said last week that “we believe in vaccines.”
But the two officials, who sharply criticized vaccine mandates as academic researchers during the pandemic, have expressed doubts about the safety and necessity of Covid boosters for healthy children and adults. This summer, Dr. Prasad overrode some agency scientists who favored widespread access to Covid shots, narrowing the vaccine’s eligibility to those 65 and older and to younger people with underlying medical conditions.
Last week, Dr. Makary echoed the views of Mr. Kennedy when he publicly questioned the longstanding recommendation to give the hepatitis B vaccine at birth. That shot is credited with nearly eliminating the transmission of the disease from mother to infant.
Dr. Prasad replaced a veteran at the agency, Dr. Peter Marks, who resigned in March and said that Mr. Kennedy’s aggressive stance on vaccines posed a danger to the public.
In June, Mr. Kennedy fired all 17 members of a powerful C.D.C. expert panel, the Advisory Committee on Immunization Practices. Insurance companies and government programs like Medicaid are required to cover the vaccinations that the panel recommends.
Mr. Kennedy handpicked eight new members that month, half of whom had expressed skepticism of vaccines at some point. (One has since stepped down.) Others have little expertise in immunology or vaccines.
On Monday, Mr. Kennedy appointed five more members, just days before the group meets to review recommendations for multiple vaccines. Some of the newly selected members have been critical of Covid vaccines or vaccine mandates.
Dr. Robert Malone is a controversial figure. He performed early experiments using mRNA in the 1980s but gained notoriety during the pandemic for claiming that Covid vaccines were unsafe, contradicting volumes of studies.
Martin Kulldorff, a biostatistician, has been generally supportive of vaccines but opposed Covid vaccination for children and vaccine mandates. Vicky Pebsworth, a nurse with a doctorate in public health, serves on the board of the National Vaccine Information Center, a nonprofit that disseminates misinformation about the risks of vaccination.
Dr. Malone and Dr. Kulldorff have served as paid expert witnesses in legal cases against vaccine makers. Dr. Pebsworth claimed in a lawsuit that a survey of families of unvaccinated children supported a hypothesis that a rise in the number of recommended childhood vaccines explained an epidemic of chronic disease.
Another panel member, Retsef Levi, is a management and health analytics expert at the Massachusetts Institute of Technology. He has been critical of a variety of vaccines and has called for Covid vaccines to be pulled from the market.
Dr. Evelyn Griffin, an obstetrician and gynecologist, questioned the safety and effectiveness of Covid vaccines in a hearing in the Louisiana House of Representatives in 2021. Dr. Kirk Milhoan, a pediatric cardiologist, questioned the safety and effectiveness of Covid vaccines at a 2024 event led by Representative Marjorie Taylor Greene, Republican of Georgia. Catherine M. Stein is an epidemiology professor who in 2022 called for an end to Covid vaccine mandates at universities.
Dr. Cody Meissner is a professor of pediatrics who opposed vaccine mandates and has questioned the ongoing need for Covid vaccines for children and pregnant women. He previously served on the advisory committee and is widely considered to be the most qualified member.
The others are not known to have spoken out against vaccines. They are Dr. Joseph R. Hibbeln, a nutritional neuroscientist; Dr. James Pagano, an emergency medicine physician; Hillary Blackburn, a pharmacist; and Dr. Raymond Pollak, a surgeon and transplant specialist.
The C.D.C. director has the power to accept or reject the immunization committee’s recommendations. The current acting director is Mr. Kennedy’s deputy at the Department of Health and Human Services, Jim O’Neill, a former biotechnology executive. The previous director, Susan Monarez, said she was forced out because she would not agree to accept the newly re-formed committee’s recommendations.
A special adviser to the C.D.C. director, Stuart Burns, is a critical player driving the health secretary’s agenda at the agency. Mr. Burns has been quietly working to remake the immunization committee and its agenda.
Mr. Burns is not a scientist but he worked for decades as a staff member for Republican congressmen known for their vaccine skepticism. One is Dr. Dave Weldon, a former representative from Florida who was also Mr. Kennedy’s original choice for C.D.C. director. The White House withdrew Dr. Weldon’s nomination just hours before his confirmation hearing because some Senate Republicans were concerned about his stance on vaccines.
Mr. Burns works closely with three other Kennedy hires who serve H.H.S. but also work closely with the C.D.C. Dr. Reyn Archer is a former Texas health commissioner who has questioned the safety and value of the Covid vaccine on social media. He serves as a liaison between the health secretary’s office and the C.D.C., and has been helping Mr. Burns to develop and guide the immunization committee.
David Geier is a steadfast figure in the anti-vaccine movement who has spent more than 20 years trying to establish a link between vaccines and autism, despite scientific consensus that there is none. Mr. Geier, who is listed as a senior data analyst in the H.H.S. directory, was given access to federal data on post-vaccination side effects and is using it to continue his studies on autism.
Lyn Redwood is a nurse practitioner and the former head of Children’s Health Defense, the anti-vaccine group founded by Mr. Kennedy. Since the early 2000s, Ms. Redwood has criticized the use of mercury as a preservative in vaccines. She has said she believes the ingredient is linked to her son’s autism.
Now listed as an expert at H.H.S., Ms. Redwood gave a presentation in June to the immunization committee, a role usually reserved for C.D.C. scientists. She said that the mercury preservative in vaccines, known as thimerosal, was toxic to children, even though dozens of studies have shown it is harmless in this form. The panel later voted to stop recommending the already limited number of flu vaccines that contained the preservative.
Principal deputy director of the N.I.H.
Skeptical of certain vaccines
N.I.H. director
Critical of Covid vaccine mandates
Dr. Matthew Memoli
Dr. Jay Bhattacharya
Dr. Matthew Memoli is a veteran infectious disease scientist at the National Institutes of Health who now serves as its principal deputy director. As a senior researcher under Dr. Anthony Fauci during the pandemic, Dr. Memoli opposed Covid vaccine mandates and declined to get a shot himself.
Since becoming a leader of the research agency, Dr. Memoli has downplayed the value of vaccines for certain respiratory diseases, according to the whistle-blower complaints of two prominent scientists.
Dr. Jay Bhattacharya, the N.I.H director, sharply criticized vaccine mandates as an academic researcher during the pandemic. He co-wrote an anti-lockdown treatise in 2020 with Dr. Kulldorff, one of Mr. Kennedy’s selections for the C.D.C. immunization committee.
During his confirmation hearing in March, Dr. Bhattacharya reiterated his support for childhood vaccinations for diseases like measles. He also said he was “convinced” vaccines did not cause autism, even as he urged more research on the question, which scientists say has long been settled.
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