The Evidence Gap in Pediatric Gender Medicine
As debates continue in Ohio and across the country about medical interventions for children experiencing gender dysphoria, it’s essential to cut through the noise and return to one simple question: What does the best evidence actually show?
Last week, the US Department of Health and Human Services (HHS) published Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices, which examines the medical interventions being used on children with gender dysphoria. The report reinforces what growing international evidence has already shown: the harms from sex-rejecting procedures are significant, long-term, and too often ignored or inadequately tracked.
Medical care should be evidence-based, ethical, and worthy of the public’s confidence—especially for children. pic.twitter.com/iP3xccfuBt
— HHS (@HHSGov) November 19, 2025
To create the report, |the HHS commissioned the most comprehensive review to date of the scientific evidence and clinical practices surrounding pediatric gender dysphoria.
The authors, experts in medicine, psychology, bioethics, and philosophy, conducted a comprehensive review of the available studies before submitting the report for peer review.
Top federal health leaders did not mince words. Health and Human Services Secretary Robert F. Kennedy, Jr. stated,
“The American Medical Association and the American Academy of Pediatrics peddled the lie that chemical and surgical sex-rejecting procedures could be good for children. They betrayed their oath to first do no harm, and their so-called ‘gender-affirming care’ has inflicted lasting physical and psychological damage on vulnerable young people. That is not medicine — it’s malpractice.”
National Institutes of Health Director Jay Bhattacharya, MD, PhD, called the report “a turning point for American medicine,” noting that the evidence “The evidence in it meticulously documents the risks the profession has imposed on vulnerable children.”
And Assistant Secretary for Health Brian Christine, MD, issued a sobering warning:
“What are we going to tell the young people who can’t have children because the medical profession stole that from them? Our report is an urgent wake up call to doctors and parents about the clear dangers of trying to turn girls into boys and vice-versa.”
The report undertakes a broad evidence review of interventions for children and adolescents with gender dysphoria, such as puberty blockers, cross-sex hormones, and surgical procedures, and forms the basis for the findings outlined below.
⚠️ The Evidence of Benefit Is Critically Weak
Despite common claims, the highest-quality reviews show very low certainty that puberty blockers, cross-sex hormones, or surgeries meaningfully improve the outcomes that matter most, such as resolving gender dysphoria, improving mental health, or reducing suicidal ideation. In other words, the promises made to parents simply aren’t backed by solid science.
🛑 Children Face Serious and Irreversible Physical Risks
What is well-documented are the serious, lifelong consequences. These interventions can leave a child permanently infertile, interfere with normal sexual development, and weaken bone health in ways that can never be reversed or repaired. Families deserve to grasp the full gravity of these risks before any child is set on a medicalized path.
📉 Surgery Brings Its Own Unique Harms
In cases where minors undergo mastectomies or “bottom surgery” on their genitals, the procedures remove healthy organs and introduce iatrogenic harm (damage created by the medical intervention itself). For young girls, this includes the permanent loss of the ability to breastfeed later in life.
🔍 Major Guidelines Are Under Serious Scrutiny
At the same time, questions are being raised about the integrity of influential guidelines such as WPATH’s Standards of Care. Investigations have uncovered significant methodological flaws, unmanaged conflicts of interest, and even internal documents showing that language was shaped for political and legal advocacy rather than clinical clarity. Families trust these organizations to provide neutral, evidence-based guidance, yet the record shows the opposite.
Studies claiming these interventions do help kids don’t hold up to serious analysis. Many rely on small sample sizes, lack proper control groups, or track patients for only a short time. With evidence this weak, it’s impossible to know whether the treatments themselves are responsible for any reported improvements.
🧪 Procedures Increasingly Viewed as Experimental Care
Because of the uncertainty surrounding long-term outcomes and the very real risk of harm, countries across Europe, including Finland, Sweden, and the UK, have significantly restricted PMT and now treat pediatric medical transition as an experimental process. Several have moved these interventions out of standard practice and into tightly controlled research settings.
Protecting Ohio’s Children
This new federal report only underscores why Ohio took decisive action last year to protect minors from experimental, irreversible interventions. CCV was honored to help lead the charge in passing House Bill 68 (HB68), the Save Women’s Sports Act and Saving Adolescents from Experimentation (SAFE) Act, which finally became law after the legislature overwhelmingly overrode Governor DeWine’s veto. HB68 ensures that children are not placed on a medicalized path of puberty blockers, cross-sex hormones, or surgeries before they are old enough to understand the lifelong consequences.
The national legal landscape has also shifted. In the Skrmetti case, the US Supreme Court affirmed that states can regulate these interventions. The Court held that such laws are constitutional because they distinguish based on age and medical use, not sex, and therefore do not violate Equal Protection. This ruling sends a clear message: states have the authority to prioritize child safety and regulate high-risk medical procedures.
Ohio now stands at a critical juncture. Moe v. Yost, the challenge to HB68, is currently before the Ohio Supreme Court. After a lower court blocked the law under the Health Care Freedom Amendment and parental-rights claims, the State of Ohio asked the high court to uphold HB68 and reverse that decision. The Court has temporarily stayed the lower court's ruling, meaning HB68 is enforceable while the case proceeds.
In October, Ohio Attorney General Dave Yost filed written arguments urging the Ohio Supreme Court to uphold HB68 in the case Moe v. Yost. The brief argues that the lower appellate court erred in granting parents or advocacy groups the right to direct high-risk medical interventions for minors. The Attorney General’s office is defending the law while the appeal is pending, and the decision to stay the lower court’s injunction means HB68 is currently enforceable.
With the US Supreme Court having already affirmed state regulatory power in this domain, Ohio’s trajectory could set an important precedent for other states.
The coming decision will shape how Ohio courts interpret state-level protections for children, and how they balance parental rights, constitutional claims, and the state’s responsibility to regulate high-risk medical practices. And now, with the US Supreme Court affirming that states may step in to protect minors, Ohio is on firm legal footing.
CCV will continue to stand with parents, protect children, and defend the truth. HB68 was an important victory, and we are grateful to HHS for its diligent work in bringing a scientific eye to politicized medical practices. Our work is not finished. We will stay engaged at every step to ensure Ohio remains a place where children are protected, not experimented on.
For more information, contact CCV at 513-733-5775 or contact@ccv.org. For media inquiries, email media@ccv.org.
As Ohio's largest Christian public policy organization, Center for Christian Virtue seeks the good of our neighbors by advocating for public policy that reflects the truth of the Gospel.
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