The text of the full report can be found here.
Introduction
The treatment of gender dysphoria in children and adolescents has become a highly debated topic. A recent report from the Department of Health and Human Services (May 1, 2025) provides a comprehensive review of the evidence behind these treatments. This first post in our series explores the overall findings of the systematic review, highlighting the quality and limitations of the evidence for medical interventions like puberty blockers, cross-sex hormones, and surgeries.
Key Findings from the Systematic Review
The report’s “umbrella review” (Chapter 5, pages 77-96) evaluated existing systematic reviews to assess the benefits and harms of treatments for pediatric gender dysphoria. The findings are striking: the evidence supporting these interventions is of very low quality. This means that claims about their benefits—such as improved mental health or quality of life—are uncertain and may differ significantly from the true effects. Studies often lack rigorous methodology, with issues like small sample sizes, short follow-up periods, and potential publication bias (page 103) clouding the results.
For example, the review found that studies claiming benefits from puberty blockers or hormones, such as de Vries et al. (2011, 2014) and Tordoff et al. (2022), are short-term and observational, lacking the robustness of randomized controlled trials (pages 98-101). These studies often fail to account for confounding factors like concurrent mental health treatment, making it hard to attribute outcomes solely to medical interventions. Additionally, the review notes a lack of systematic tracking of harms, which may underreport risks like infertility or bone density issues (page 13).
What This Means
The low-quality evidence raises serious questions about the widespread use of medical interventions for children with gender dysphoria. Without clear data on long-term outcomes, families and clinicians face uncertainty when making decisions. This gap in evidence has led countries like the UK to restrict puberty blockers, prioritizing psychosocial approaches instead (page 13).
Three Arguments Against Transitioning Children
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Insufficient Evidence of Benefit: The systematic review found that the evidence for psychological benefits from puberty blockers, hormones, or surgeries is very low quality, with studies often biased or inconclusive (page 13). This uncertainty makes it risky to pursue invasive treatments with unproven efficacy.
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Significant Risks of Harm: Medical interventions carry serious risks, including infertility, sexual dysfunction, impaired bone density, and potential cognitive impacts (page 14). These risks are particularly concerning for children, whose bodies and minds are still developing.
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Natural Resolution of Gender Dysphoria: Research suggests that gender dysphoria often resolves without intervention in many cases, especially when untreated (page 21). Medical transition may disrupt this natural process, leading to irreversible changes for children who might otherwise reconcile with their bodies.
References
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Department of Health and Human Services. (2025). Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices, page 13.
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Ibid., page 14.
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Ibid., page 21.
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3 comments
May 26, 2025 at 6:04 am
tildeb
It’s important to understand the numbers for the third point point: about 9 out of every 10 cases of ‘gender incongruity’ resolve through puberty AND the suicide rate is LOWER than for those who start the process of transitioning (nearly 100% of people who start puberty blockers go on to take opposite sex hormones with all the medical risks directly attached to doing so).
Committing to exercise medicalized ‘gender care’ as practiced today is a travesty in every sense of the word. It must be considered a leading candidate defining what medical malpractice looks like in action. And most of it targets vulnerable children. This is unconscionable.
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May 26, 2025 at 8:33 am
The Arbourist
@Tildeb
Disputing these harmful practices should be easy, the medical evidence is becoming quite clear on the issue. Yet, we have to continue to push the rock of truth up bullshit mountain because people understand and defend emotional narratives to a much greater degree than evidence and facts.
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May 26, 2025 at 9:30 am
tildeb
The age of ‘vibes’ redefined as only in agreement are we being ‘kind’.
From gender care affirming Dr Leibowitz:
“A discussion about the complexity and ethical debate on gender care can only take seriously take place between people when both parties agree on the following—this is my opinion—that gender identity is a real and valid concept that is distinct from assigned sex, although overlapping, very complexly intertwined, but a distinct concept. Variations in alignment between the two are not inherently rooted in delusion, and often correcting that alignment with evidence-based medicine can improve people’s lives.
If the two parties talking cannot agree on this paragraph, you’re then talking past each other.”
This is the babble driving the vibe, bereft of physiological definition of what gender is or means, attempting to justify chemical and surgical intervention on a real body for the benefit of improving ‘mental health’ supposedly ’caused’ by gender incongruity. But it requires belief in gender as if a real thing and that we can be born in the ‘wrong’ body. This is neither science nor medicine. It is belief. And so emotion is attached to it that inserts morality in order to pretend questioning any of this makes one an unbeliever, someone who by this definition must therefore be ‘unkind’.
From a commentator who ‘fixes’ this paragraph by replacing gender with religious belief:
“A discussion about the complexity and ethical debate on the middle east can only seriously take place between people when both parties agree on the following—this is my opinion—that there is only one God, who is a real and valid concept that is distinct from any other gods, although overlapping, very complexly intertwined, but a distinct concept. Variations in alignment between the two are not inherently rooted in delusion, and often correcting that alignment with coercion and gas-lighting can improve our perception of other people’s lives.
If the two parties talking cannot agree on this paragraph, you’re then talking past each other.”
It’s the same reasoning. And defence of it uses the same tactics of any other religious apologetics. Such belief in gender as if a thing rather than ethereal brought into being by belief alone is magical thinking accompanied by the same intolerance of disagreement held by fundamentalist believers. Defence is attempting to wear the language of science and evidence and medicine for cover and disguise its lack of these elements. That’s why ‘medicine’ attributed to ‘gender care’ is straight up quackery that causes real harm to real people in real life.
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