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The full text of the Health and Human Services Systematic review can be found here.

Introduction

In our final post, we explore the systematic review’s findings on psychotherapy as an alternative to medical interventions for pediatric gender dysphoria, alongside international shifts in treatment approaches. The Department of Health and Human Services’ 2025 report (Chapter 14, pages 239-259) highlights the potential of non-invasive psychotherapy and the growing global retreat from medicalized care.

Key Findings on Psychotherapy and Global Trends

The review notes a significant gap in research on psychotherapeutic approaches for gender dysphoria, partly due to the mischaracterization of such treatments as “conversion therapy” (page 252). However, psychotherapy is a well-established, non-invasive method for managing mental health conditions, including those often co-occurring with gender dysphoria, like depression and anxiety (page 248). Systematic reviews have found no evidence of harm from psychotherapy in this context, unlike medical interventions, which carry significant risks (page 16).

Internationally, countries like Finland, Sweden, and the UK have shifted away from the “gender-affirming” model, prioritizing psychosocial interventions (pages 142-145). The UK’s Cass Review, for instance, found weak evidence for medical interventions and recommended psychotherapy as a first-line approach (page 63). These countries have restricted puberty blockers and hormones due to concerns about their safety and efficacy, reflecting a broader recognition of the need for caution (page 56).

Looking Forward

The rise in youth gender dysphoria coincides with a broader mental health crisis among adolescents, suggesting that social and psychological factors may play a significant role (page 239). Psychotherapy offers a way to address these underlying issues without the irreversible risks of medical interventions. As more countries adopt this approach, the U.S. faces pressure to align its practices with emerging evidence.

Three Arguments Against Transitioning Children

1. Psychotherapy as a Safer Alternative: Psychotherapy is a non-invasive option with no reported adverse effects in treating gender dysphoria, unlike medical interventions that risk serious harm (page 16).

2. International Restrictions Highlight Risks: Countries like the UK and Sweden have restricted medical interventions due to weak evidence and significant risks, suggesting a need for caution in the U.S. (page 56).

3. High Rates of Natural Resolution: The natural history of gender dysphoria shows that it often resolves without medical intervention, supporting the use of psychotherapy to explore identity without irreversible steps (page 21).

References

• Department of Health and Human Services. (2025). Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices, page 16.

• Ibid., page 56.

• Ibid., page 21.