EXCLUSIVE — Senate Republicans are demanding answers from leading children’s health organizations in the United States regarding their standards of care for medical gender transition for minors in light of the international controversy over the quality of evidence supporting so-called “gender-affirming” care for youth with gender dysphoria.
Sen. Bill Cassidy (R-LA), the top Republican on the Senate Health, Education, Labor, and Pensions Committee, sent inquiries Wednesday evening to three of the leading medical associations issuing guidance in the U.S. regarding the standards of care for medically transitioning minors with gender dysphoria.
The Endocrine Society, the American Academy of Pediatrics, and the World Professional Association for Transgender Health each have recommendations for the use of puberty blockers, cross-sex hormones, and surgical procedures to medically transition minors and are the largest influences in advocacy for youth gender transition medicine.
“The public must be properly informed on the scientific evidence your organization relies on, especially since these guidelines have the potential to influence physicians and patients, including minors,” Cassidy wrote to the organizations, according to the letters obtained by the Washington Examiner.
According to the medical advocacy organization Do No Harm, which lobbies against transgender medical procedures, more than 8,500 minors received puberty blockers or cross-sex hormone therapies between 2019 and 2023 in the U.S.
During that same period, more than 5,700 minors underwent sex change surgeries in U.S. hospitals.
Cassidy wrote to the heads of the Endocrine Society, the AAP, and the WPATH, saying that each “must answer for its failures given its oversized impact on children and young adults seeking gender transition procedures.”
Although certain physician groups have begun questioning the provision of transgender procedures for minors in the U.S., much of the movement against gender transition medicine for minors has come from the European countries that pioneered the procedures, including Scandinavian states and the United Kingdom.
The British National Health Service suspended the use of puberty blockers and cross-sex hormone therapies for minors earlier this year following the production of a nearly 400-page comprehensive review of medical evidence for the procedures, conducted by renowned British pediatrician Hilary Cass.
The Cass Review final report found that there has been a lack of high-quality evidence to support the use of puberty blockers and cross-sex hormones for minors, including insufficient support for the positive or negative effects on mental health, physical health, and cognitive development into adulthood.
The Cass report also highlights that there is a high amount of circularity in the citations of research supporting the efficacy and safety of transgender medicine for minors.
In terms of standards of care guidelines, this translates to a process among the three organizations that Cassidy describes as “adopting, cosponsoring, and providing input” in one another’s guidelines.
“While collaboration among medical organizations is commonplace, here organizations are adopting policies developed without scientific rigor, which will cause harm to patients,” Cassidy wrote.
Cassidy also noted in his letter to the WPATH undue interference from officials at the Department of Health and Human Services in the creation of the WPATH’s formal 2022 Standards of Care guidelines, which were assented to by both the AAP and the Endocrine Society.
Documents uncovered in a lawsuit against state-level bans on gender transition medicine for minors revealed that staff members for HHS Assistant Secretary for Health Rachel Levine, who identifies as a transgender woman, pressured the WPATH to remove age limit guidelines for transgender surgical procedures on minors.
Emails between Levine’s staff and WPATH officials indicate that Levine’s staff stressed the political importance of dropping age requirements for obtaining gender transition surgeries, which led the WPATH to change its official Standards of Care from earlier versions of the document.
Cassidy asked the WPATH to specifically address the alleged interference from Levine’s office in developing its standards of care and asked all three organizations to produce for the HELP Committee a detailed overview of what evidence they used to generate their standards of care.
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The Endocrine Society, the AAP, and the WPATH did not respond to the Washington Examiner with a request for comment about Cassidy’s inquiry.
Cassidy requested a response by Oct. 24.