The U.S. Department of Health and Human Services has released a new report on gender dysphoria care that, if implemented, will mark the end of the interventionist, affirmative model of WPATH, the controversial international organization dedicated to transgender health. . In more than 400 pages, the relationship – Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practice – takes an evidence-based approach and raises concerns about the safety and effectiveness of treatments such as puberty blockers, cross-sex hormones and surgery. Highlighting the scientific uncertainty and significant risks of pediatric medical transition, the report challenges two dogmas of child treatment: that a child’s sex is his or her self-perceived sex and that failure to transition leads to suicide. The document in fact proposes a more cautious approach in a non-ideological language and favors psychosocial interventions and in-depth psychological assessments, respecting the well-being of minors. In fact, it often cites the Cass report, the independent investigation commissioned by the English NHS and led by pediatrician Hilary Cass that has had a significant impact on health policies in the United Kingdom and on the international debate.
Over the last ten years, it is significantly increased the number of children and adolescents who identify as transgender or non-binary, often diagnosed with gender dysphoria. This report, commissioned by Executive Order 14187 of January 28, 2025, analyzes the scientific evidence and clinical practices related to the treatment of gender dysphoria in children, with a focus on the “gender-affirmative care” approach. This includes social, pharmacological (puberty blockers, cross-sex hormones), and surgical (such as mastectomies) interventions, considered by some to be “lifesaving” but increasingly controversial. The review does not provide clinical guidelines or policy recommendations, but offers accurate information for policymakers, clinicians, therapists, medical organizations, patients, and families, addressing evidence, clinical practices, risks, benefits, and ethics.