On Wednesday, the U.S. Department of Health and Human Services released a peer-reviewed version of its May 2025 report, which reviews the evidence and best practices for the treatment of pediatric gender dysphoria. Notably, the peer review process did not alter the findings of the report, which found “low certainty” evidence for benefits in an “umbrella review” of systematic reviews and raised concerns about the unfavorable risk-benefit ratio of medical transition. Significantly, though, the report aims to analyze the state of the evidence, not to make explicit policy recommendations. Peer reviewers found the methodology rigorous and reproducible. “What is here is thorough, compelling, and well done. The main findings and recommendations of the Review is consistent with the findings and recommendations of other high-level evidence reviews and analyses that have been published on this topic.” wrote Dr. Johan C. Bester of the Saint Louis University School of Medicine. This was also echoed by two experts in evidence-based medicine hailing from the Belgian Centre of Evidence-Based Medicine. “We have no major remarks on the study design, nor on the conclusions” the two wrote. The peer review supplement can be accessed here, which also includes the identities of the report authors—including MI senior fellow Leor Sapir— now made public for the first time. I encourage skeptical readers to engage with the report’s findings on its own terms. The report represents a rare opportunity to educate the public and policymakers on the risk-benefit analysis of medical transition from the perspective of evidence-based medicine, not culture war polemic. For more coverage, see Ben Ryan’s breakdown of the report authors, and commentary by the Washington Post Editorial Board, the Boston Globe, Unherd, and the New York Post.
On Wednesday, the New Zealand government announced that it will cease prescribing puberty blockers to new patients for the purpose of pediatric medical transition until after the completion of the UK’s clinical trials. The decision was animated by an evidence brief commissioned by the Ministry of Health which found that there “is a lack of high-quality evidence that demonstrates the benefits or risks of the use of gonadotropin-releasing hormone analogues for the treatment of gender dysphoria or incongruence.” Patients currently prescribed puberty blockers will be grandfathered in, however, and will be allowed to resume treatment.
In City Journal, I detail how a Continuing Medical Education (CME) course sponsored by the Texas Medical Association misleads physicians about the evidence for benefits of pediatric medical transition and clearly clashes with content standards outlined by the Accreditation Council for Continuing Medical Education. In my analysis, I demonstrate how the information presented in the course clashes with all four content standards and the general standard that educational content “is fair and balanced” and “supports safe, effective patient care.” I also highlight the ACCME’s double standard of removing an evidenced-based CME at Washington State University, while allowing associations like TMA to promote misinformation. ACCME’s complaint form for CME violations can be found here.
In National Review, Psychiatrist Kristopher Kaliebe writes about the ongoing scandal involving the ACCME, Washington State University, and the Society for Evidence-Based Gender Medicine (SEGM). Kaliebe explains that after trans activists flagged a CME produced by SEGM for use at Washington State University, the larger CME accrediting body, the ACCME, requested that WSU take down the course while an investigation commenced into the content standards. “It is inconceivable that these courses violate the ACCME’s standards for continuing medical education. SEGM designed them with those standards in mind, and Washington State University spent nine months reviewing the courses before approving them. And while these courses are now unavailable for credit, physicians still have access to a slew of continuing medical education offerings that promote sex changes for children” Kaliebe points out. Notably, SEGM’s CME was developed from its 2023 conference on international perspectives on evidence-based treatment for pediatric gender dysphoria, which featured “medical experts and researchers from more than 30 countries, specializing in everything from psychology and psychiatry to endocrinology and bioethics.”
In City Journal,, Christina Buttons writes about what she calls the “essentialism bias” in the study of gender medicine. Buttons compellingly argues that biological accounts of mental disorders, including gender dysphoria, wield disproportionate rhetorical influence in the public imagination, despite shaky supporting evidence. Buttons goes on to argue that biological accounts of gender dysphoria and trans-identification often influence the way doctors and patients conceptualize the condition and treatment, in ways that fail to reflect reality. For example, despite the intuitiveness of the biological account of trans-identification, Buttons points out that there are no objective biomarkers, and studies which assert that the trans-identified have a “brain sex” that matches their “gender identity” are often confounded by sexual orientation, among other issues. “People deserve clear and accurate information about the causes of their distress so they can make informed decisions about how best to address it—and to avoid the potentially life-long consequences of following the wrong advice” Buttons concludes.
A federal judge in San Diego has signaled that they’re likely to side with parents and teachers who oppose a school district policy which prohibits schools from informing parents about their child’s “gender identity” or pronouns without formal consent. The plaintiffs challenged the policy on 1st and 14th amendment grounds. Although a formal ruling wasn’t issued, the judge remarked that “you know what’s really important is the fact that the parents are being denied the ability to seek whether it's a medical, psychological or social treatment of their children if their children are showing the slightest indication that they have a gender incongruity issue.”
Last weekend, I wrote for the Dispatch about the future of the debate over pediatric medical transition. Furthermore, the piece provides a detailed analysis of the arguments and beliefs that animate the different approaches to treating gender dysphoria. The article serves as an accessible entry point for readers unfamiliar with the debate to better understand the suppositions that drive support for gender medicine, as well as the good-faith scientific and ethical concerns that drive a more cautious, developmentally attuned approach to the treatment of dysphoria.
Joseph Figliolia
Policy Analyst
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