On Tuesday, the Kansas Senate voted 31-9 to override Gov. Laura Kelly’s veto of the “Help Not Harm Act,” a bill prohibiting minors from accessing sex-trait modification interventions. Similarly, the Kansas House voted 84-35 in favor of the veto override, allowing the embattled bill to become law despite Kelly’s disapproval. “Today, Kansas House Republicans successfully overrode Governor Kelly’s reckless veto of the Help Not Harm Act- voting overwhelmingly in favor of protecting Kansas kids from the irreversible harms of experimental gender transition surgeries and medicines. Governor Kelly chose to side with the radical Left, but this override now ensures that the act will become law-bringing Kansas in line with multiple other states and nations that already protect vulnerable minors from the life-altering effects of medicalized gender transition interventions” Kansas representatives declared in a joint statement.
On Wednesday, the Department of Health and Human Services (HHS) released new guidance to federal agencies and the public expanding on the sex-based definitions of male and female introduced in Executive Order 14168. The guidance reiterates that there are only two sexes, male and female, and that one’s sex is determined by the type of gametes produced by one’s reproductive system. The guidance is clear to note, however, that “Having the biological function to produce eggs or sperm does not require that eggs or sperm are ever produced.” Moreover, the order preemptively addresses the common criticism that intersex conditions invalidate the sex binary by clarifying that “Rare disorders of sexual development do not constitute a third sex because these disorders do not lead to the production of a third gamete. That is, the reproductive system of a person with such a disorder does not produce gametes other than eggs or sperm.” Notably, the Washington Post released an op-ed rejecting the guidance’s embrace of the sex binary, however, in the Boston Globe Dr. Carole Hooven has written an excellent defense of the Trump administration’s definitions.
The Trump Department of Justice dismissed the Biden administration's certiorari petition requesting the Supreme Court review the Eleventh Circuit’s decision in Eknes-Tucker v. Alabama to uphold Alabama’s law prohibiting minors from accessing sex-trait modification procedures. The move builds on the DOJ’s recent decision to withdraw its position in the case of Tennessee v. Skrmetti. The Biden administration had previously joined the Skremtti suit, arguing that Tennessee’s SB1, which prohibits minors from access sex-trait modification procedures, violates the equal protection clause.
On Thursday, HHS formally rescinded March 2022 guidance entitled “HHS Notice and Guidance on Gender Affirming Care, Civil Rights, and Patient Privacy.” “Today’s rescission provides important notice to the regulated community that the 2022 OCR Notice and Guidance no longer represents the views or policies of HHS OCR,” said OCR Acting Director Anthony Archeval. Archeval went on to add that “The rescission is a significant step to align civil rights and health information privacy enforcement with a core Administration policy that recognizes that there are only two sexes: male and female.”
A federal judge has temporarily blocked enforcement of the Trump administration’s executive order prohibiting the use of federal funds for sex-trait modification procedures for persons under 19, just one day after a federal judge in Baltimore blocked enforcement of the EO in a separate lawsuit. The plaintiffs in the suit include the attorneys general for Washington, Oregon and Minnesota, as well as three physicians. In her ruling, U.S. District Court Judge Lauren King sided with the plaintiffs and argued that the provision of the EO that makes funding contingent on following the directive oversteps the president’s authority under the separation of powers. Judge King also determined that the order likely violates the equal protection clause of the 5th amendment because, in her estimation, the “sex-based distinctions drawn by the Executive Order are not substantially related to achieving the Order’s purpose.”
Indiana has joined a suit–along with sixteen other states–challenging a May 2024 Department of Health and Human Services rule which adds “gender dysphoria” to the definition of disability under Section 504 of the Rehabilitation Act. One of the core complaints of the suit is that the Americans with Disabilities Act “expressly excludes from that definition ‘transvestism, transsexualism, pedophilia, exhibitionism, voyeurism, (and) gender identity disorders not resulting from physical impairments or other sexual behavior disorders.’” The suit goes on to argue that the HHS rule exceeds the authority granted to the federal agency and imposes significant costs and regulatory burdens on states.
Christine Rosen writes about the outsized role played by the American Academy of Pediatrics (AAP) in advancing “gender affirming care” in the United States. Rosen condemns the AAP for betraying its mission to “to attain optimal physical, mental, and social health and well-being for all infants, children, adolescents and young adults” while working to promote unsubstantiated medical practices on minors. Rosen is particularly harsh towards the AAP because of the organization’s prestige and the role it plays in guiding both parents and policymakers. As Rosen points out, however, the AAP’s stance on gender medicine is not the first time the organization has put activism before science. She goes on to cite the AAP’s stance on school closures and masking. “Having for so long indulged in partisan political posturing and having shown itself willing to ignore scientific fact in the service of ideology, the American Academy of Pediatrics has no integrity left to compromise” Rosen concludes.
In City Journal, Leor Sapir writes about the ACLU’s strategic blunder of representing a “non-binary” plaintiff in its challenge of Trump’s EO prohibiting federal funds from being used to support “affirming care” for persons under 19. Sapir shrewdly argues that the spotlight on non-binary gender medicine will force the ACLU to defend medical practices with an even weaker evidence base than “binary” medical transition, practices that are rendered based on nothing more than a patient’s “embodiment goals,” which in the case of non-binary identities, have no parallel in nature. “Nonbinary is both the result and a likely cause of gender medicine’s drift away from a clinical model, which at least pretended to care about evidence-based medicine, toward an autonomy-focused framework that deems cosmetic procedures ‘medically necessary,’ for insurance purposes.” Moreover, Sapir goes on to explain how patients with non-binary identities would have been excluded under the Dutch protocol’s original eligibility criteria for adolescent patients.
Lawyers for Keira Bell, a detransitioner and former patient at the UK’s Tavistock Clinic, and other campaigners are calling on the UK’s Health Research Authority (HRA) to abandon its planned clinical trial for puberty blockers. As it currently stands, puberty blockers are not available to minors for use in routine care, however, a clinical trial slated to begin this Spring would allow research participants to access the drugs in a controlled research setting. Bell and her lawyers are arguing, however, that the clinical trial itself is unethical and unlawful because “these drugs that have not indicated any benefit, only detriment, and facilitate no return.” Moreover, campaigners argue that the Cass Review is, paradoxically, being misappropriated to justify the clinical trials even though the Review itself determined that the evidence in support of the drugs was weak and that blockers “may permanently disrupt the brain maturation of adolescents, potentially rewiring neural circuits that cannot be reversed.” The HRA has been given two weeks to respond.
Joseph Figliolia
Policy Analyst
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