HHS Landmark Report Released Nov 19, 2025: Purported Evidence for Medical Transition of Minors Is “Very Low Quality” While Harms Are Serious and Mostly Irreversible

The U.S. Department of Health and Human Services Peer-Reviewed Report on Treatment For Pediatric Gender Dysphoria is the most comprehensive review in the world to date of the evidence and systematic reviews regarding the benefits and harms of treatment for children and adolescents with gender dysphoria. The Report found:

• The evidence supporting sex-rejecting procedures, i.e., puberty blockers, cross-sex hormones, and surgeries, for children and adolescents with gender dysphoria is of very low quality.
• The harms of these sex-rejecting procedures are predictable, long-term and serious—including sterility, infertility, impaired sexual function, bone damage, adverse cognitive impacts, cardiovascular disease, metabolic disorders, psychiatric disorders, surgical complications, and regret—and are most often irreversible, frequently ignored, and inadequately tracked or researched.
• The quality of evidence is very low regarding positive effects on gender dysphoria or improvement in mental health or suicidality, which is the most frequently cited purported reason for these treatments.

This is the strongest official U.S. statement to date that children deserve protection from such treatments, not experimentation.

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What the HHS Report Says  

On November 19, 2025, HHS released a 240-page supplement to its groundbreaking May 2025 Review. This new document includes:

• Detailed peer reviews from leading experts in diverse fields

• Point-by-point replies to critics of the Review (including the American Psychiatric Association)

• New risk-of-bias assessments of the latest pro-intervention studies (both rated “critical risk of bias”)

• Minor clarifications and updates to the original Review

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Read the official HHS Press Release and Full Report HERE.

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Core findings remain unchanged and are now even stronger:

• Every high-quality systematic review in the world (Finland, Sweden, Norway, England’s Cass Review, and now HHS) rates the evidence for mental-health benefits of medical sex-rejecting procedures in minors as very low or low quality.

• Harms from puberty blockers and cross-sex hormones are not speculative—they are grounded in basic physiology and endocrinology and decades of adult medical data (sterility, sexual dysfunction, osteoporosis, cardiovascular events).

• Most children with “gender dysphoria” will naturally resolve their distress by the end of puberty if not socially or medically “transitioned” (historical desistance rates 60–90%; modern cohorts still show significant resolution when non-interventionist care is provided).

• Ethical conclusion: Medical treatments should never be driven by ideology or misguided fear of short-term distress. When medical interventions pose unnecessary, disproportionate risks of harm, as is the case with sex-rejecting procedures, healthcare providers should refuse to offer them.

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Timeline: How We Got Here

• May 1, 2025 – HHS releases the original 400+ page Review and Appendix 4 (umbrella review of every known systematic review in the world).

• May–October 2025 – HHS issues invitation to peer review. Major medical organizations (AAP, Endocrine Society) refuse to participate in peer review, with the exception of the APA.

• November 10, 2025 – HHS finalizes the Supplement incorporating feedback.

• November 19, 2025 – Public release of peer-reviewed Report.

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Why This Is a Game-Changer for CPRC’s Mission

For years, CPRC has been a leading voice in American courtrooms and legislatures saying three simple truths:

1. Children cannot consent to medical and/or life-long harms, such as infertility, sterilization, sexual disfunction, or the many other harms associated with sex-rejecting procedures.

2. Parents have a fundamental constitutional right to protect and direct the medical care of their minor children.

3. When evidence is weak and harms are this grievous, states have a compelling interest—indeed a duty—to protect children.

The HHS report now puts the full authority of the federal government behind every one of those statements.

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Concrete Impact on CPRC’s Work

• Litigation: This report will be cited in CPRC cases from Georgia to the U.S. Supreme Court. It discredits the claim that “gender-affirming care,” including social transitioning, is the evidence-based standard of care.

• Legislation: Lawmakers in 2026 sessions now have federal backing to pass (or defend) strong child-protection laws without fear of being labeled “anti-science.”

• Culture: Parents who have been pressured into believing “affirm or your child will suffer harm” now have an authoritative government document they can hand to schools, therapists, and doctors.

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The Studies Critics Love—And Why HHS Still Rejects Them

The Supplement directly addresses the handful of studies activists cite most often (Tordoff 2022, Turban 2019–2021, Chen 2023, etc.):

• All of these studies suffer from critical flaws in study design or risk of bias (confounding, subjectivity, massive loss to follow-up, inappropriate control groups, or failure to account for psychotherapy).

• None provide high—or even moderate—quality evidence of benefit.

• New 2024–2025 studies submitted after the original Review were formally assessed with the ROBINS-I tool and rated critical risk—meaning they cannot be used to guide clinical practice.

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What Should Happen Next (CPRC’s Call)

1. Every state should immediately prohibit puberty blockers, cross-sex hormones, and surgeries for children and young people still in development.

2. Schools must stop "socially transitioning" children.

3. Schools should notify parents whenever a minor child requests to be treated as something other than their sex and acknowledge the parents' rights in developing the school’s response.

4. Therapists and doctors who encourage minors toward sex-rejecting procedures should lose their licenses.

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Take Action Today!!!

This report only becomes real change when courageous people act.

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Your gift today helps CPRC:

• File new lawsuits to enforce parents’ rights to protect their children from sex-rejection procedures

• Defend existing laws all the way to the U.S. Supreme Court  

• Equip parents and legislators with the truth and facts they need