The Department of Health and Human Services just released its final report on gender dysphoria. Its findings are impossible to ignore.
Drawing on the strongest systematic reviews in Europe and the U.S., the report shows that the evidence for medical interventions in minors is far shakier than widely assumed -- and that the risks, including infertility, sexual dysfunction, reduced bone density, cognitive effects, cardiometabolic disease, psychiatric complications, and surgical harms, are far more serious than the public has been led to believe.
Yet many physicians -- the very people tasked with guiding families and gender nonconforming youth -- may never see this evidence.
That’s because several major medical organizations function as gateways to an information cartel about gender medicine. Their refusal to acknowledge or share emerging evidence leaves clinicians in the dark -- and patients pay the price.
Consider the striking imbalance of continuing medical education (CME) courses on this topic. After residency, physicians rely on CME programs to stay current on emerging evidence and clinical standards.
There are numerous programs for CME credit promoting gender-affirming interventions for minors, including courses that contradict the evidence base. For example, a Med-IQ–accredited CME on AMA Ed Hub recommends Bicalutamide, a sex hormone blocker, for adolescents while downplaying the risks of liver damage. A 2024 case confirmed liver failure in a trans teen. Promoting off-label endocrine drugs without adequate safety data violates ACCME content-validity standards and endangers patient safety. Those courses remain available to physicians today, without correction or caveat.
But when a course challenges that narrative, it triggers immediate scrutiny.
We know this firsthand. We collaborated on a CME program developed by the Society for Evidence-Based Gender Medicine (SEGM), with Washington State University serving as the accreditor. The course explored Europe’s shift toward more cautious, psychotherapy-first approaches. It underwent nine months of review: conflict-of-interest checks, faculty vetting, scientific quality assessments, and full compliance under the Accreditation Council for Continuing Medical Education (ACCME) standards. Then activists got wind of it. Within hours they had unleashed a pressure campaign so intense that ACCME opened an inquiry. WSU yanked the course overnight.
The contrast is difficult to ignore: content that aligns with current ideological expectations remains undisturbed, while legitimate evidence that questions it is removed the moment activists aggress.
Disturbingly, this dynamic extends into academic research itself: when evidence challenges the preferred narrative, it too is sidelined or buried.
The World Professional Association for Transgender Health (WPATH) commissioned the Johns Hopkins Evidence-Based Practice Center to review the literature on pediatric gender interventions. When the findings reportedly failed to support WPATH’s assumptions, the organization pressured Johns Hopkins not to publish the results. The review vanished.
More activist backlash erupted after SEGM contracted with McMaster University to conduct independent systematic reviews. Activists went after the researchers personally, and several felt compelled to withdraw their names from their own papers out of fear. Yet again, evidence that should have informed clinical practice simply disappeared.
Professional medical organizations -- the bodies that set clinical norms and shape practice -- have flatly refused to confront the emerging evidence. These organizations have, on this topic, become enforcers of Medical Lysenkoism. Their tactics mirror Trofim Lysenko’s catastrophic reign over Soviet agriculture from1930s–1960s. The “hate” label foisted upon today’s scholar insistent on rigor in gender medicine is equivalent to the “bourgeois” label forced upon Soviet geneticists severely persecuted for objecting to “class-struggle botany.” Scholars who question prevailing assumptions face protracted delays, public attacks, or outright ideological rejection.
The recent peer review process for the HHS report on gender dysphoria laid bare the extent to which major medical groups will sidestep inconvenient evidence. The Endocrine Society and the American Academy of Pediatrics -- two groups with enormous authority over pediatric gender protocols – were invited to participate. Both declined. Their refusal ensured that the most influential voices in American pediatric gender medicine avoided grappling with the evidence now challenging their positions.
As immigrants whose families have suffered in totalitarian societies in China and the Soviet Union, we understand the motivation and consequences of large-scale lies. In a totalitarian system, it’s not merely some menacing oppressor with state power who generates propaganda. Everyone participates. And the motivation to participate in lies range from a wish for social approval to a craving to be perceived as a righteous hero.
The erosion of open scientific discourse harms everyone, regardless of ideology. Medicine depends on the freedom to ask difficult questions, evaluate data honestly and educate the next generation of clinicians accordingly.
The idea-laundering taking place at trusted American medical institutions must stop. Medicine must return to a principles-first endeavor. Patients, families, and clinicians deserve nothing less.
Zhenya Abbruzzese, a healthcare researcher, is co-founder of the Society for Evidence-Based Gender Medicine (SEGM).
Dr. Erica Li is an assistant professor of pediatrics at Washington State University. The views expressed above are her own and do not represent those of her employer.
Drawing on the strongest systematic reviews in Europe and the U.S., the report shows that the evidence for medical interventions in minors is far shakier than widely assumed -- and that the risks, including infertility, sexual dysfunction, reduced bone density, cognitive effects, cardiometabolic disease, psychiatric complications, and surgical harms, are far more serious than the public has been led to believe.
Yet many physicians -- the very people tasked with guiding families and gender nonconforming youth -- may never see this evidence.
That’s because several major medical organizations function as gateways to an information cartel about gender medicine. Their refusal to acknowledge or share emerging evidence leaves clinicians in the dark -- and patients pay the price.
Consider the striking imbalance of continuing medical education (CME) courses on this topic. After residency, physicians rely on CME programs to stay current on emerging evidence and clinical standards.
There are numerous programs for CME credit promoting gender-affirming interventions for minors, including courses that contradict the evidence base. For example, a Med-IQ–accredited CME on AMA Ed Hub recommends Bicalutamide, a sex hormone blocker, for adolescents while downplaying the risks of liver damage. A 2024 case confirmed liver failure in a trans teen. Promoting off-label endocrine drugs without adequate safety data violates ACCME content-validity standards and endangers patient safety. Those courses remain available to physicians today, without correction or caveat.
But when a course challenges that narrative, it triggers immediate scrutiny.
We know this firsthand. We collaborated on a CME program developed by the Society for Evidence-Based Gender Medicine (SEGM), with Washington State University serving as the accreditor. The course explored Europe’s shift toward more cautious, psychotherapy-first approaches. It underwent nine months of review: conflict-of-interest checks, faculty vetting, scientific quality assessments, and full compliance under the Accreditation Council for Continuing Medical Education (ACCME) standards. Then activists got wind of it. Within hours they had unleashed a pressure campaign so intense that ACCME opened an inquiry. WSU yanked the course overnight.
The contrast is difficult to ignore: content that aligns with current ideological expectations remains undisturbed, while legitimate evidence that questions it is removed the moment activists aggress.
Disturbingly, this dynamic extends into academic research itself: when evidence challenges the preferred narrative, it too is sidelined or buried.
The World Professional Association for Transgender Health (WPATH) commissioned the Johns Hopkins Evidence-Based Practice Center to review the literature on pediatric gender interventions. When the findings reportedly failed to support WPATH’s assumptions, the organization pressured Johns Hopkins not to publish the results. The review vanished.
More activist backlash erupted after SEGM contracted with McMaster University to conduct independent systematic reviews. Activists went after the researchers personally, and several felt compelled to withdraw their names from their own papers out of fear. Yet again, evidence that should have informed clinical practice simply disappeared.
Professional medical organizations -- the bodies that set clinical norms and shape practice -- have flatly refused to confront the emerging evidence. These organizations have, on this topic, become enforcers of Medical Lysenkoism. Their tactics mirror Trofim Lysenko’s catastrophic reign over Soviet agriculture from1930s–1960s. The “hate” label foisted upon today’s scholar insistent on rigor in gender medicine is equivalent to the “bourgeois” label forced upon Soviet geneticists severely persecuted for objecting to “class-struggle botany.” Scholars who question prevailing assumptions face protracted delays, public attacks, or outright ideological rejection.
The recent peer review process for the HHS report on gender dysphoria laid bare the extent to which major medical groups will sidestep inconvenient evidence. The Endocrine Society and the American Academy of Pediatrics -- two groups with enormous authority over pediatric gender protocols – were invited to participate. Both declined. Their refusal ensured that the most influential voices in American pediatric gender medicine avoided grappling with the evidence now challenging their positions.
As immigrants whose families have suffered in totalitarian societies in China and the Soviet Union, we understand the motivation and consequences of large-scale lies. In a totalitarian system, it’s not merely some menacing oppressor with state power who generates propaganda. Everyone participates. And the motivation to participate in lies range from a wish for social approval to a craving to be perceived as a righteous hero.
The erosion of open scientific discourse harms everyone, regardless of ideology. Medicine depends on the freedom to ask difficult questions, evaluate data honestly and educate the next generation of clinicians accordingly.
The idea-laundering taking place at trusted American medical institutions must stop. Medicine must return to a principles-first endeavor. Patients, families, and clinicians deserve nothing less.
Zhenya Abbruzzese, a healthcare researcher, is co-founder of the Society for Evidence-Based Gender Medicine (SEGM).
Dr. Erica Li is an assistant professor of pediatrics at Washington State University. The views expressed above are her own and do not represent those of her employer.
