He Department of Health and human Services of the United States He announced a report of more than 400 pages that is the result of An extensive review of the medical care that minors receive with gender dysphoria in that country and the evidence that supports the treatments that are applied, carried out in compliance with Executive Order 14187, of January 28, 2025.
The document recommends put exploratory therapies Tending to identify the causes of discomfort, before opting for the “affirmative approach” of the feeling of belonging to another sex expressed by adolescents whose personality is in training.
The published text alludes to “the growing international concern About the pediatric medical transition ”, in relation to the measures that more and more countries –United Kingdom, Sweden, Finland, Norway– They are taking to limit or directly Prohibit puberty blockages, cross hormonization and surgeries in minors.
“After recognizing the experimental character of these medical interventions and their harmful potentialthe health authorities of a number of countries have imposed restrictions, ”says the document, and cites the case of the prohibition, in the United Kingdom of the use of puberty blockers as a treatment for pediatric gender dysphoria.
It was that world context that led to the Department of Health and Human Services of the United States to carry out this “review of evidence and best practices for the treatment of pediatric gender dysphoria.”
After verifying that in the last decade, the number of children and adolescents who question their sex and identify as transsexuals or non -binary has grown significantly, They point out that the approach proposed in these cases has been the treatment known as “gender statement”, which is based on Accept almost without precautions or expect the child’s self -demolated identity to accept your “Social Transition” (name change and, in certain cases, registration of the new identity), Puberty suppressor drugs To prevent sexual development, then opposite sex to acquire secondary sexual characters and finally Surgeriesusually mastectomy.
“Thousands of American children and adolescents have received these interventions,” says the report.
The increase in youth dysphoria has occurred “in the context of A broader mental health crisis It affects adolescents, ”they remember.
The document refers to the concern of “parents of children and adolescents identified as transsexuals” that “are often discussed on the best way to support them” and those who These therapies are presented as “necessary” and “lifeguard.”
“Many of these children and adolescents have Psychiatric conditions or concurrent neurodevelopmentwhich makes them especially vulnerable, “they warn, so” they deserve to receive compassionate attention, based on tests “and adapted to the specific needs of their case.
They also point out that “the diagnosis of gender dysphoria is based entirely on Subjective self -reports and in behavioral observations, without any physical, image or laboratory objective marker “; only” focuses on attitudes, feelings and behaviors that, as they know they fluctuate during adolescence, ”they add, not without common sense.
And in addition, they remember that “existing research suggests that (gender dysphoria) will send without intervention in most cases “. Fact that underlines the imprudence of treating it with partial or totally irreversible methods – in minors that are also physically healthy – and with worrying side effects.
“The controversies around the medical transition of minors go beyond the scientific debate; they are deeply cultural and political,” the review report continues -the public discourse is dominated by intensely polarizing narratives. Some see the medical transition of minors as a matter of civil rights pressing, while others consider it a deep Medical failure and an alert reminder that even modern medicine is vulnerable to serious errors. ”
The latter is the case of French professionals whose book was reviewed in a previous note [Ver: Hormonización y cirugías de género: un libro afirma que la medicina está olvidando su juramento de no dañar]
After pointing out that at present in the US, the approach that is given to the treatments of pediatric gender dysphoria World Professional association for Transgender Health (WPath)”, The review indicates that the protocols that this NGO “They were adopted internationally before the publication of the first results studies.”
It is also worth clarifying that, although it seeks to present itself as an official voice, WPath is an association formed by professionals who share the affirmative model and dominated by trans activism.
The authorities of the countries that have restricted affirmative therapies, “now recommend psychosocial approaches, instead of hormonal or surgical interventions, as the main treatment,” says the review.
For this reason, he clarifies, a “methodologically rigorous evaluation of evidence that supports the pediatric gender medicine” was ordered in the United States, specifically of “direct evidence with respect to the benefits and damage of treatment for children and adolescents with gender dysphoria”.
They clarify that although the short period in which these treatments have been applied difficult to evaluate both their benefits and their damage, “they can be extracted important conclusions of the established knowledge about human physiology and the effects and mechanisms of the pharmacological agents used ”.
Among them, they list the “risks of the pediatric medical transition”, namely: “Infertility/sterility, sexual dysfunction, deterioration of bone density accumulation, adverse cognitive impacts, cardiovascular diseases and metabolic disorders, psychiatric disorders, surgical complications and repentance.”
They warn that studies carried out on the protocols prepared by WPath and Endocrine Society are not recommended because “They lack rigor in development and transparency ”.
The WPath has been pointed out, they remember, to suppress “systematic reviews that its leaders believed that they would undermine their recommended treatment approach” and because in their latest protocols eliminated “almost all recommended age for medical and surgical interventions in response to political pressures. ”
A lapidary confirming follows: “The ‘affirmation of the genre’ care, as practiced in the US clinics, is characterized by A process led by the child in which they often minimize or omit in a single two -hour session ”.
Many Argentine families will be familiar with this description of how the services of care for transal minors act, since The same light and imprudence is verified here in many casesas reported by the manada association that groups mothers and fathers of teenagers with gender dysphoria.
Another parallel with the local situation is the accusation that reviews “American medical associations“For playing” a key role in the creation of the perception that there is a professional consensus in favor of the pediatric medical transition, “when It really is the lobby exercised by “a small number of specialized committees, influenced by WPath ”
“It is not clear that the official opinions of these associations are shared by the medical community in general,” they suggest. The same is worth asking for the case of Argentina where the Argentine Society of Pediatricsor rather his board of directors, issued a statement defending the use of puberty blockers (not for medical cases for which they were elaborated but for pubers distressed by their sexual development), of Cross hormones and even Surgeries to minors. Statement that obviously He was not consulted with his 20,000 partners that mostly should not even know that text.
“Evidence on the benefits of pediatric medical transition is very uncertain, while Evidence about damage is less uncertain”, Says one of the conclusions of the report.
Then he makes an ethical consideration about medicine: “When medical interventions pose unnecessary and disproportionate damage of damage, health professionals They must refuse to offer them even if the patients prefer them, request or demand. Does not do so increase the risk of iatrogenic damage and Reduces consumerism medicinethreatening the integrity of the profession and undermining confidence in the medical authority. ”
Insist on the need for More and better research on a medical practice that is obviously still in an experimental stage. With the Risk of turning many children into guinea pigs.
Another extremely important conclusion: “No association between gender dysphoria and suicide tendency has been found, and There is no evidence that the pediatric medical transition reduces the incidence of suicide. ”
This is crucial because one of the main battle knights with which the supporters of the affirmative approach threaten the parents: “A trans daughter is preferable before a dead son.”
They conclude with a recommendation: “Psychotherapy is a non -invasive alternative to endocrine and surgical interventions for the treatment of pediatric gender dysphoria. The systematic reviews of evidence have not found evidence of adverse effects of psychotherapy. “
