Robert De Niro’s daughter appears as a transgender person
Aerin, daughter of actor Robert De Niro, appeared as a trans woman in a recent interview.
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US Health and Human Services have published a report reviewing medical interventions for minors seeking gender-affirming care.
In a 400-page review published on May 1, the unnamed author determined that there was a lack of evidence to support interventions such as adolescent blockers, sex hormones, and surgery, highlighting the potential risks despite most healthcare providers and experts supporting the benefits.
According to a statement from HHS, physicians, medical ethicists and methodologists contributed to the report, but the institution refused to provide names to its contributors.
Gender-affirming care is the scope of social, psychological, behavioral and medical interventions designed to support people who affirm their gender identity, according to the World Health Organization.
The American Medical Association, which represents more than 250,000 American physicians, passed a resolution in June 2023 calling for the protection of this type of care. Over 30 leading medical associations and health organizations around the world support health care for transgender adults and youth.
“This report misrepresents the current medical consensus and does not reflect the reality of pediatric care,” said Dr. Susan J. Cresley, president of the American Academy of Pediatrics.
What the HHS Transgender Care Report says
In addition to examining the role of medical interventions, the authors also argued that gender maintenance care in the United States is a “child-driven” process in which mental health assessments are “often minimized or omitted.”
There are no routine protocols for gender-affirming care, but they are generally cautious when treating transgender youth, according to Dr. Joshua Sauffer, endocrinologist and executive director at Mount Sinai Transgender Medicine and Surgery Center in New York.
“The young people’s approach is conservative,” he said in a December 2024 interview. “When we support parents and children, we try to be thoughtful and conservative.”
The HHS Report also criticized the World Professional Association for Transgender Health and the American Medical Association to “generate a perception of professional consensus” on how gender-affirming care should be practiced.
The authors argued that these organizations “restrained objections and suppressed suppressed debates” on the topic. WPath has not yet responded to USA Today’s request for comment.
CASS reviews are cited throughout the HHS report. Named after Dr. Hilary Cass, a British pediatrician who chaired the review, the April 2024 report concluded that there was a lack of evidence in support of medical interventions such as adolescent blockers and hormone therapy to manage gender-related distress among teenagers.
CASS recommends that these interventions be used only for research purposes, and National Health Services England urged them to stop prescribing adolescent obstruction for transgender adolescents outside of clinical trials, according to a statement released in August. The UK Supreme Court recently said that the legal definition of women is related to biological sex.
Many experts from the US and countries around the world are concerned about the CASS report and criticize its methodology and how it did not include other studies showing the benefits of adolescent blockers and hormone therapy.
Reactions to HHS Reports: From “Thanks” to “Severely Misleading” and “Deeply Troubled”
Conservative organizations like Do No Harm praised the report, saying in a statement they were “thank and encouraged” by gender-affirming care scrutiny.
However, Casey Pick, director of law and policy for the Trevor Project, a national LGBTQ+ youth advocacy group focusing on suicide prevention, said the report was “deeply troubling” and “refuses best practices in healthcare for transgender people.”
She also points to the author’s support for “exploration therapy” and how it can be closely matched with conversion therapy.
Conversion therapy, also known as compensation therapy, is when a religious leader, license counselor, or peer support group attempts to change someone’s sexual orientation or gender identity. All major health and mental health organizations denigrate practices and consider them to be harmful.
“This report goes a step further by not only rejecting best practices in healthcare for transgender people, but by recommending conversion therapy, although the new brand’s name is “exploration therapy,” Pick said. “Despite the claims in the report, this is actually a harmful practice of conversion therapy, not only using a more accessible language.
Sarah Kate Ellis, president and CEO of Glaad, also denounced the report. “This so-called guidance is highly misleading as recommendations from all the major health authorities around the world,” added Cathy Renna, Communications Director for the National LGBTQ Task Force.
Doctors working in transgender care argue that children and adolescents identified as transgender should have gender-affirming treatments that they can use as options.
Like other drugs, experts say there are risks associated with taking adolescent blockers and hormones. For example, the American Academy of Pediatrics says that children taking adolescent blockers can reduce stress and self-esteem as their peers reach puberty.
However, all major US healthcare providers say gender-affirming care for transgender youth has shown that in the short term, gender-affirming care can lead to mental health outcomes, including reduced depression and suicide. A new HHS report argues there is no connection between gender discomfort and suicide.
Adrianna Rodriguez can visit adrodriguez@usatoday.com.