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(from left) Donald Trump, Robert F. Kennedy Jr.
Experts tell The Advocate that the document can't be taken seriously and is riddled in misinformation.
The Trump administration escalated its assault on transgender youth Thursday with the release of a controversial new report from the U.S. Department of Health and Human Services that promotes conversion therapy and discredits gender-affirming care. Advocates and experts have said the report is filled with misinformation about both.
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Commissioned under President Donald Trump’s January Executive Order 14187, the 409-page report falsely claims medical transition is harmful and unproven, and promotes “exploratory therapy”—a rebranded version of conversion practices widely condemned by major medical associations.
Related: New Trump Medicaid directive attacks trans people's access to gender-affirming care
The order directed HHS to attack WPATH’s standards of care, revoke federal funding for transition-related treatments, and reshape public health policy to align with Trump’s political agenda.
NIH Director Dr. Jay Bhattacharya, who has no background in gender-affirming care, introduced the report. Bhattacharya rose to prominence during the COVID-19 pandemic as a co-author of the controversial Great Barrington Declaration, which pushed to lift lockdowns and allow widespread infection to build herd immunity—a position sharply rejected by public health experts.
The HHS report claims that gender-affirming care lacks evidence of benefit, but makes this argument by dismissing peer-reviewed research and reframing therapeutic approaches as medical risks. It labels the gender-affirming care model as experimental and portrays puberty blockers and hormone treatments as unethical interventions pushed by activists rather than doctors. While the document stops short of issuing policy mandates, critics say it lays the groundwork for future federal restrictions.
Notably, the report endorses what it calls “gender exploratory therapy,” which it positions as an alternative to what it derides as “affirmation-only” approaches. But experts say this is simply conversion therapy under a new name. “They can call it whatever they want,” said Kellan Baker, executive director of the Whitman-Walker Institute. “The idea is the same—it is a practice with a predetermined goal: to try to change who someone is. That is the definition of conversion therapy.” Baker warned that the rebranding is a deliberate attempt to avoid the legal and political liabilities now associated with a discredited and widely banned practice.
In its press release, HHS emphasized that the report’s authors would remain anonymous. While unnamed authorship on agency reviews is not unprecedented, a former HHS official told The Advocate it is highly irregular for the department to spotlight the anonymity.
Medical and legal experts immediately denounced the report’s implications.
“Today’s report seeks to erase decades of research and learning, replacing it with propaganda,” said Shannon Minter, legal director of the National Center for Lesbian Rights. “It promotes the same kind of conversion therapy long used to shame LGBTQ+ people.”
GLAAD President and CEO Sarah Kate Ellis called the document “discredited junk science.”
“A report in the suggestion that someone’s authentic self and who they are can be ‘changed’ is discredited junk science,” Ellis said in a statement. “This so-called guidance is grossly misleading and in direct contrast to the recommendation of every leading health authority in the world. This report amounts to nothing more than forcing the same discredited idea of conversion therapy that ripped families apart and harmed gay, lesbian, and bisexual young people for decades.”
Janna Barkin, author of He’s Always Been My Son and A Grand Love, has a 27-year-old transgender son who transitioned as a minor. In an interview with The Advocate, Barkin called the report “deeply troubling” and “extremely disappointing.”
“My child was struggling, depressed, and anxious until he received thoughtful, lifesaving care,” Barkin said. “We found medical professionals who helped guide our decisions, and after he got the care he needed, his light came back. He was able to live fully and happily as the man he is.”
She warned that this kind of government interference not only undermines science but endangers lives.
“I feel like trans people are being used to push an agenda that seeks to eliminate not just trans people, but other marginalized communities as well,” Barkin said. “It is terrifying. Trans kids are waking up afraid. Trans adults are afraid. This administration’s focus on erasing people is not about protecting children—it’s about control.”
The Trevor Project warned the report may further endanger trans youth, who already face high rates of suicide. Research consistently shows that gender-affirming care improves mental health outcomes, while conversion efforts increase the risk of depression and suicide.
Related: Doctors warn of ‘terrifying’ effects as Trump creates snitch line to report gender-affirming care patients
“It is deeply troubling to see the country’s top authority on health publish a collection of recommendations that seemingly have no basis in following established health care best practices, science, or input from providers who actually administer the type of health care in question," director of law and policy at The Trevor Project, Casey Pick, said in a statement. "This report not only rejects health care best practices for transgender people — it goes a step further by recommending conversion therapy, though under a new, rebranded name, ‘exploratory therapy’. Despite the report’s claims, this is, in fact, the same harmful practice of conversion therapy, just using friendlier language."
Baker, a nationally recognized, Johns Hopkins-educated expert on health equity, told The Advocate the HHS report is “a political document pretending to be science.”
“This is conversion therapy under a different name,” Baker, who is trans, said. “It is a cynical, dangerous attempt to rebrand a practice that’s been proven to harm people and dress it up as ‘exploration.’ But the intent is the same: to deny trans youth the care they need.”
Baker emphasized that “every major U.S. medical association supports gender-affirming care because it saves lives and affirms dignity.”
“This document does the opposite,” he said. “It undermines trust, spreads misinformation, and leaves families and providers wondering if they’ll be prosecuted for doing the right thing.”
“It’s gaslighting, plain and simple,” said Barkin. “They’re trying to paint care as danger and danger as protection.”
The Endocrine Society, the world’s oldest and largest organization of hormone researchers and clinicians, also weighed in. “Representing 18,000 members who treat and research diabetes, obesity, fertility, bone health, hormone-related cancers, as well as gender dysphoria, the Endocrine Society believes in access to health care, and that medical decisions should be made by the clinician and the patient’s family based on scientific evidence,” the organization said in a statement to The Advocate. It is currently reviewing the report.
Adrian Shanker, former Deputy Assistant Secretary for Health Policy in the Biden administration, criticized the administration’s approach: “Trans people, like all Americans, deserve the highest quality health care and deserve to know the science behind our health decisions, which is why this report is so concerning—it’s a compilation of junk science parading as a scientific report.”
Shanker also highlighted procedural issues, noting that the report’s conclusions were predetermined by the executive order: “This administration has missed no opportunities to remove the rights and health of trans people, and they’ve really proven just how far they will go for an anti-trans agenda.”
Shanker emphasized, “Efforts to change a person’s sexual orientation or gender identity have been attempted for decades, and in every instance they’ve caused harm. Conversion therapy doesn’t convert anyone, and it’s not therapy; it’s just harm.”
Editor's note: This developing story has been updated with additional reporting.
