Concern after the HHS report, defenders of therapy for trans children on the care affirmed by the sexes

The Ministry of Health and Social Services (HHS) has published what he called “Complete examination“Transgender care for children and adolescents on Thursday, calling for a broader use of psychotherapy for young people with gender dysphoria rather than affirmative care.

The document of more than 400 pages details the alleged damage of medical interventions for young people, including the use of puberty blockers and alleged risks, such as infertility.

The “evidence exam report and best practices” is a response to January executive decree Emitted by President Donald Trump, saying that the federal government would “finance, would sponsor, promotion, assistance or support” to transitional care for children under 19.

“Our duty is to protect the children of our country – not to expose them to unproven and irreversible medical interventions,” said Dr. Jay Bhattacharya, director of the National Institutes of Health, in a statement THURSDAY. “We have to follow the Order of Sciences, not activist agendas.”

The care affirmed by the sexes is supported by several major medical organizations. He can go to allow him a child to choose his pronouns to treatments generally prescribed to older adolescents. Studies show that treatments are generally sure And that care has a positive impact on mental health, which psychotherapy cannot provide on its own, said experts.

“Require that someone [go] Thanks to a prescribed course of therapy, can be misused by governments to try to essentially block access to care, “Dan Karasic, a professor emeritus of psychiatry at the University of California, told ABC News that psychotherapy resolves the dysphoria of the sexes.”

Puberty blockers safety, hormonal therapies

One of the most common treatments in affirmative sex care is the use of puberty blockers, which are used to delay the appearance of puberty among young transgender and allies.

The report said that his examination of studies has revealed that weak evidence that puberty blockers are safe or that they have improved mental health in children with gender dysphoria, and “high certainty evidence” that they often cause infertility.

The report also said: “Evidence at low certainty suggest that puberty blockers can compromise bone health”.

However, Studies have shown That adults who have used puberty in the past have experienced menstrual cycles, childbirth and false layers at rates similar to those of the general population.

Dr. Morissa Ladinsky, professor of pediatrics clinic at the University of Stanford in California, said that puberty blockers have been used as treatment for more than 30 years, mainly for a condition called CPP, or central early puberty, that is to say, puberty begins too early.

“These drugs are extremely well studied,” she told ABC News. “The long -term effects of puberty drugs, when used in children, for temporary periods, work as a completely reversible break button.”

She said that side effects related to sexual function or bone density are generally observed in adults, which can take prostate cancer drugs in order to reduce testosterone or endometriosis.

The HHS report has also discussed hormones between cross -sex, more commonly known as hormonal therapies, claiming that there is “high proofs of certainty” that hormonal therapies have “physiological effects” and that many studies have been “not specifically designed to grasp the entire range of long -term results”.

Although hormones can wear side effects, like any medication, they can considerably improve mental health Among those who suffer from gender dysphoria, studies show.

Thedinsky said hormonal therapies are often used with older adolescents who have undergone gender dysphoria over a long time.

Hormonal therapies “are all used and are used in pediatric and adolescent medicine for a very long time,” she said. “Anyone who has already used combined contraceptive pills has taken oral estrogens. So it is not that these drugs are unique, experimental, have succeeded in a shelf. It is a standard pharmacology in the practice of medicine.”

Controversy around surgeries

The examination indicated that he revealed that three studies on surgeries for children or adolescents with gender dysphoria “with most considering only mastectomy”.

The mastectomy asserted by the genre, known colloquially as “superior surgery”, is a surgical procedure that eliminates breast tissue to create a more masculine trunk.

The report indicates that the authors have found a low certainty of evidence on the effects of surgeries affirming the sexes on adolescents, in particular suicidality, depression, asexual function, quality of life and regret.

Thedinsky said that there is no genital surgery asserted by the sexes that occur on minors and no other surgery asserted by the sexes carried out on young children.

“There is a very small group of trans-masculine adolescents, meaning 17-ISH, 18, who-in our level of care based on evidence and focused on guidelines-allows a tiny group of these older trans-mascent adolescents of dysphoria provided and sustained of sex to undergo a male thoracic surgery,” she said.

Ladinsky continued: “It is very, very rare and this procedure can only be carried out with long periods of surveillance around gender dysphoria with doctors, immense parental consent and professional approval by those who take care of the young person.”

HHS pleads for psychotherapy

The HHS report recommends the use of psychotherapy as treatment for children and adolescents with gender dysphoria.

“Psychotherapy is a non -invasive alternative to endocrine and surgical interventions for the treatment of pediatric gender dysphoria,” said the report. “Systematic evidence journals have found no evidence of adverse effects of psychotherapy in this context.”

Karasic has said that certain types of psychotherapy can be used to treat symptoms of anxiety and depression in cisgenres and transgender people, but psychotherapy should not be considered a substitute for care affirming the sexes.

“There is absolutely no evidence that psychotherapy replaces people who need medical care,” he told ABC News. “There is substantial evidence of the advantages of [gender-affirming] Taking care of minors, and that is why all traditional medical and mental health groups support this proof that psychotherapy is a substitute. “”

Karasic said that psychotherapy is not bad, but rather that it has its place and, very often, children and adolescents receive psychotherapy as well as a medical intervention.

“If people offer the availability of therapy for people who need it, I think everyone would agree with this,” he said. “But when people say that medical intervention should not be provided because therapy can be used instead, it’s bad. There is simply no evidence in support.”

Response from the medical community

The American Academy of Pediatrics published a statement Thursday, saying that he is “deeply alarmed” by the HHS report.

“For such an analysis to bring credibility, it must consider all of the available data and the full spectrum of clinical results rather than counting on certain perspectives and a close set of data,” said the declaration in part. “This report distorts current medical consensus and does not reflect the realities of pediatric care.”

AAP also published a statement With several groups, including the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, the American College of Physicians, the American Osteopathic Association and the American Psychiatric Association, opposing an offense to medical care.

“Our organizations have systematically opposed any legislation, regulation or executive action which interferes in the confidential relationship between a patient and his doctor or undermines the provision of standards based on patient care care care and the training and education of doctors,” read the declaration on Thursday. “Patients should be able to discuss health problems with their trusted doctor to determine together what care suits them best.”

According to the anti-LGBTQ + anti-LGBTQ + session Union of American Civil Liberties.

Thedinsky said that these invoices are harmful and that they do not solve gender dysphoria for anyone.

“If a blatant and obvious disinformation is used to make political decisions that affect millions of Americans, we open Pandora’s box to considerably decrease the health of all, rather than raising it,” she said. “The other important thing is that we knew on 25 states that have made illegal elements of this care, he did not do that children of trans identity are no longer trans.”