There is no question that gender dysphoria among children is a rapidly growing issue in the United States. According to Reuters and Komodo Health, the number of new gender dysphoria diagnoses for children nearly tripled between 2017 and 2021, with over 121,000 diagnoses in that timespan among children ages 6-17. Insurance claims revealed that in 2021 alone, at least 1,390 children with a gender dysphoria diagnosis started taking puberty blockers, 4,231 started taking cross-sex hormones, and 282 had mastectomies connected to gender dysphoria.
But while there is no doubt about the growing number of children questioning their gender and struggling with difficult mental health issues, the best way to address this problem remains a topic of heated debate. A new report from the U.S. Department of Health and Human Services is the latest to cast doubt on the idea that dangerous drugs and surgeries are an effective way to address gender dysphoria in minors.
Harmful drugs and surgeries don’t help children
In May 2025, HHS released a report about various interventions for children with gender dysphoria and the effectiveness of these approaches. One major approach covered by the report has often been misleadingly called “gender-affirming care.”
This approach can include everything from “social affirmation of a child’s self-reported identity,” to harmful drugs such as puberty blockers and cross-sex hormones, to life-altering surgeries that change or remove healthy body parts.
Despite what many activists have claimed, the use of these dangerous drugs and surgeries for children is not backed by high-quality evidence. In fact, the HHS report found that guidelines recommending harmful drugs and surgeries for children in the U.S. are “especially problematic” because they “were developed in ways that contravene best practices for guideline development.”
According to the report, these drugs and surgeries “carry risk of significant harms including infertility/sterility, sexual dysfunction, impaired bone density accrual, adverse cognitive impacts, cardiovascular disease and metabolic disorders, psychiatric disorders, surgical complications, and regret.”
Meanwhile, the report notes that systematic reviews have found “deep uncertainty” about the purported benefits. Some activists have pressured parents into allowing their children to take harmful drugs or undergo life-altering surgeries by telling the parents that if they do not, their children might kill themselves. But the report found “no evidence” that such procedures “reduce[] the incidence of suicide.” Other recent reports have also debunked this “suicide myth.”
Finally, the report dismantled the idea that there is any “consensus” among experts supporting the use of puberty blockers, cross-sex hormones, and surgeries to address gender dysphoria. It explained that “a small number of specialized committees,” influenced heavily by an activist organization called the World Professional Association for Transgender Health (WPATH), worked to create a false perception of “consensus.”
The human toll of transition efforts
The findings of the HHS report mirrored those of a similar thorough review headed by Dr. Hilary Cass, former president of the Royal College of Paediatrics and Child Health in England. Dr. Cass found that evidence in the field of gender dysphoria is “remarkably weak” and does not justify the drastic and unethical practices being done on children today.
Dr. Cass’s review led the U.K. to prohibit the use of puberty blockers, and to restrict other harmful gender transition efforts on minors. The HHS report should lead the U.S. to do the same, because as we have already seen, these harmful drugs and surgeries have a tragic human toll.
Clementine Breen
Clementine Breen knows this pain all too well. As a child, she became the victim of sexual abuse, which resulted in anxiety, depression, and a fear of puberty. But instead of giving Clementine the help she needed, a counselor told her that the reason for her distress was that she was actually a boy trapped in a girl’s body.
Dr. Johanna Olson-Kennedy, who runs the largest pediatric gender clinic in the country, met with Clementine when the girl was just 12 years old. Not long into the appointment, Dr. Olson-Kennedy prescribed Clementine puberty blockers. Two years later, surgeons removed her breasts.
When Clementine was 17 years old, Dr. Olson-Kennedy told her she should get a hysterectomy. Through all this, Clementine was told that if she didn’t go through with the procedures, she would be at a higher risk of suicide. Tragically, Clementine later attempted to take her own life anyway.
By God’s grace, Clementine has become more comfortable with her body and is no longer attempting to change her gender. Sadly, she will have to live with many of the harmful effects of these drugs and surgeries for the rest of her life.
Doctors never asked Clementine about the abuse she was subjected to as a young child, nor did they warn her about the long-term health problems she would face. She has since filed a medical malpractice lawsuit because of the suffering she endured.
Prisha Mosley
Prisha Mosley has a similarly tragic story. She was sexually assaulted at age 14, became pregnant, and suffered a miscarriage. She was soon diagnosed with severe depression, obsessive-compulsive disorder, and an eating disorder. But instead of providing Prisha with loving support and medical care, her doctors and counselors pushed her down the road to harmful drugs and surgeries.
A pediatrician and a counselor convinced Prisha’s parents that she was a boy trapped in a girl’s body, and doctors put her on testosterone shortly thereafter. At 18, Prisha underwent a double mastectomy.
Thankfully, Prisha today has come to fully embrace who she is as a woman. But a corrupt medical establishment manipulated and forever changed the course of her life. She will have to live the rest of her life with unwanted effects like a deep voice, a body in almost constant pain, and breasts that have been permanently removed.
Children deserve real care
Stories like Clementine’s, Prisha’s, and so many others are preventable tragedies. Research has shown that 88 percent or more of pre-pubertal children struggling with gender dysphoria will naturally come to peace with their bodies—as long as no one interferes with the course of puberty.
Counselors who can talk through these issues in a healthy way, rather than pushing children toward harmful drugs and surgeries, can help children through this process. That’s exactly the kind of counseling that Kaley Chiles wants to provide.
Kaley is a counselor in Colorado who has a heart for children struggling with gender dysphoria. But a Colorado law bars Kaley and other counselors in the state from saying anything to clients under 18 that would encourage them to accept their biological sex instead of pursue “gender transition.”
The law allows counselors to provide “[a]cceptance, support, and understanding” for clients who wish to “explore” a sexual orientation or gender identity, and it allows counselors to “assist” anyone who is “undergoing gender transition.” But it essentially prohibits counselors from helping children who are struggling with gender dysphoria to become more comfortable with their natural bodies.
Colorado officials can’t force Kaley or other counselors to discuss only the state’s preferred view of issues like gender identity. With the help of Alliance Defending Freedom, Kaley is challenging this unjust law, and in March 2025, the U.S. Supreme Court agreed to hear the case, Chiles v. Salazar, in its upcoming term.
Children deserve real care, not experimental drugs and surgeries that can cause lifelong damage. The HHS report makes this fact clear, and counselors such as Kaley should be free to truly help children who are struggling with gender dysphoria.
