Trump live updates: President renews the threat of revoking Harvard's tax-satisfactory status

Other parts of the review seemed to question the idea that some people have a gender identity that does not match their gender at birth.

In January, President Trump signed an executive regulation entitled “Protection of children from chemical and surgical mutilation” in order to give the Ministry of Health and Human Services for 90 days in order to create a report on the best practices for the treatment of young people who say that their gender does not match their births.

However, the arrangement made it clear that the administration had already drawn its own conclusion about the treatments of the gender about the minors and characterized the “blatant damage they have done” as “stain in the history of our nation”.

The 400-page report took on a more sober tone, but achieved a similar conclusion. In a remarkable deviation from the standard for medical reviews, the authors were not identified until a review process would begin after publication in the “coming days”.

HHS official refused to answer questions about what the review process would mean. The department found that the participating doctors, medical ethicists and methodologists were all from “a wide range of political viewpoints”, which were selected “for their commitment to scientific principles”.

The report stated that the new evaluation was not intended to set a standard for medical care or to submit political recommendations.

It was mainly based on an analysis of the reviews of scientific studies on puberty blockers, hormone therapies and operations that were published in recent decades when these treatments were made available for the first time.

The evaluation came to the conclusion that the advantages of medical interventions were expedient that the damage that can include the loss of fertility were lower.

The “clinical practice in this area of ​​medicine is exceptional and worrying”, says the report and criticized the American medical groups for the promotion of intolerant work “environments in which clinicians feel forced into self -censor”.

The question of whether and when treatments such as puberty blockers, hormone therapies or operations are appropriate for young people was the subject of a violent debate.

Several European countries have limited treatments in recent years after scientific reviews have found poor quality of the evidence to support their advantages and uncertainty about long -term risks.

In the United States, 24 countries have passed laws that prevent doctors from offering such treatments for young people.

The American Academy of Pediatrics carries out its own review of the evidence. The academy and the most important medical groups in the United States continue to support these treatments to relieve the psychological stress that many transgender youth experience.

“This report is wrong with the current medical consensus and does not reflect the realities of pediatric care,” said Dr. Susan Kressly, President of the Academy. “The report prioritizes the opinions on passionate evidence.”

Transgender -Rights advocates criticized the new evaluation in order to paint an ideological view with scientific splendor.

During the first 100 days in the office of Mr. Trump, his government tried to limit the recognition of transgender identities in public life. The administration threatened to end the financing of hospitals that offer people under 19 years of gender -specific treatments and people open when they work in the military.

The administration has drawn with men after transgender women in federal prisons and the gender identities of transgender people on passports no longer reflect.

“Is the hostility of administration based on this medical care on actual scientific research, or is it ideologically of the open disapproval of transgender people through the administration and the conviction that the transgender identity is wrong?” said Shannon Minter, legal director of the National Center for Lesbian Rights.

The center represents transgender people in several lawsuits who question the constitutionality of the administration's policy.

Casey Pick, Director of Law and Politics at the Trevor project, a non -profit organization that focuses on suicide prevention under LGBTQ boys, said: “To the extent that this is a document that challenges even the ability of a young person to identify as a transgender is an ideological statement -which is not a medical statement.”

The report is a victory for those who have described this medical field as part of a wider project that refuses to realities the biological gender.

Roger Severino, Vice President of domestic politics at Heritage Foundation, conservative thinking, welcomed the HHS report and accused “profit-oriented doctors and ideological groups”, families to convince families that “the sex of a child, whatever they say”.

According to the government, about 3 percent of the students identify as a transgender, a number that has increased significantly in the past decade. A much smaller percentage of these young people is looking for medical interventions.

The problem of medical transition for minors has nevertheless become a political flash point. Mr. Trump became the focus of his campaign, and some Democrats believe that the strategy helped him win.

The new HHS report continues as similar reports in European countries that have introduced new restrictions on gender treatments for young people.

An independent review of the clinical services for young people in England under the direction of Dr. Hilary Cass, the former president of the Royal College of Pediatricians, came similar to the quality of the evidence to support the use of puberty blocking and hormonal treatments in minors. (Operations are not available for minors in Great Britain.)

However, this review, which was carried out over a period of four years, interviewed young patients, transgender-growing, parents and clinicians in order to obtain a broad picture of the medical area.

Dr. Cass came to the conclusion that the evidence of the advantages and risks of the treatments were “remarkably weak”, but said that some young people would probably still benefit from an early intervention.

“There are young people who absolutely benefit from a medical path, and we have to make sure that these young people have access – as part of a research protocol because we have to improve research, but do not assume that this is the right way for everyone,” said Dr. Cass in an interview last year.

This review came to the conclusion that the National Health Service in England only restricts the use of puberty closure to research studies, and clinicians were recommended to prescribe teenagers with “extreme caution” hormones.

Other clinicians who expressed concerns about the area of ​​youth family medicine were ambivalent about how the new report could be used.

“I am glad that the authorities in the United States have finally taken into account what is going on in Europe in recent years,” said Erica Anderson, a child psychologist and former president of the US Professional Association of Transgender Health.

She was loudly about her concerns that youth ghuria clinics have decided by careful reviews of mental health, since the population of children who are looking for gender -specific treatments has grown.

But Dr. Anderson, who still supports early interventions for some young people, noted that it was impossible to ignore the inflammatory order of the executive regulation, which led to the report.

“It's like calling someone a ranking and then deciding that you want to have a conversation with him,” she said. “Well, that doesn't really work very well with actual people with feelings and stories.”

Mr. Minter from the National Center for Lesbian Rights said that the HHS report by emphasizing psychotherapy via medical interventions effectively supports conversion therapy in order to change the gender identity or sexual orientation of a minor.

Leading medical groups have supported bans in practice and prove that they cause depression, anxiety and self -hatred.

However, the Supreme Court has agreed to hear a request for prohibition of the conversion therapy in Colorado, which was brought by a licensed professional advisor, whose Christian faith includes the belief that “people thrive if they consistently live with God's design, including their biological gender”.

Other therapists, including Dr. Anderson, have argued that a so -called “exploratory” therapy with supportive clinics can be helpful in order to disguise problems with the mental health of gender identity in young people.

Kellan Baker, who examines the transgender health policy at Whitman Walker, a non -profit municipal health center in Washington, said that the report was a departure from the way health policy in the United States was generally shaped.

“It is important that the medication is practiced by those with expertise who work according to trained clinics in accordance with the care standards that are determined by their respective medical areas – not by the Federal Government,” said Dr. Baker.

He said he feared that the government's report could be given as justification to refuse the medical care of transgender youth.

The centers for Medicare and Medicaid Services, a department of HHS, sent a letter to state medicaid agencies last month in which they were asked not to use MedicAID funds for the supply of gender transfer for minors.

The Attorney General Pam Bondi has instructed the Ministry of Justice to examine doctors who offer such care.

“This document is not a standard for the supply, but is called the government as a justification for refusing to cover the medical care of the young transgender transiting more,” said Dr. Baker.