Trump Can Bring Transparency to the Transgender Mess

Of all the messes that Joe Biden is leaving Donald Trump, the dirtiest may be the federal government’s endorsement of sex-change treatments for children.

The Biden administration has supported expanding children’s access to invasive and irreversible medical interventions while ignoring the mounting evidence -- including from a landmark federally funded study -- that children aren’t benefitting. Trump can right this wrong by providing physicians and families with full transparency about the sorry state of the medical research and protecting children from being subjected to further experimentation and pain.

The outdoing president’s moral and medical muddle is clear in his administration’s tortured attempt, in July, to assert its opposition to sex-change surgeries for children. This claim was false, given the Biden administration’s simultaneous attempts to overturn the bans on such surgeries in 26 states. The administration’s real views can be found in the news, from June, that senior officials at the Department of Health and Human Services pressured the field’s international standard-setter -- the World Professional Association of Transgender Health -- to drop all age limits for surgeries and hormonal treatments. The association obliged.

Such political meddling in medicine is all the more astounding because the federal government can’t show that children benefit from sex-change treatments. Since 2015, the National Institutes of Health has funded an ongoing study that activists hoped would prove otherwise. Yet in October, the study’s lead author -- Dr. Johanna Olson-Kennedy, head of the Center for Transyouth Health and Development at Children’s Hospital Los Angeles -- refused to publish the findings. The New York Times reported that all she would say is that children as young as eight who were taking puberty blockers showed no improvement in their mental health (although she is now suing over the reporting).

Within days of Olson-Kennedy’s stunning admission, our organization submitted Freedom of Information Act requests with NIH, seeking the study team’s reports on their findings as well as the underlying data. NIH provided us with the reports yet ignored our request for the data. The omission is telling, as are the reports.

The study violates NIH’s requirement that the research it funds must be “free from bias resulting from an investigator’s financial conflict of interest.” Olson-Kennedy provides puberty blockers and other treatments at her practice, as do at least three of her co-researchers. They have a vested interest in seeing their own business model validated. The reports also reveal failures of basic child safeguarding. Intoxication or substance abuse restricts children from participating in the study only if it impairs “the ability to give true informed consent” in the opinion of the study staff. Moreover, the study lacks a control group, making it impossible to discern whether changes in mental health can be traced to puberty blockers.

The researchers hypothesized that they would see an improvement in mental health, but they couldn’t produce their intended result even with the study’s flaws. Olson-Kennedy now claims that mental health didn’t improve because kids who received blockers were already doing fine, but that contradicts previous reports from her and her fellow researchers that a quarter of the study subjects had “suicidal ideation” and that more than half had “elevated depression symptoms” and “clinically significant anxiety” at the outset of treatment. Such conflicting statements aren’t a sign of honest brokers seeking evidence.

With the NIH’s signature research project on the rocks, the Biden administration has had to look to other sources to justify its support for child sex changes. Once again, no good evidence exists. Senior officials have touted the standards released by WPATH -- the organization that dropped the age limits -- yet that organization is censoring evidence, too. Earlier this year, documents from a federal court case in Alabama revealed that WPATH had commissioned systematic reviews of evidence from Johns Hopkins University, only to bury the reviews when the evidence on benefits to children was found to be weak.

None of these disturbing developments have dissuaded the Biden administration from supporting child sex changes, including on the federal taxpayer’s dime. Thankfully, the arrival of the Trump administration provides an opportunity to put evidence ahead of ideology, starting with three steps.

First, the incoming president should direct the National Institutes of Health to immediately disclose all data and evidence from its ongoing study. Physicians and families deserve to know what the authors and federal authorities are hiding.

Second, the president should order the Department of Health and Human Services to conduct a systematic review of all available evidence on the efficacy of transgender treatments for children. The European countries that have conducted such reviews have generally found that the evidence is lacking, and they have subsequently restricted children’s access to puberty blockers, cross-sex hormones, and surgeries.

Third, the president should work with Congress to ban all taxpayer funding for child sex-change treatments, which could be included in a reconciliation package early in the new year. This would lay the groundwork for a broader ban -- either legislatively or through regulation -- on all transgender medical interventions for children.

The Biden administration is complicit in a disturbing and dangerous experiment on children, showing no regard for evidence or ethics. As president, Trump must do what his predecessor has refused to do: provide the transparency that Americans deserve and the protections that vulnerable children desperately need.

Stanley Goldfarb, M.D., is the chairman at Do No Harm, where Roy Eappen, M.D., is a senior fellow.