Evidence Versus Eminence

Evidence Based Studies
The Agency’s report attaches five expert reports from subject-matter experts, including health care researchers who studied the quality of the evidence relied upon for “gender affirming" care. Links to their reports are below along with quotations from their key findings.

  • Romina Brignardello-Petersen, DDS, MSc, PhD (clinical epidemiology and health care research) & Wojtek Wiercioch, MSc, PhD (health care research) - AHCA Brignardello-Petersen Report
    • “We found low and very low certainty evidence suggesting improvements in gender dysphoria, depression, anxiety, and quality of life, as well as low rates of adverse events, after treatment with puberty blockers and cross-sex hormones.” (page 4)
    • “There is very low certainty about the effects of puberty blockers on suicidal ideation.” (page 3)
    • “Due to the important limitations in the body of evidence, there is great uncertainty about the effects of puberty blockers, cross-sex hormones, and surgeries in young people with gender dysphoria.” (page 5)
  • James Cantor, Ph.D. (psychology) - AHCA Cantor Report
    • “The research importantly distinguishes completed suicides—which occur primarily in biological males and involve the intent to die—from suicidal ideation, gestures, and attempts—which occur primarily in biological females and represent psychological distress and cries for help. The evidence is minimally consistent with transphobia being the predominant cause of suicidality. The evidence is very strongly consistent with the hypothesis that other mental health issues, such as Borderline Personality Disorder (BPD), cause suicidality and unstable identities, including gender identity confusion.” (page 3)
    • “The international consensus of public health care services is that there remains no evidence to support medicalized transition for youth. The responses in the U.S. stand in stark contrast with Sweden, Finland, France, and the United Kingdom, which are issuing increasingly restrictive statements and policies, including bans on all medical transition of minors.” (page 3)
  • Quentin Van Meter, MD (pediatric endocrinology) - AHCA Van Meter Report
    • “The affirmation advocates repeatedly refer to the established increased risk of suicide if any of the affirmation strategies are not followed to completion. They point to their own published studies touting dramatic improvement in mental health status of patients who are affirmed in all three ways, but they cite data from convenience sampling, which never should be used to prove anything other than association, at best. Such studies can never prove causation.” - (page 9)
  • Patrick Lappert, MD (plastic surgery) - AHCA Lappert report
    • “The claim is made that chest masculinization has proven benefit in reducing dysphoria and the associated risk of suicide. But published studies that make this claim of benefit offer evidence that is low to very low quality.” (page 4)
  • G. Kevin Donovan, MD, MA (pediatrics and bioethics) - AHCA Donovan report
    • “Until we can demonstrate the efficacy and safety of any proposed treatment or intervention, its usage must properly be considered a medical experimentation and require fully informed consent. Anything less is a betrayal of both our principles and our progeny.” (page 7)