T he Department of Health and Human Services just released its report on gender dysphoria. Its findings are impossible to ignore.
Drawing on systematic reviews in Europe and the U.S., the report shows that the evidence for medical interventions in minors is shakier than assumed — and that the risks, including infertility, reduced bone density, cognitive effects, cardiometabolic disease, psychiatric complications and surgical harms, are more serious than the public has been led to believe.
Yet many physicians may never see this evidence.
That’s because major medical organizations function as gateways to an information cartel about gender medicine. Their refusal to acknowledge emerging evidence leaves clinicians in the dark — and patients pay the price.
Consider the imbalance of continuing medical education (CME) courses on this topic. After residency, physicians rely on CME programs to stay current on emerging evidence and clinical standards.
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There are numerous programs for CME credit promoting gender-affirming interventions for minors, including courses that contradict the evidence base. For example, a CME on AMA Ed Hub recommends Bicalutamide, a sex hormone blocker, for adolescents while downplaying the risks of liver damage. A 2024 case confirmed liver failure in a trans teen. Promoting off-label endocrine drugs without adequate safety data endangers patient safety. Those courses remain available today.
But when a course challenges that narrative, it triggers immediate scrutiny.
We know this firsthand. We collaborated on a CME program developed by the Society for Evidence-Based Gender Medicine (SEGM), with Washington State University serving as the accreditor. The course explored Europe’s shift toward more cautious approaches. It underwent months of review: conflict-of-interest checks, faculty vetting and scientific quality assessments. Then activists got wind of it. WSU yanked the course overnight.
The contrast is difficult to ignore: content that aligns with current ideological expectations remains undisturbed. Evidence that questions it is removed the moment activists aggress.
This dynamic extends into academic research itself: when evidence challenges the preferred narrative, it too is buried.
The World Professional Association for Transgender Health (WPATH) commissioned the Johns Hopkins Evidence-Based Practice Center to review the literature on pediatric gender interventions. When the findings reportedly failed to support WPATH’s assumptions, the organization pressured Johns Hopkins not to publish the results. The review vanished.
Professional medical organizations have refused to confront the emerging evidence. These organizations have become enforcers of Medical Lysenkoism. Their tactics mirror Trofim Lysenko’s catastrophic reign over Soviet agriculture from the 1930s to the 1960s. The “hate” label foisted upon today’s scholar insistent on rigor in gender medicine is equivalent to the “bourgeois” label forced upon Soviet geneticists severely persecuted for objecting to “class-struggle botany.” Scholars who question prevailing assumptions face public attacks or ideological rejection.
The recent peer review process for the HHS report on gender dysphoria laid bare the extent to which medical groups will sidestep inconvenient evidence. The Endocrine Society and the American Academy of Pediatrics were invited to participate. Both declined. Their refusal ensured that the most influential voices in pediatric gender medicine avoided grappling with the evidence challenging their positions.
Medicine depends on the freedom to ask difficult questions, evaluate data honestly and educate clinicians accordingly. The idea laundering taking place at American medical institutions must stop. Patients, families and clinicians deserve nothing less.
Zhenya Abbruzzese, a healthcare researcher, is co-founder of the Society for Evidence-Based Gender Medicine (SEGM).
Dr. Erica Li is an assistant professor of pediatrics at Washington State University. The views expressed above are her own and do not represent those of her employer.