{"id":3534,"date":"2025-10-25T10:42:36","date_gmt":"2025-10-25T08:42:36","guid":{"rendered":"https:\/\/trajectoiresjeunestrans.fr\/non-categorise\/partisan-involvement-in-health-policy-decisions-the-example-of-the-united-states\/"},"modified":"2026-01-25T17:39:55","modified_gmt":"2026-01-25T16:39:55","slug":"partisan-involvement-in-health-policy-decisions-the-example-of-the-united-states","status":"publish","type":"post","link":"https:\/\/trajectoiresjeunestrans.fr\/en\/news\/partisan-involvement-in-health-policy-decisions-the-example-of-the-united-states\/","title":{"rendered":"Partisan involvement in health policy decisions: the example of the United States"},"content":{"rendered":"

[vc_row][vc_column][vc_column_text css=””]A report by the United States Department of Health and Human Services (HHS)<\/strong>, published on 1 May 2025<\/a><\/span>, presents itself as a scientific review of the \u201ceffectiveness and safety\u201d of gender-affirming care for trans minors. Commissioned by the White House under Presidential Executive Order No. 14187<\/a><\/span>, it claims to provide an evidence base to guide public health policy. In reality, as shown by two independent analyses published recently (Rider et al., 2025<\/a><\/span>; Dowshen et al., 2025<\/a><\/span>), it is less a scientific exercise than a political document aimed at delegitimising an established medical practice. <\/p>\n

A political, not scientific, mandate<\/strong><\/p>\n

The report falls within the framework of Presidential Executive Order No. 14187, signed on 28 January 2025 by Donald J. Trump and entitled \u201cProtecting Children from Chemical and Surgical Mutilation.\u201d This text, available on the official White House website<\/a><\/span>, states: <\/p>\n

\u201cAcross the country today, medical professionals are maiming and sterilizing a growing number of impressionable children under the radical and false claim that adults can change a child\u2019s sex through a series of irreversible medical interventions.\u201d<\/p>\n

The order further states that \u201cit is the policy of the United States that it will not fund, sponsor, promote, assist, or support the so-called \u2018transition\u2019 of a child from one sex to another.\u201d It therefore instructs the HHS: \u201cThe Secretary of HHS shall, consistent with applicable law, take all appropriate actions to end the chemical and surgical mutilation of children.\u201d<\/p>\n

These passages show that the mission entrusted to the HHS was not aimed at a neutral evaluation of the scientific literature, but at constructing an argument to justify the withdrawal of federal funding <\/strong>for gender-affirming care for people under the age of 19 (all categorised as \u201cchildren\u201d). The order moreover uses morally charged terms (\u201cmutilation,\u201d \u201csterilisation,\u201d \u201cfalse claim\u201d) rather than language drawn from the scientific literature, thereby placing the discussion on an ideological rather than a medical footing. <\/p>\n

Budgetary instrumentalisation<\/strong><\/p>\n

Since September 2025, this orientation has extended into budget negotiations surrounding the House HHS Appropriations Bill<\/em>. As revealed by journalist Erin Reed<\/a><\/span>, the Republican draft bill funding the Department of Health includes a clause prohibiting any federal funding for \u201csocial, psychological, behavioral, or medical intervention to treat gender dysphoria.\u201d<\/p>\n

This clause – described as a poison pill <\/em>– is intended to make the budget bill unacceptable to Democrats, to the point of triggering a shutdown <\/em>(budgetary paralysis), by tying the continuation of health programme funding to a ban on gender-affirming care.<\/p>\n

An official statement <\/a><\/span>published on the White House website illustrates this rhetorical framing, accusing Democratic lawmakers of being \u201cthe party of open borders, violent crime, and transgender for everybody.\u201d This combination of budgetary threats and stigmatising language places the issue of trans health within a financial and moral power struggle<\/strong>, in which access to care becomes a variable of political negotiation.<\/p>\n

Critiques by Rider et al. (2025): methodological shortcomings and political bias<\/strong><\/p>\n

Rider and co-authors argue that the HHS report \u201cwas not peer-reviewed, and its authors were not identified.\u201d These shortcomings run counter to the minimum standards of a systematic review. The authors also emphasise that \u201cmost paediatric care relies on evidence of a quality and robustness comparable to that supporting gender-affirming medical care.\u201d The HHS\u2019s demand for randomised controlled trials is, more broadly, methodologically unrealistic <\/strong>in paediatrics. This double standard therefore reflects an intention to selectively discredit the literature favourable to gender-affirming care, in order to pursue the policy initiated by Presidential Executive Order No. 14187. <\/p>\n

Critiques by Dowshen et al. (2025): lack of rigour and misinterpretation<\/strong><\/p>\n

Dowshen and colleagues note that \u201cmore than 20 % of the references in the HHS report come from mainstream news articles, blogs, or social media posts,\u201d and conclude that \u201csuch citations fall well below the minimum level of evidentiary credibility generally expected of a scientific review.\u201d The authors highlight several interpretive distortions<\/strong>: the report foregrounds \u201ctwo deaths by suicide<\/em>\u201d in a cohort of 315 treated trans youth, while omitting that the same study documents a significant improvement <\/strong>in depression, anxiety, and overall well-being after two years of hormone therapy. They further add that the HHS \u201clists hypothetical risks without providing any evidence,\u201d even though \u201cgender-affirming treatments have been used safely and effectively for decades to treat cisgender youth with precocious puberty.\u201d <\/p>\n

A biased use of \u201cquality of evidence\u201d<\/strong><\/p>\n

Both commentaries converge on a central point: the HHS misused the concept of quality of evidence<\/strong> to legitimise an ideological rejection. Dowshen and colleagues note that \u201cthe HHS report uses the technical concept of \u2018quality of evidence\u2019 to justify rejecting gender-affirming care, while at the same time acknowledging that no data support the alternative it promotes \u2013 psychotherapy alone.\u201d <\/p>\n

Safety, benefits, and clinical ethics<\/strong><\/p>\n

Both articles challenge the alarmist presentation of risks: the HHS report \u201cprovides no evidence that puberty-blocking medications and hormone therapy are harmful.\u201d On the contrary, they recall that these treatments have been used for decades with low rates of adverse effects and well-established clinical effectiveness. Rider and colleagues also point out that longitudinal studies show reductions in depressive and suicidal symptoms<\/strong>, as well as improvements in quality of life \u2013 elements absent from the report. From an ethical standpoint, both teams invoke the principle of non-maleficence: refusing or interrupting treatments that have been validated exposes the young people concerned to an increased risk of distress and suicide. <\/p>\n

A political instrument under the guise of science<\/strong><\/p>\n

In conclusion, Dowshen and colleagues denounce \u201ca dangerous intrusion of politics into medicine.\u201d The HHS report follows in practical continuity with the stance of its Secretary, Robert F. Kennedy Jr., who has stated that he intends to \u201cmake the proof<\/a><\/span>\u201d in order to retroactively justify a political decision. Written in just 90 days, this anonymous report contains conclusions that appear to have been drafted in advance. These elements indicate that the HHS report is neither a neutral review nor a methodological contribution to research on gender-affirming care. Rather, it more closely resembles a tool designed to legitimise a policy of exclusion, developed in a climate of budgetary and ideological tension. Its content\u2014widely discredited by the scientific community\u2014forms part of a strategy aimed at dislodging trans-affirming medicine from the domain of clinical science and relegating it to that of moral and partisan debate. For researchers and clinicians, this case should serve as a major warning: it demonstrates how governmental institutions can instrumentalise the rhetoric of scientific rigour to justify normative rollbacks. For trans youth and their families, it concretely signifies an increased risk of denial of care and institutional stigmatisation. <\/p>\n

And for the scientific community, a fundamental question arises: how far can we allow science to become the alibi of a political power that uses it to restrict human rights rather than to improve public health?<\/p>\n

This article was translated from French into English using artificial intelligence tools.<\/em>[\/vc_column_text][\/vc_column][\/vc_row][vc_section][vc_row section_type=”container-width”][vc_column]

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\r\n\t\t\t\t\t\tThe Netherlands strengthens its gender-affirming care model for trans minors<\/span><\/a>\r\n\t\t\t
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The Netherlands strengthens its gender-affirming care model for trans minors<\/span><\/h3><\/a>\t\t\t
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The evidence supports gender-affirming care\n<\/p>Read more<\/span>\t\t\t\t\r\n\t\t\t\t\t<\/polygon>\r\n\t\t\t\t\t<\/polygon>\r\n\t\t\t\t<\/svg>\r\n\t\t\t<\/a>\t\t\t<\/div>\r\n\t\t<\/div>\r\n\t\t\t<\/div>\r\n\t\t\t\r\n\t\t\t\r\n\t\t\t

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\r\n\t\t\t\t\t\tPuberty Blockers and Suicidality: New Study of 230,000 Youths<\/span><\/a>\r\n\t\t\t
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Puberty Blockers and Suicidality: New Study of 230,000 Youths<\/span><\/h3><\/a>\t\t\t
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Lower Suicidality Among Transgender Youths\n<\/p>Read more<\/span>\t\t\t\t\r\n\t\t\t\t\t<\/polygon>\r\n\t\t\t\t\t<\/polygon>\r\n\t\t\t\t<\/svg>\r\n\t\t\t<\/a>\t\t\t<\/div>\r\n\t\t<\/div>\r\n\t\t\t<\/div>\r\n\t\t\t\r\n\t\t\t\r\n\t\t\t

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\r\n\t\t\t\t\t\tWithout consent: the scientific misconduct scandal at Norway\u2019s national centre for trans youth<\/span><\/a>\r\n\t\t\t
\"Oslo<\/div><\/div>\t\t<\/div>\r\n\t\t\t\t\t\t
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Without consent: the scientific misconduct scandal at Norway\u2019s national centre for trans youth<\/span><\/h3><\/a>\t\t\t
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Illegitimate research on trans minors\n<\/p>Read more<\/span>\t\t\t\t\r\n\t\t\t\t\t<\/polygon>\r\n\t\t\t\t\t<\/polygon>\r\n\t\t\t\t<\/svg>\r\n\t\t\t<\/a>\t\t\t<\/div>\r\n\t\t<\/div>\r\n\t\t\t<\/div>\r\n\t\t\t\r\n\t\t\t\r\n\t\t\t

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\r\n\t\t\t\t\t\tIt Is False to Say That Medical Transitions Worsen Young People\u2019s Mental Health<\/span><\/a>\r\n\t\t\t
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It Is False to Say That Medical Transitions Worsen Young People\u2019s Mental Health<\/span><\/h3><\/a>\t\t\t
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On the pseudoscientific exploitation of a study\n<\/p>Read more<\/span>\t\t\t\t\r\n\t\t\t\t\t<\/polygon>\r\n\t\t\t\t\t<\/polygon>\r\n\t\t\t\t<\/svg>\r\n\t\t\t<\/a>\t\t\t<\/div>\r\n\t\t<\/div>\r\n\t\t\t<\/div>\r\n\t\t\t\r\n\t\t\t\r\n\t\t\t

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\r\n\t\t\t\t\t\tWebinar \u201cA Trans-Skeptical Parenthood\u201d on July 2 at 6:30 p.m.<\/span><\/a>\r\n\t\t\t
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Webinar \u201cA Trans-Skeptical Parenthood\u201d on July 2 at 6:30 p.m.<\/span><\/h3><\/a>\t\t\t
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Trans Youth Trajectories webinar\n<\/p>Read more<\/span>\t\t\t\t\r\n\t\t\t\t\t<\/polygon>\r\n\t\t\t\t\t<\/polygon>\r\n\t\t\t\t<\/svg>\r\n\t\t\t<\/a>\t\t\t<\/div>\r\n\t\t<\/div>\r\n\t\t\t<\/div>\r\n\t\t\t\r\n\t\t\t\r\n\t\t\t

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\r\n\t\t\t\t\t\t2.2% of young people in France are trans or non-binary<\/span><\/a>\r\n\t\t\t
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2.2% of young people in France are trans or non-binary<\/span><\/h3><\/a>\t\t\t
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Findings from a nationally representative survey\n<\/p>Read more<\/span>\t\t\t\t\r\n\t\t\t\t\t<\/polygon>\r\n\t\t\t\t\t<\/polygon>\r\n\t\t\t\t<\/svg>\r\n\t\t\t<\/a>\t\t\t<\/div>\r\n\t\t<\/div>\r\n\t\t\t<\/div>\r\n\t\t\t\r\n\t\t\t\r\n\t\t\t

Two analyses of the HHS report<\/p>\n","protected":false},"author":1,"featured_media":3533,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[52],"tags":[],"class_list":["post-3534","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news","grve-entry-item","grve-blog-item"],"yoast_head":"\nPartisan involvement in health policy decisions: the example of the United States - Trans Youth Trajectories<\/title>\n<meta name=\"description\" content=\"Two analyses of the HHS report\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/trajectoiresjeunestrans.fr\/en\/news\/partisan-involvement-in-health-policy-decisions-the-example-of-the-united-states\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Partisan involvement in health policy decisions: the example of the United States - 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