An author of the recent Department of Health and Human Services (HHS) review on “gender affirming care” for minors has stepped forward, explaining why the team chose to remain anonymous and why the findings matter profoundly.
In a June 26 op-ed for The Washington Post, Alex Byrne, a professor of philosophy at Massachusetts Institute of Technology, revealed his participation in the nine-member team behind the review. According to Byrne, the authors chose not to identify themselves initially partly because they were concerned about professional backlash.
“Disclosure might distract attention from the review’s content or lead to personal attacks or professional penalties,” Byrne wrote. “Those who have raised concerns about the field of pediatric gender medicine are well aware of the risks to reputations or careers.”
As CatholicVote previously reported, HHS, under the direction of an executive order from President Donald Trump, released a wide-ranging review May 1 that revealed the lack of solid evidence behind gender-related medical interventions for minors. It raised serious questions about the long-term physical and psychological risks of such treatments.
Byrne described the review as a rigorous, interdisciplinary analysis informed by experts in endocrinology, psychiatry, medical ethics, health policy, and other fields. Although he is not a physician, Byrne said his background in philosophy, particularly medical ethics, helped him evaluate the arguments critically.
“Philosophy overlaps with medical ethics and, when properly applied, increases understanding across the board,” he said. “Philosophers prize clear language and love unravelling muddled arguments, and the writings of pediatric gender specialists serve up plenty of obscurity and confusion.”
>> Catholic health group backs HHS review: ‘Gender affirming’ care is harmful to children <<
The review was completed by a politically diverse group, according to Byrne. He emphasized that most contributors, including himself, were liberals.
The report lambasted the American Academy of Pediatrics’ “gender-affirming care” approach, arguing that it rests on “very weak evidence.” According to the report, puberty blockers, cross-sex hormones, and mutilating surgeries carry significant risk of infertility, lifelong sexual dysfunction, and surgical complications and there is no solid proof that minors’ mental health improves.
“After surveying all the evidence, and applying widely accepted principles of medical ethics, we found that medical transition for minors is not empirically or ethically justified,” Bryne said.
One of the report’s key conclusions is that medical transition for minors is “ethically inappropriate” due to its unfavorable risk/benefit profile. The report aligns with Sweden’s 2022 decision to restrict such interventions, as well as similar moves by other European countries.
Byrne criticized medical organizations for rejecting the report without engaging with its evidence.
“If [the report] misrepresents existing research,” he asked, “why not clinch the case with some examples? Yet none were provided.”
The report also highlighted concerns about language manipulation in the field. Euphemisms like “gender-affirming top surgery” obscure the reality of removing healthy breast tissue from young girls, Byrne wrote.
“The review is a sober examination of what by any standards are drastic medical interventions for physically healthy minors,” he said. “It deserves to be read by people of all political leanings. Whether its early critics bothered to do so is unclear.”
He also pointed to the replacement of words like “girls” with “individuals assigned female at birth” as a tactic that “has the Orwellian effect of making plain truths impossible to state.”
Calling for open debate and intellectual honesty, Byrne concluded, “We all stand to benefit from free and open inquiry, in medicine, academia and in society more broadly.”
