HHS demands explanations from medical groups regarding sex-rejecting procedures for minors

The U.S. Department of Health and Human Services (HHS) issued a letter on Oct. 14 to leading medical organizations requiring them to explain whether they continue to support sex-rejecting procedures for minors, in light of the department’s findings that the procedures harm children.

The inquiry also asks the organizations to explain whether they will change their recommendations on the procedures, and what medical evidence supports their positions.

According to an Oct. 14 HHS press release, the department has also requested a timeline for any changes and said it expects written answers within 10 business days.

“Today’s action is the latest step in the Trump Administration’s sustained effort to protect children from sex-rejecting procedures and bring transparency and accountability to so-called ‘gender medicine’ in pediatric care,” the release said. HHS Secretary Robert F. Kennedy Jr. called on the organizations to explain the basis for their medical standards.

“When medical organizations set standards that shape the care of children, they have a responsibility to explain the evidence behind those standards,” Kennedy said. “HHS has asked these organizations for clear answers about their current positions, the evidence supporting their guidance, and whether they intend to change it. Parents and clinicians deserve transparency, and we expect these organizations to provide it.”

The letters were sent to the World Professional Association for Transgender Health, the American Medical Association (AMA), the American Psychiatric Association, the American Psychological Association, the Endocrine Society, and other organizations, the release noted.

HHS described the letters as a final demand after previously asking the organizations in December 2025 to explain their positions and any plans to revise their guidance, according to the release.

In the follow-up letter to the Endocrine Society, Kennedy said that the department had requested a response regarding its position on sex-rejecting procedures for minors initially on Dec. 30, 2025, and was met with silence. 

“One would expect that an organization holding itself out as a steward of national medical standards and claiming to place the health and safety of children above all else might have something to say when the evidence calls its guidance into question,” Kennedy wrote. “Surely a medical society so confident in its position would welcome the chance to defend it. Endocrine Society’s refusal to engage is difficult to square with the principles it so frequently professes.”

In the follow-up letter to the AMA, Kennedy noted that some organizations have taken action following the HHS’ May 2025 report documenting substantial evidence of harm for minors from sex-rejecting procedures. The American Society of Plastic Surgeons (ASPS) updated its position in February, Kennedy noted, explaining that the society now holds that the evidence in support of sex-rejecting procedures is “low quality/low certainty.” 

Kennedy pressed the AMA to clarify where it stands, as the ASPS did. 

“While AMA seemingly changed course on sex-rejecting procedures on minors in a statement made to The New York Times, the Association later reversed course saying that its position has not changed,” he wrote. “AMA should be willing, as ASPS was, to engage with the evidence and state its position plainly.”

In the release, the department also noted its efforts to bar hospitals participating in Medicare and Medicaid from performing the procedures on children and to prohibit federal Medicaid and Children’s Health Insurance Program funding for those procedures.