Risch wants HHS to prove its recommendations are 'evidence-based' and not driven by a 'contentious ideology'

By Brianna Herlihy - March 29, 2023

Republican lawmakers led by Sen. Jim Risch, R-Idaho, are demanding that the Department of Health and Human Services (HHS) reveal the evidence the agency relies on to encourage medical providers to perform "gender affirming care" – like hormone therapies and sex-change surgeries – on minors with gender dysphoria.

In a letter to HHS Secretary Xavier Becerra, Risch and fourteen of his Republican colleagues from the House and Senate said "HHS has a moral responsibility to ensure its recommendations are evidence-based and not driven by a contentious ideology," and alleged that HHS is encouraging medical providers to perform "gender affirming care."

"We are increasingly alarmed that HHS’ advocacy has led health professionals to prescribe dangerous and experimental drugs and surgeries to troubled children — in many cases covered with taxpayer dollars," the lawmakers wrote.

"’Gender affirming care’ is far from proper health care given the treatments include experimental hormonal and surgical interventions on children’s bodies that cause permanent damage," they wrote.

"Millions of parents across the nation are fearful that medical professionals are advocating for and are performing irreversible interventions on their children that will permanently alter them both physically and emotionally," the lawmakers said.

Signatories to the letter said they "want answers as to what guidance HHS is sharing regarding this so-called care, the evidence for these policy decisions, and a full systemic review to ensure these changes are not ideologically motivated."

The Republicans say they’re worried the agency is presuming that adolescents can give informed consent for life-altering procedures, despite long-standing medical community and legislative standards that say young people are not capable of making such long-term decisions until the age of 18 – "when they are responsible for consenting to their own major medical and other significant life decisions."

"Studies show that children who experience gender discordance often outgrow gender dysphoria and reconcile with their biological sex when medical professionals do not encourage or provide treatment to spur a gender change," the lawmakers wrote, adding that research shows up to 98 percent of such children come to accept their biological sex after puberty.

The lawmakers said children who do undergo puberty blocking drugs and cross-sex hormones are at risk of developing permanent physical and mental health problems, like as infertility, blood clots, osteoporosis and mood changes.

The letter also rejected claims from "gender affirm care" proponents that gender surgery reduces suicide and suicidal thoughts in gender dysphoric youth.

Those claims, the lawmakers say, "lack evidentiary support and are contradicted by other studies."

"A new analysis found that children in states who were allowed access to cross sex treatments without parental consent had a 14 percent higher suicide rate than those in states where parental consent was required," the letter said. It added that the most comprehensive study on this subject, conducted over a 30-year period in Sweden, shows people who underwent gender transition have a far higher risk of suicide than the general population.

The lawmakers gave the agency a 30-day deadline to provide analysis that led the Department to determine that the benefits of "gender affirming care" outweigh the physical and psychological risks to kids, a "systematic review" of the medical literature HHS used to form the basis for its policy supporting "gender-affirming care," and other detailed information from the agency about its position on the subject.

Senators Kevin Cramer, N.D, Mike Crapo, Idaho, Joni Ernst, Iowa, Marsha Blackburn, Tenn., Mike Lee, Utah, Marco Rubio, Fla., Mike Braun, Ind., Dan Sullivan, Alaska, Ted Cruz, Texas, and Josh Hawley, Mo. signed the letter, along with Reps. Russ Fulcher, R-Idaho, Jeff Duncan, R-S.C., Ralph Norman, R-S.C., and Doug LaMalfa (R-Calf.).