The National Association of Social Workers (NASW) is gravely concerned with a newly released U.S. Department of Health and Human Services document that reviews scientific literature about treatments for gender dysphoria because it contains massive inconsistences.
The 409-page document, Treatment for Pediatric Gender Dysphoria, was commissioned under President Trump’s Executive Order 14187. It aligns with the administration’s anti-transgender policy agenda and ignores existing scientific consensus.
The document frames gender identity as pathological unless resolved through desistance, or having the person stop or severely limit certain behaviors. It also advocates withholding gender-affirming care, despite the distress this can cause people who have gender dysphoria.
This document is also a clear attempt to erase the voices of transgender youth because their perspective is not included in the report. It focuses more on detransitioners, or people who no longer identify as transgender and have decided to stop or reverse gender affirming care, while marginalizing people who benefit from gender affirming care.
NASW supports LGBTQIA+ people and best practices for their care
NASW has long advocated access to affirming, equitable, and comprehensive care for LGBTQIA+ youth and pushed back against federal and state policies that discriminate against people who are LGBTQIA+.
The association supports evidence-based clinical practices supported by major health organizations. And NASW has urged social workers to base their practice on current, peer-reviewed science and recognized best practices.
Clients, including youth, within developmentally appropriate boundaries, have the right to participate in decisions about their care.
Report fails to take into account how the Trump Administration is undermining LGBTQ+ care
The HHS document does raise valid questions about long-term evidence gaps. However, it fails to acknowledge that funding to close these gaps has been limited. In fact, HHS, via the National Institutes of Health, in March 2025 cancelled dozens of LGBTQIA+ related grants that totaled about $40 million.
While the report highlights concern about clinical rigor and informed consent practices, it fails to acknowledge the role the Trump Administration has taken in diminishing and halting the work of underfunded practitioners who have devoted decades of research in hopes of creating a more equitable society for LGBTQIA+ adults and children.
The document fairly points to the need for better data, especially on detransition and regret, but these goals can never be reached without proper research funding.
Trump on Jan. 20 signed an executive order, Defending Women From Gender Ideology Extremism and Restoring Biological Truth to the Federal Government, that defined sex strictly as binary and banning any federal programs that “promote gender ideology.”
Since January, the Trump administration has pursued budget and policy actions targeting LGBTQIA programs and protections. For example, a leaked FY2026 budget draft would eliminate all specialized LGBTQ+ youth services on the 988 suicide/crisis line, sharply reducing the number of counselors trained to work with high-risk LGBTQ youth.
The manipulation of research and clinical guidance to serve anti-trans policy goals is disheartening and extremely dangerous. The document elevates low-evidence critiques while dismissing or discrediting higher-quality studies and guidelines from the American Medical Association, American Academy of Pediatrics, the Endocrine Society and the World Professional Association for Transgender Health.
The National Association of Social Workers stands firmly with transgender and gender-diverse youth. We reject the conclusions of the HHS May 2025 report, which undermines decades of peer-reviewed science, silences trans voices, and politicizes medicine. NASW remains committed to advancing gender-affirming, developmentally appropriate, and ethical care.
