Trump’s Attack on Trans Youth Research Is a Tragic Error

President Trump has made his hostility toward transgender people abundantly clear.

On the first day of his second term, he issued a sweeping executive order against “gender ideology” that led federal employees to erase public health data from websites and remove pronouns from email signatures, among other actions. A week later he banned trans people from the military in an executive order laced with animus, suggesting, ridiculously, that being trans “conflicts with a soldier’s commitment to an honorable, truthful and disciplined lifestyle.” (A federal judge issued a preliminary injunction halting the order last week.)

It’s unsurprising, then, that the administration’s early funding cuts to health research have included millions of dollars worth of grants focused on trans people and gender identity. So far, the canceled grants mostly seem to involve adults. But Mr. Trump also wants to hobble scientific studies on what puberty blockers, hormones and surgical procedures such as mastectomies do to young people who are undergoing treatment for gender dysphoria. One of his early executive orders threatened to withhold federal funding from medical institutions providing these treatments. In combination with the “gender ideology” order, this effectively defunds research studying them.

I’ve long been a critic of American youth gender medicine. Researchers in this field have often produced slipshod work and drawn premature conclusions about the benefits of blockers, hormones and surgery. There are serious unanswered questions about the safety and efficacy of these treatments, which have been banned or restricted in about half of American states and a number of European countries in the wake of several damning government-sponsored reports.

But cutting back on research about these treatments would be a tragic error. What this field needs — and what gender-questioning youth deserve — is reform, oversight and higher methodological standards. To cripple this field in its infancy would be to leave countless families in intolerable limbo.

I regularly hear from parents whose kids express severe distress about their biological sex. These parents desperately want to help their children, but are torn about whether medical interventions are worth the potential risks.

Reliable, evidence-based research on these questions is hard to come by. A parent whose child is considering transition might hope to find insight in a study that followed youth at a Seattle gender clinic between 2017 and 2018. But that team used byzantine statistical techniques to claim that young people who went on blockers and/or hormones enjoyed improved mental health, even though their own data offered no meaningful evidence of improvement. Another team, publishing in JAMA Pediatrics, reported reductions in chest dysphoria in youth as young as 13 who received mastectomies. But to reach that conclusion, researchers primarily relied on a survey that included a number of questions that would naturally shift in the direction of “improvement” after the patient no longer had breasts, like “I sleep with a binder on at night.”