President-elect Donald Trump’s comprehensive plan to end “unscientific and harmful” government-funded gender-affirming care for minors is supported by science, writes Nicolas Hulscher, MPH, an epidemiologist and foundation administrator at the McCullough Foundation, who has raised similar concerns regarding the physical and psychological effects of such treatments on youth.
Hulscher’s analysis cites extensive studies indicating serious risks associated with gender-affirming treatments. For instance, a systematic review by Baxendale has revealed that puberty blockers, often prescribed to delay adolescent development, may have irreversible effects on cognitive function, with potential impairments even after treatment discontinuation.
Additionally, the review highlights that the impact of these treatments on neuropsychological health has yet to be adequately studied in long-term, controlled trials, underscoring the risks associated with this medical intervention.
Trump’s plan also draws on findings about physical complications from gender-affirming surgeries, especially when performed on minors. According to Hulscher’s research, an estimated 13,000 gender reassignment surgeries were performed on minors between 2019 and 2023, with complication rates ranging significantly depending on the procedure.
For example, phalloplasty—the surgical creation of a phallus in female-to-male transitions—has a reported complication rate of 76.5%, often involving urethral fistulas. Even vaginoplasty procedures, which generally have lower complication rates, still pose risks, with up to 46% of patients experiencing complications like bleeding, infection, or surgical breakdown. Some studies show regret rates of 2% to 4% in individuals who have undergone gender reassignment surgeries.
Trump’s plan, which he refers to as “a means to end child abuse,” seeks to address concerns over these documented risks. He aims to revoke policies enacted under the Biden administration that encourage medical treatments lacking scientific validation. Trump’s proposal includes a directive for the Department of Justice to investigate pharmaceutical companies and hospital networks to determine if they have failed to disclose adverse long-term effects of these treatments, or have illegally marketed puberty blockers and hormones for gender transitions.
Research by Dhejne et al., reviewed by Hulscher, shows that individuals who underwent sex reassignment surgeries experienced significantly higher rates of suicide attempts, with a 19-fold increase in risk compared to the general population. Additionally, a longitudinal study by Bränström and Pachankis found no significant reduction in mental health-related healthcare visits following such procedures, challenging claims that gender-affirming surgeries inherently improve mental well-being.
Trump’s comprehensive approach includes legislation that would recognize only male and female genders as assigned at birth, reinforced by a proposed amendment to Title IX protecting female athletes from male competition in women’s sports. Furthermore, the plan outlines protective measures for parental rights, ensuring that no minor can pursue gender transition without parental consent.
The Trump administration also seeks to defund any federal programs promoting gender transition for minors. According to the president-elect, hospitals that perform these procedures on minors could lose eligibility for Medicaid and Medicare. “We are not funding what amounts to child abuse,” Trump said.
Hulscher’s analysis notes that the side effects of puberty blockers and hormone treatments are extensive, with studies reporting adverse effects including bone density loss, mood swings, and cognitive impact. A study on puberty blockers reviewed by Hulscher also linked their use to increased cardiovascular risk factors and, in some cases, irreversible sterility.
With this plan, Trump seeks to eliminate taxpayer funding for what he calls “unscientific and harmful practices” targeting minors. By aligning with the findings of researchers like Hulscher, Trump aims to halt procedures that have long-term, detrimental consequences on both physical and mental health.