Ignoring the Charge of “Gender Affirming Care” as Gay Conversion Therapy

The Liberal Media’s Response to the HHS Report Underscores Its Necessity

The U.S. Department of Health and Human Services (HHS) report, Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices, released May 1, 2025, has sparked intense debate. Liberal media outlets, echoing the American Academy of Pediatrics (AAP) in defending “gender-affirming care,” or, “Pediatric Medical Transition” (PMT), as it is called here, dismiss the report as politically motivated. Yet their refusal to engage with one of the central claims of the LGB community — that PMT functions as a form of gay conversion therapy for same-sex attracted youth — suggests why the completion of this evidence-based review is so critical for the United States. The report’s meticulous documentation of the overrepresentation of gay, lesbian, and bisexual youth in gender clinics, coupled with disturbing historical parallels demands attention. The media’s silence on this point underscores why the report is so important.

The HHS report reveals a stark pattern. Gay, lesbian, and bisexual youth dominate gender clinic caseloads, a trend spanning decades. The Dutch Protocol (2000–2008) found 62 of 70 patients were homosexual, six bisexual, and only one heterosexual (p. 66). A 2020 U.S. survey showed over 60% of transgender or non-binary youth were same-sex attracted (p. 65).

The report warns that U.S. gender clinics, prioritizing affirmation, may misdiagnose distress from internalized homophobia as gender dysphoria (GD), leading rapidly to the prescription of puberty blockers, hormones, or surgeries that risk infertility or sexual dysfunction (p. 62; p. 64). The Cass Review, which examined the UK’s Tavistock clinic, found 68% of girls were lesbian and 21% were bisexual, with homophobia often driving GD, yet rarely explored when the affirmation-only model was applied (Cass Review, 2024, p. 118).

U.S. clinicians are witness to these risks. Jamie Reed, a lesbian, and the whistleblower at a Missouri gender clinic, saw same-sex attracted youth rushed into interventions without investigation into their traumatic backgrounds. She faced accusations of transphobia for questioning this haste. Tamara Pietzke, another former gender clinician, described a 13-year-old in Washington, exposed to a homophobic environment with a complex history of abuse, trauma and mental health issues who was approved for testosterone on her first visit despite no clear GD diagnosis (p. 201). Such cases can end in tragedy. One of the young same-sex attracted Dutch Protocol patients died from vaginoplasty complications (p. 68).

History provides haunting parallels to contemporary PMT, revealing how societal pressures and medical interventions have long intersected with personal distress. In the 1950s, George Jorgensen, later known as Christine, a gay man grappling with his same-sex attractions, sought hormone therapy and surgical interventions to alleviate his profound discomfort. He attributed his struggles to a “glandular imbalance” and perceived issues with his genitalia, reflecting the limited frameworks available to understand his identity at the time (p. 42). Jorgensen’s discovery of Lili Elbe’s autobiography, Man into Woman, played a pivotal role in shaping his transsexual identity, offering a narrative that resonated with his experiences and aspirations. His family, eager to distance themselves from the social stigma attached to homosexuality in that era, embraced his transition as a more acceptable alternative to acknowledging his sexual orientation (p. 228).

Jorgensen’s physician, Christian Hamburger, was himself influenced by personal experiences, particularly his lesbian sister’s struggles with societal rejection, which informed his approach to gender and sexuality. Initially, Hamburger viewed Jorgensen as homosexual, yet his treatment decisions marked a shift toward medicalizing such distress (p. 44). In 1953, Hamburger analyzed 756 letters from individuals seeking similar interventions, noting a striking prevalence of homosexuality among them. One poignant example was a 16-year-old girl who expressed her love for another girl and her desire to live as a boy, illustrating the complex interplay between same-sex attraction and gender dysphoria (p. 45; p. 47). Similarly, the historical case of Einar Wegener, who transitioned to Lili Elbe under the care of Magnus Hirschfeld, highlights how individuals navigated homophobic societies by redefining their gender to align with their desires, often with medical support (p. 42).

Modern PMT, the report argues, may perpetuate this by medicalizing distress due to internalized homophobia (p. 48; p. 71). By drawing these connections, the report underscores the risk of repeating history’s mistakes, where medical solutions were applied to complex personal and cultural challenges, often with unintended consequences.

The medicalization of gender dysphoria raises a profound justice issue, echoing the dark history of pathologizing homosexuality. Until 1973, medicine used hormones to suppress same-sex attraction, a practice now widely condemned (p. 71). Today, pediatric medical transition (PMT), with its risk of sterility, threatens to repeat this legacy by steering same-sex attracted youth toward irreversible interventions, potentially undermining their future as gay or lesbian adults seeking parenthood in same-sex relationships (p. 65). The HHS report argues that PMT, by prioritizing affirmation of gender dysphoria without probing underlying homophobia, mirrors gay conversion therapy in its failure to address sexual orientation (p. 227, p. 256). Instead, it advocates for psychotherapy, which offers proven benefits or, at worst, no harm, unlike the uncertain outcomes of medical transition (p. 78). The Cass Review (p. 150). reinforces this, criticizing affirmative care’s neglect of sexuality and defending psychotherapy’s neutral, exploratory approach. Far from being conversion therapy, psychotherapy—once central to the Dutch Protocol—remains patient-centered, prioritizing youth’s long-term well-being over rushed medical solutions (HHS Report, p. 89; p. 256).

Liberal media dismiss these concerns. The New York Times, The Washington Post, Science and CNN regard the report as an attack on PMT. They fail to engage with the overrepresentation of same-sex attracted youth diagnosed as trans by gender clinics. The AAP shares this blind spot. Its 2018 policy notes 50–70% of gender-diverse youth are same-sex attracted but deems this incidental. Its affirmative model assumes evaluations address homophobia, dismissing the HHS report’s 80–90% prevalence claim (p. 228). While citing PMT’s mental health benefits, the AAP overlooks ethical concerns about misdiagnosing gay youth. The AAP claims to be in the process of doing its own systematic review of the evidence.

The Tavistock scandal offers a haunting precedent. In 2019, five clinicians resigned from the UK’s GIDS, alarmed by a reality that spawned a dark joke among staff: At the rate they were going “there would be no gay people left.” Reported in The Times and discussed in The Homoarchy, 2021, this quip reflected fears that same-sex attracted youth were being misdiagnosed and rushed into sexuality-destroying interventions. Dr. Matt Bristow cited youth identifying as trans after homophobic bullying, warning these procedures were, in effect, “conversion therapy for gay children.” His observations were also detailed in the book, Time to Think, by Hannah Barnes.

This collective silence underscores the urgent need for the HHS report’s call to action. With meticulous detail, it documents the overrepresentation of gay youth in pediatric medical transition (p. 65), the profound risks of irreversible medical interventions (p. 71), and troubling historical parallels to the pathologization of homosexuality. Building on the Cass Review’s sobering findings and the cautionary collapse of the Tavistock’s Gender Identity Development Service, the report lays bare a critical blind spot in the U.S. approach to gender dysphoria, where well-intentioned policies risk repeating past mistakes.

The report directly challenges the affirmation-only paradigm, endorsed by the American Academy of Pediatrics and amplified by liberal media, which often glosses over the intricate interplay of sexual orientation and gender identity. It demands a seismic shift toward an evidence-based framework that prioritizes psychotherapy to address societal pressures, internalized homophobia, and stigma. Such an approach seeks to safeguard against the premature medicalization of sexual orientation. Grounded in decades of clinical evidence and ethical imperatives, the HHS report stands as a clarion call — a pivotal intervention compelling clinicians, policymakers, and the public to confront these uncomfortable truths. By heeding its warnings, we can forge a path that protects vulnerable youth from irreversible harm, ensuring care that is compassionate, rigorous, and truly in their best interests.