For years, America’s leading medical and psychological organizations have insisted that so-called “gender-affirming care” for minors is medically necessary, evidence-based, and even lifesaving. Questioning these claims could get you labeled a bigot, accused of harming children, or professionally ostracized.
Now, they are being pressed to put their money where their mouth is.
On Oct. 14, the Department of Health and Human Services (HHS), under Secretary Robert F. Kennedy Jr., issued formal demands to six influential medical organizations: the American Academy of Pediatrics, American Psychological Association, American Psychiatric Association, American Medical Association (AMA), Endocrine Society and World Professional Association for Transgender Health (WPATH).
The demand is rather simple: State your current position on medical gender-transition interventions for minors, identify any planned revisions, and say when they will happen. In announcing the letters, Kennedy made clear HHS also wants to see the evidence, saying these organizations “have a responsibility to explain the evidence behind those standards.”
They have 10 business days to respond.
As of this writing, none of the organizations have responded publicly.
— HHS (@HHSGov) October 19, 2026No dodging. No vague statements. HHS is demanding medical organizations explain where they stand on sex-rejecting procedures for minors and the evidence behind their guidance.
This action is the latest step in the Trump Administration’s effort to protect children from harmful… pic.twitter.com/ledjySfUtz
HHS says it first wrote to these groups on Dec. 30, 2025. In its letters to the American Psychological Association (APA), WPATH and the AMA, the department wrote, “To date, the Department has received nothing.”
In his letter to the APA, Kennedy wrote, “For an organization that rarely wants for words on this subject, the silence is telling — and deeply disappointing.”
And he’s right.
For an organization that has spent years lecturing clinicians like me about affirming gender identity, policing language and promoting ideological positions under the guise of science, offering HHS no substantive reply when asked to defend its recommendations is quite remarkable.
But the most significant development, in my opinion, is HHS’s direct challenge to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM).
In its letter to the psychiatric association, HHS states that the DSM has not been updated to reflect the current evidence on the harms of pediatric medical transition. It demands that the association identify potential revisions or corrections to the manual and provide a timeline for those changes.
Considering that the American Psychiatric Association’s Future DSM Strategic Committee is already mapping out the next edition, this letter comes at the perfect time to make sure some actual science makes it into the manual. In that same roadmap, the committee concedes that the criticism that the DSM is built on expert consensus rather than empirical science is, “strictly speaking,” true. It is even proposing to rename it the “Diagnostic and Scientific Manual.” You can’t make this up.
Finally — someone from the top is demanding accountability.
The DSM has become the unquestionable authority in mental health. Its diagnostic labels influence treatment decisions, insurance reimbursement, research funding and how patients understand themselves. Yet many of its diagnostic categories rely on clusters of subjective symptoms and expert consensus rather than objective biological markers. Despite this, the profession routinely treats its classifications as though they are settled scientific facts rather than psychiatric constructs subject to revision, disagreement, and institutional influence.
When an organization carries this much authority over clinical practice, we should demand the highest standards of scientific integrity.
Apparently, that’s too much to ask.
Meanwhile, other medical organizations are beginning to acknowledge the uncertainty that activists and professional associations have spent years dismissing.
In February, the American Society of Plastic Surgeons issued an updated position statement, acknowledging the low quality of available evidence and recommending that surgeons delay gender-related breast/chest, genital and facial surgery until patients are at least 19.
This should concern every parent who was assured that the science was settled.
And let’s not forget WPATH, whose Standards of Care have helped shape medical policies and treatment recommendations. HHS has challenged the integrity of its guideline-development process, including allegations involving suppressed evidence reviews, conflicts of interest and political considerations. On June 17, the Federal Trade Commission and four states sued WPATH over those standards. In a July 28 motion to dismiss, WPATH called its Standards of Care non-actionable scientific opinion.
So much for settled science.
The issue extends far beyond gender medicine. We are watching what happens when professional organizations become so accustomed to institutional authority that they seemingly forget they have an obligation to justify their recommendations.
Science is supposed to welcome scrutiny. It is supposed to withstand challenges, invite disagreement and correct itself when evidence demands it.
It is not supposed to demand obedience.
HHS’s letters do not automatically overturn clinical guidelines or force these organizations to revise their positions. But they do something we have desperately needed in medicine and mental health: They put the burden of explanation back on the institutions making the claims.
For those of us who have spent years challenging ideological conformity within our profession, this is our moment of truth — are these organizations going to produce their evidence to support their claims, or will they finally have to admit that their so-called science was more ideological than factual? I’m going to bet the latter.
Soad Tabrizi, LMFT, is a licensed Marriage and Family Therapist, writer, and founder of Conservative Counselors – a directory connecting reality-based therapists with clients seeking mental health care without fear of ideological judgment. Based in Orange County, California, she operates a private practice and is licensed in nine states. She writes on Substack, where she also hosts a monthly live show, On the Couch, for her subscribers. Her work challenges the ideological capture of psychology and calls out woke orthodoxy in therapy and culture. An unapologetic Christian and outspoken advocate for conservative clinicians, she fights for their rightful place in the mental health profession.