During a recent Supreme Court hearing, Justice Samuel Alito raised questions about the efficacy of puberty blockers and hormone treatments for transgender youth. He pointed out that both the UK and Sweden have revised their policies to restrict access to these treatments. Alito specifically referenced the Cass Review, a study conducted in the UK, which found the rationale for early puberty suppression to be unclear and the evidence supporting mental health benefits to be weak.
The Cass Review, named after Dr. Hilary Cass, has faced criticism from LGBTQ advocates, scholars, and practitioners. Despite the controversy, the review prompted healthcare providers in the UK to reduce their use of puberty blockers. Earlier this year, England's National Health Service decided to stop prescribing puberty blockers for children and young people with gender dysphoria, citing insufficient evidence of safety and clinical effectiveness. The treatment would only be available through clinical trials and private clinics, with existing patients allowed to continue.
Solicitor General Elizabeth Prelogar noted that while the UK and other countries have imposed restrictions, they have not completely banned gender-affirming care. The Cass Review acknowledges that such care may be necessary for some transgender adolescents, emphasizing the need for individualized approaches.
In contrast, major medical associations in the United States, including the American Medical Association, American Psychiatric Association, Endocrine Society, American Psychological Association, American Academy of Pediatrics, and American Academy of Child & Adolescent Psychiatry, support gender-affirming care. These organizations consider it the gold standard of clinically appropriate treatment, capable of providing life-saving benefits for both children and adults.
