Supporting people who regret medical gender transition procedures, especially minors, is a top priority for the Trump administration, Assistant Health and Human Services Secretary for Health Brian Christine said.
Christine spoke with the Washington Examiner ahead of his appearance at a Detransitioner Awareness Day conference on Wednesday. The event was intended to raise awareness of those who regret undergoing transgender procedures and “detransition” back to identify with their biological sex.
Regardless of whether a patient took puberty blockers or cross-sex hormones or underwent invasive reconstructive surgery for so-called “gender-affirming care,” Christine said detransitioners need not only clinical healthcare but also support from policymakers.
“They need mental health support, they need emotional support, they need love, and they need to understand that this government, this administration, this secretary of HHS, and this assistant secretary for health stand with them to protect them and get them through these things,” Christine said.
Christine, who practiced urology for 30 years before becoming the head of the U.S. Public Health Service Commissioned Corps late last year, was a key player in developing the Trump administration’s report on transgender medicine for minors.
That report, along with similar reports produced in the United Kingdom and other countries, found only very weak evidence to support medicalized transitions for children and teenagers. Instead, existing studies point to mental health support, counseling, and behavior-based therapies for youth struggling with gender dysphoria.
But there are even fewer data to inform what kind of care is appropriate for people who detransition, in part because the number of detransitioners is still relatively small.
A 2022 estimate from the University of California, Los Angeles, reported there were roughly 1.3 million transgender-identified adults in the U.S. and about 300,000 transgender-identified teenagers ages 13 to 17.
Some studies suggest that, of those who medically transition, between 1% and 10% experience regret. It is also difficult to differentiate between people who discontinue transgender treatment, such as temporarily stopping cross-sex hormones due to cost, and those who permanently detransition.
Multiple outlets reported last spring that the White House directed the National Institutes of Health, the research arm of the Department of Health and Human Services, to fund grant projects better studying detransitioners, including reasons for detransitioning and long-term health outcomes of pursuing medical gender transition.
From a clinical perspective, Christine said, detransitioners can experience significant lifelong side effects. These include bone and muscle density problems due to puberty blockers or cross-sex hormones and urinary or reproductive problems due to vaginoplasty or phalloplasty, more commonly known as “bottom surgery.”
“Anytime that you put a knife-to-skin, there’s always potential for complications,” Christine said. “And so these kids can have to live the rest of their lives with complications from their mutilating surgeries.”
Activist groups have called on HHS to update medical diagnostic criteria with specific medical codes for detransitioners to assist physicians and healthcare professionals in providing treatment following complications.
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Currently, the only code for detransitioners in the ICD-10-CM, the official U.S. medical diagnostic coding system, is “personal history of sex reassignment.” Advocates say this code is too vague.
The organization Do No Harm, which stands against gender transition medicine for minors, presented last year at the Centers for Disease Control and Prevention’s panel for updating the ICD-10, arguing that providing more codes that thoroughly describe complication symptoms will help detransitioners receive better care.
