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A new report from the U.S. Department of Health and Human Services (HHS) has raised concerns in the trans community by questioning gender-affirming care and promoting harmful ideas and practices. Although this report is focused on pediatric gender-affirming care, we know this may still bring up fear or confusion, so we want to make one thing clear: your care with Plume is not changing. Let’s break down what the report says, what it doesn’t mean, and why your care remains safe with us.

What’s going on with the new HHS report I’m seeing in the news?

On May 1, 2025, HHS released its own version of the U.K.’s discredited Cass Review—a 400-page “review” that attempts to undermine decades of research and standards supporting gender-affirming care, especially for trans youth. The report promotes psychotherapy over medical care, which could enable discredited and harmful practices like conversion therapy.

Although the report is focused on youth and claims it is “not intended to serve as a clinical practice guideline,” its misleading and biased conclusions could be misused or weaponized to influence key stakeholders, such as policymakers, providers, or payers. 

At the same time, the White House, via the National Institutes of Health (NIH), is proposing new research focused on “social transition and/or chemical and surgical mutilation” of children who transition. The NIH has been directed to study topics like “regret” and “detransition” in both youth and adults. According to the memo, this initiative is “very important to the President and the Secretary.”

The scope, design, and funding for these studies are expected to be announced soon, with results likely to be released in the next six months.

Does this mean trans adults will lose access to gender-affirming care?

No. This report does not change your ability to access care. It has no legal authority and does not alter existing laws or policies. It also does not reflect the position of the broader medical community.

Every major medical organization—including the AMA, APA, Endocrine Society, and AAP—continues to affirm that gender-affirming care is evidence-based, safe, and life-saving. Additionally, they all released statements refuting and discrediting the HHS Review and its attempts to politicize evidence-based medicine. 

Will  Plume be forced to shut down or stop offering care?

Absolutely not. Plume is here for you. We remain fully committed to providing safe, affirming, and evidence-based care to trans and gender-diverse adults. Your access to gender-affirming hormone therapy (GAHT) and other services is not changing. We are also actively working with advocacy and medical organizations to defend and protect our community’s continued access to care.

Is gender-affirming care still considered safe and supported by science?

Yes. More than 2,000 scientific studies have examined and determined the positive effect of gender-affirming care since 1975.  Gender-affirming care has been studied for decades and is backed by an overwhelming consensus from medical experts in the U.S. and globally. It is the only proven treatment for gender dysphoria and has significantly improved quality of life and mental health outcomes for trans people.

Medications used in GAHT are well-established and have been safely prescribed for a variety of conditions beyond transition-related care. Regret rates for gender-affirming care are consistently shown to be extremely low, less than 1%, which is far lower than many common procedures like joint replacement.

Is this report promoting conversion therapy?

While the report doesn’t explicitly promote conversion therapy, its recommendations closely align with practices long discredited by the medical community. It promotes psychotherapy as the sole treatment approach for transgender youth, while casting doubt on evidence-based interventions like puberty blockers, hormone therapy, and, in rare cases, surgery.

Experts warn that mandating psychotherapy instead of medical care, rather than offering it alongside gender-affirming treatments, can function as a modern form of conversion therapy. This approach has been broadly rejected by major medical organizations, including the American Psychiatric Association and the American Academy of Pediatrics.

Dr. Dan Karasic, a psychiatrist and professor emeritus at UCSF, notes: “There’s absolutely no evidence that psychotherapy is a substitute for those people who need medical care.” Most transgender youth already engage in mental health support as part of their care plan. The concern is not with therapy itself, but with how it’s being used—as a gatekeeping mechanism that denies youth access to the full spectrum of care supported by decades of research.

Why is this report being released now?

This report is part of a broader political strategy to undermine decades of peer-reviewed science, attack gender-affirming care, and restrict access to medically necessary treatment, especially for trans youth. It follows the Trump administration’s rescinding of the NIH’s Scientific Integrity Policy and the administration’s directive for the NIH to launch biased studies focused on “regret” and “detransition.” These directives also use inflammatory language such as “chemical and surgical mutilation,” signaling an intent to promote conversion therapy under the guise of research.

This is part of a coordinated effort to:

  • Defund legitimate scientific research.

  • Remove trans-related medical education materials from federal health websites like the NIH and CDC.

  • Push discredited and harmful practices like conversion therapy.

  • Undermine existing Standards of Care and globally recognized medical guidelines.

  • More broadly, reverse civil rights protections for the trans community

While the HHS report claims it is not intended to serve as a clinical guideline, its release, on the heels of these other anti-science moves, clearly shows that this is not about ensuring safety. It’s about control and power. And it sets a dangerous precedent: one where science is no longer driven by evidence, but by politics.

What can I do if I feel overwhelmed by this news?

We know this is stressful. You are not alone! We suggest checking out our blogs Real Self-Care Tips That Prioritize Wellness and Stability and  How to Stay Safe and Sane as a Trans Person Online. Some other things you can do to care for yourself include:

  • Visit: translifeline.org or Call: (877) 565-8860 for peer support

  • Unplug from social media and the news cycle when you need to.

  • Reach out to people who affirm and support you—chosen family, community, or your care team.

  • Do something that brings you joy: go for a walk, watch your favorite show, eat your comfort food, or play music you love.

  • Take action if it feels energizing: join advocacy efforts, attend a local event, or volunteer for a cause that matters to you. We suggest taking action with A4TE or supporting your local trans resource center

Where can I get more information or support?

If you have questions about your care or need support, please reach out to us directly through the Spruce app or email us at members@getplume.co. Our team is here and ready to help you feel safe, affirmed, and informed.