US Dept of Health and Human Services has demanded six organizations provide the research foundations for their policies regarding gender care for minors within 10 days. Further, HHS has demanded what changes the organizations are intending to make to their policies in light of the HHS Review from 2025 into minor care, and what timeline exists for those changes.

I have submitted a response, not in place of those organizations, not to defend them from the accusations made by HHS, but to offer exactly the type of guidance HHS has been seeking. That response was sent to Secretary Kennedy at HHS, with copies to each of the organizations he is seeking a response from. The documents below constitute that response.

The cover letter begins:

Dear Secretary Kennedy:

I am a private citizen, not affiliated with any of the organizations addressed by the above referenced request. However, I have been involved in care supervised by the documents at the root of the issues you seek to address.

HHS has sent demand letters to medical organizations that had direct or indirect impact on gendered care, for minors and adults. There are specific accusations against specific organizations but generally the letters assert that HHS has documented substantial evidence of harm for minors from sex-rejecting procedures that the organizations have supported and provided. The evidence addressed patients from heterogeneous cohorts, with differing clinical presentations and treatment pathways. The guidelines at issue for that care impact adults also.

I do not intend to address the specific allegations against any organization, but rather address the concerns that prompted the HHS to investigate the care category. The published letters to the organizations requesting current positions, proposed changes, and timelines gave the impression it was open to some discussion on the topic. In the Author’s Note to The Problem with Distress , I wrote:

It [this book] was written because something fundamental has become difficult to say in the field of gender-related care: that medicine exists to understand before it acts.
This work argues for something deceptively simple: that patients—especially developing ones—deserve diagnosis before intervention and to be understood as individuals rather than processed as categories.

I was a patient (not a minor) during the periods when DSM-3 and HBIGDA SOC-3/4 existed in the 1980s and 1990s. I have been a patient during the period when DSM-5 and SOC-8 have been formally in place. I participated in commenting on the proposed drafts of SOC-7 and SOC-8 when they were open for public comment. I have published works that address the medical issues, the changing medical landscape and impacted populations being treated by the organizations highlighted.

My submission addresses the three subjects raised in your requests: current position, proposed changes, and timing. I offer these responses independently, rather than on behalf of any organization.

The full letter is here:
Cover letter to Secretary Kennedy sent on October 19, 2026 (PDF)