US urges states to rethink puberty blockers in light of UK evidence

The US government is urging states to reconsider funding puberty blockers for minors, citing the UK’s Cass Review as a model for reform.

In a letter seen by The Telegraph, the Center for Medicare and Medicaid Services (CMS) called on state medical directors to align with recent findings from the UK, Sweden, and Finland, which have restricted medical interventions for children with gender dysphoria.

“Several developed countries have recently diverged from the US,” the CMS stated, highlighting the Cass Review’s conclusion that there is “not a reliable evidence base” to support widespread use of puberty blockers and hormone treatments. The review, released in April 2024, found that children were often pushed toward medical intervention without sufficient mental health support.

Dr Hilary Cass, who led the independent UK review, advised that “talking therapies” should be prioritised over irreversible treatments. The CMS letter said the UK’s approach may better reflect the principle to “do no harm to America’s children.”

Currently, 27 US states have enacted bans or restrictions on gender-affirming care for minors, though puberty blockers remain available in others. Under President Donald Trump, the federal government has intensified efforts to prohibit what it calls “destructive and life-altering procedures,” including surgery and hormone treatments.

Critics, including Democratic attorneys general and trans advocacy groups, have filed lawsuits to block federal funding restrictions. Meanwhile, Yale Law School’s Integrity Project has questioned the Cass Review’s authority, calling it flawed and not an accurate representation of current medical evidence.

Despite these objections, the Trump administration continues to use the Cass Review as a policy benchmark, marking a rare moment of alignment with British health policy.