The Evidence of Harm: What the Data Really Show About Pediatric Transgender Procedures | Leor Sapir

One of the first executive orders President Donald Trump signed after his inauguration last January was titled “Protecting Children from Chemical and Surgical Mutilation.” The order directed the Department of Health and Human Services (HHS) to produce a systematic review of pediatric transgender procedures and their impact on children within 90 days.

In May 2025, HHS published a more than 400-page review, titled “Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices.” In November last year, an updated, peer-reviewed version was published with additional appendices and supplements.

Leor Sapir, a senior fellow at the Manhattan Institute, is one of the report’s main outside co-authors. In our in-depth interview, Sapir provides a detailed overview of the review’s findings and conclusions.

“We tried to be as factual and defensible as we possibly could,” he said.

The goal of the report, he says, is to “engage with people in the medical profession who may not be aligned with the administration, but who do care about questions of medical evidence and medical ethics.”

In this episode, he breaks down:

- The prevalence of sex-changing procedures in the United States, as well as the reversal in approaches in various Scandinavian countries and in the UK.

- How misleading and unscientific language was used by professionals across many fields to promote pediatric sex transitioning.

- The role of the organization, World Professional Association for Transgender Health (WPATH), in establishing “gender-affirming care” as the accepted standard.

- How clinicians, in his view, distorted the principle of patient autonomy to increase pediatric sex change surgeries.

There is one chapter in the report that everyone should read, Sapir said. And that is the chapter about ethics.

“The question on everybody’s mind is: Should we do it? That’s an ethical question. And medical ethics is, you would hope, [what] governs the field of medicine,” he told me.

Views expressed in this video are opinions of the host and the guest, and do not necessarily reflect the views of The Epoch Times.