The Trump administration questioned the evidence supporting gender-affirming health care for youth in a lengthy review published Thursday by the Department of Health and Human Services (HHS) that could further upend the nation’s transgender care landscape.

The roughly 400-page, unsigned review states there is a “lack of robust evidence” supporting interventions such as puberty blockers, hormone therapy and the rare surgeries to treat gender dysphoria in minors. It advocates for a greater reliance on psychotherapy to treat the condition, which is characterized by severe psychological distress that stems from a mismatch between a person’s gender identity and sex at birth.

The document contradicts guidance from major medical organizations including the World Professional Association for Transgender Health and the American Medical Association, which opposes statewide bans on gender-affirming care for youth. Neither group immediately returned a request for comment on the report.

“Our duty is to protect our nation’s children — not expose them to unproven and irreversible medical interventions,” National Institutes of Health Director Jay Bhattacharya said in a news release accompanying Thursday’s report.

The review’s release comes at the direction of an executive order President Trump issued days into his second term to end federal support for gender-affirming care for minors, which his........

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