What's behind HHS claims that gender-affirming care 'may' radicalize
Since announcing Robert F. Kennedy Jr. as his pick for Health and Human Services secretary last year, President Trump and Kennedy have touted their dedication to "Gold Standard Scientific Research" and making federal health agencies "beacons of Transparency."
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agencies → affirm → Transparency
But a recent report released by the agency has left some experts with substantial doubts about its researchers' methods, its claims about its findings and its authors' political intentions.
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report → release → findings
The report, titled "Where the Clinic Meets the Movement: Does Gender Ideology Arm Left-Wing Authoritarian Psychology?" was not peer reviewed and its underlying data and funding have also not been made available.
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data → title → Psychology
(One author says its data will be released "soon.")
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data → say → ?
The report is the latest in a string of efforts by HHS to undermine established clinical standards of care for transgender patients.
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report → undermine → patients
Many experts interviewed for this story said it frames transgender identity as illegitimate or even dangerous.
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it → interview → identity
In recent years, right-wing figures and media outlets have advanced the narrative that transgender people and those who support them are violent or dangerous to society.
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who → advance → society
The phrase "gender ideology extremism" has appeared in White House directives.
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phrase → appear → directives
These arguments have proliferated despite a substantial body of evidence showing transgender people are far more likely to be targets of violence, rather than perpetrators.
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people → proliferate → perpetrators
One of the authors of the latest HHS report is Colin Wright, an evolutionary biologist with the Manhattan Institute, a right-wing policy think tank that's been at the forefront of campaigns against diversity, equity and inclusion initiatives and "wokeness."
While it's not uncommon for HHS to work with outside experts on reports, said Adrian Shanker, a former deputy assistant secretary for health policy at the department in the Biden administration, in his experience, "The department had longstanding contracts with generalist science writing firms.
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department → work → firms
"That's vastly different from how this administration seems to already have the answers for the reports they're publishing before they start.
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they → seem → reports
And they're partnering with politically-aligned researchers and think tanks to develop reports that meet a political conclusion rather than a scientific one," said Shanker.
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Shanker → partner → conclusion
HHS did not respond to NPR's interview request for this story.
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HHS → respond → story
In emails with NPR, report co-author Wright provided lengthy responses to NPR's questions, but insisted his answers could not be used unless they were reprinted in their totality.
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Wright subsequently posted NPR's questions and his answers on his X account.
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Other authors of the report did not accept NPR's interview requests.
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authors → accept → requests
Wright said the paper will eventually be submitted to a scientific journal, adding, "the fact that our report has not yet undergone peer review at a journal does not make it pseudoscience."
What's missing
The term "gender ideology" is a rhetorical device often used by the religious right to suggest that acceptance of any alternatives to a fixed idea of traditional gender norms, corresponding with someone's sex at birth, is part of a larger plot to corrupt society.
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acceptance → say → society
The existence and acceptance of transgender people is often also seen as an indicator of a sinister agenda.
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existence → see → agenda
In the HHS report, the term is used interchangeably with "gender-affirming care," which is the accepted medical and mental health standard of care for treating transgender patients.
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which → use → patients
"Generally speaking, I do not believe the term 'gender ideology' is a political term, even though many on the left reject it.
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many → speak → it
It accurately captures the reality that debates surrounding issues of transgenderism are not simply debates about facts, but belief systems," Wright told NPR in a statement later posted on social media.
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Wright → capture → media
The HHS report's core conclusion is that support for gender-affirming care is tied to what it describes as "Left-Wing Authoritarianism" and "a willingness to justify political violence."
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it → affirm → violence
According to the report, "gender ideology may function as an ideological accelerant, telling left-wing authoritarian psychology who the enemy is, why the situation is urgent, and—in those already disposed toward force—that violence is legitimate.
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violence → accord → force
"
"'May' is doing important work in that sentence," Wright said in response to NPR's questions.
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In another post on X, Wright said "Gender 'medicine' is the only area of healthcare" that supplies people with targets for hostility, and called support for gender-affirming care "an extremist political movement disguised as a medical guideline.
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that → say → guideline
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The "ideological accelerant" conclusion isn't backed up in the actual data the study presents, wrote Alexander Tsai, a psychiatry professor at Harvard Medical School in response to the paper.
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Tsai → back → paper
Other academics who study political violence have also noted significant design flaws in the research and a lack of some key points of context.
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who → study → context
"If I were to be a peer reviewer for this paper, I would recommend that it be rejected.
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it → recommend → paper
I just don't believe that it's written in good faith and the measures are not well validated," said Liliana Mason, a political psychologist at Johns Hopkins University who has spent more than a decade researching what drives support for political violence.
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what → believe → violence
The report's researchers, including graduate students at Rutgers University, said they used a paid online survey platform to ask around 1,200 adults about their support for gender-affirming medical care, government censorship and aspects of capitalism.
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they → include → capitalism
Survey takers were then asked whether they believe violence is justified against figures like Charlie Kirk, the pro-Trump political organizer who was assassinated in 2025, President Donald Trump and Brian Thompson, the health insurance CEO who was killed by Luigi Mangione in 2024.
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who → ask → 2024
Mason found several problems with the study, including a survey sample that overrepresents Democrats compared to the political demographics in the United States.
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that → find → States
The study also omits key context her research has found which shows that approval for political violence shows up on both sides of the spectrum for people with the strongest partisan identities.
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approval → omit → identities
"What they're saying is 'these people on the left are dangerous people.
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people → say → left
[They're saying this] without putting into context how common these attitudes are across the political spectrum," said Mason.
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Mason → say → spectrum
Wright acknowledged to NPR that that context is "relevant background," but said "The purpose of our study was not to argue that violence is uniquely left-wing or that right-wing authoritarianism and right-wing violence are unimportant."
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authoritarianism → acknowledge → study
The HHS study's use of a "Left-Wing Authoritarianism" scale also puzzled Mason.
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use → puzzle → Mason
She said that there's been a long academic discussion focused on the flaws of a widely used "Right-Wing Authoritarianism" scale that emerged after World War II.
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that → say → II
Many researchers have since realized the scale mostly measures attitudes associated with being conservative.
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scale → realize → attitudes
Mason said experts in her field do not deny the existence of authoritarian personalities on the left, but ended up developing other, less partisan scales including one based on people's values for raising children.
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experts → say → children
…and 50 more, not listed.
The Aporia
