A U.S. Department of Health and Human Services report linked support for gender-affirming care to political violence, even though its data and funding hadn’t been made public when NPR reported on it September 30, 2026. Researchers and other experts challenged the report’s methods and political context as the Trump administration moved to end Medicaid and CHIP funding for gender-affirming care for youth.
Federal policy and medical care
The report, “Where the Clinic Meets the Movement: Does Gender Ideology Arm Left-Wing Authoritarian Psychology?,” hadn’t undergone peer review. One author said the data would be released “soon.” Its central claim ties support for gender-affirming care to “Left-Wing Authoritarianism” and “a willingness to justify political violence.” The report says “gender ideology may function as an ideological accelerant,” identifying an enemy and making violence seem legitimate to people already disposed toward force.
HHS has described the work of federal health agencies as a commitment to “Gold Standard Scientific Research” and making them “beacons of Transparency.” Adrian Shanker, a former deputy assistant secretary for health policy at HHS in the Biden administration, said the department previously worked with generalist science writing firms that “were not political in any way.” The current administration, he said, is “partnering with politically-aligned researchers and think tanks to develop reports that meet a political conclusion rather than a scientific one.” HHS didn’t respond to NPR’s interview request.
The report uses “gender ideology” interchangeably with gender-affirming care, which the article describes as the accepted medical and mental health standard of care for transgender patients. Colin Wright, an evolutionary biologist with the Manhattan Institute and one of the report’s authors, called support for care “an extremist political movement disguised as a medical guideline.” He said the word “may” in the report’s claim “is doing important work.”
Evidence under dispute
Researchers, including graduate students at Rutgers University, used a paid online survey platform to question around 1,200 adults. Participants answered questions about gender-affirming medical care, government censorship, aspects of capitalism and whether violence was justified against Charlie Kirk, President Donald Trump and Brian Thompson.
Liliana Mason, a political psychologist at Johns Hopkins University, said the sample overrepresented Democrats compared with U.S. political demographics. It also left out context from her research showing approval of political violence across the political spectrum among people with the strongest partisan identities. “If I were to be a peer reviewer for this paper, I would recommend that it be rejected,” she said, citing measures she said “are not well validated.” Alexander Tsai, a psychiatry professor at Harvard Medical School, wrote that the “ideological accelerant” conclusion isn’t supported by the data presented.
Mason also questioned the report’s “Left-Wing Authoritarianism” scale, saying it largely measures how closely respondents are associated with the Democratic Party. Wright defended the measure, calling it well validated, and argued that another scale would have made it a different study.
Care restrictions and agency action
In August 2026, the Trump administration announced it would end Medicaid and CHIP funding for gender-affirming care for youth. The administration cited an HHS review that described evidence supporting care models as “very low-quality” and urged greater reliance on psychotherapy. Doctors and pediatricians disputed that assessment, saying clinical recommendations rely on nuanced considerations and that other recommendations could also be classified as based on “low-quality” evidence. Supportive talk therapy already plays a prominent role in gender-affirming treatment models. A recent study cited in the article found that less than 0.1% of American minors with private insurance receive puberty-blocking medication or gender-affirming hormones.
Career HHS staff told NPR they hadn’t known about the report before its public release. One HHS health official said, “We're supposed to be the department that people look to for actual facts — these are lies.” The official added, “These are real people's lives that they're messing with.” Andrew Ortiz, an attorney with the Transgender Law Center, said HHS had been directed to implement anti-trans executive orders. He said calls to the center’s help desk surged after Trump took office in 2025, with many callers seeking advice about leaving the United States.
According to NPR, the report is HHS’ third recent attempt to reject gender-affirming standards of care. Wright said the report was “only the first” in a series he is working on with the research team. The source reports no union or labor campaign connected to the dispute; researchers, medical professionals and the Transgender Law Center make up the organized response it describes.