International group critiques Utah transgender review cited by congressional Democrats

SALT LAKE CITY — An international group released a report on Thursday critiquing a Utah review of youth transgender treatments. The review has largely been ignored by the state lawmakers who commissioned it amid doubt over its conclusions.

The Society for Evidence-Based Gender Medicine, a nonprofit founded by physicians from the United States, Britain and Australia, identified critical flaws with the review's methods and its choices to exclude information.

To be a reliable tool, systematic reviews must provide unbiased recommendations about the efficacy of medical treatments based on a rigorous survey of potential harms, according to Dr. William Malone, the group's cofounder.

"When those standards aren't met, the result isn't clarity — it's confusion dressed up as certainty," Malone said.

Utah's review was intended to be a systematic analysis of evidence regarding hormonal transgender treatments for minors. But it was not systematic and left out key details about risks of infertility and regret, the group reported.

Utah's review cited by Democrats

Since it was released last year, Utah's review has been referenced by transgender advocates as a counterpoint to the United Kingdom's Cass Review and the review conducted by the Department of Health and Human Services.

Unlike these systematic reviews, which found a lack of evidence supporting hormonal transgender treatments for minors, the Utah review claimed to find proof of "positive mental health and psychosocial functioning outcomes."

Activists cited these findings to protest a law Republican lawmakers approved this year to permanently ban hormone treatments for minors. Congressional Democrats seeking to reverse Trump administration policies also cited the review.

Related:

Rep. Kennedy is sponsoring a bill to limit gender-related treatments for teens nationwide

The author of Utah's law restricting gender-related surgeries for minors now wants to make it easier for patients who go on to regret such treatments to sue their doctor.

In February, 106 federal lawmakers signed a letter in opposition to proposed rule changes that would prohibit Medicaid funding for youth transgender treatments and block Medicare at hospitals that provide the treatments.

The letter relies heavily on the Utah review to support its arguments, including a lengthy paragraph summarizing the review's findings and its claims about the body of evidence supporting transgender treatment for pediatric patients.

A federal judge in Oregon paused the new policies last month, ruling that Department of Health and Human Services Secretary Robert F. Kennedy Jr. had overstepped his authority by disqualifying providers of transgender treatments for minors from federal programs.

Despite state lawmakers all but closing the debate on transgender treatments for minors during the 2026 legislative session, the positive findings of Utah's review continue to stand out as an outlier on the national stage.

What did Utah's review find?

In 2023, the Utah Legislature prohibited sex reassignment surgeries for minors, put a pause on puberty blockers and cross-sex hormones for new child patients, and ordered a review of medical evidence to inform future policies.

The review was conducted by the Drug Regimen Review Center at the University of Utah's College of Pharmacy. The Utah Department of Health and Human Services presented it to a committee in June 2024 and it was published in May 2025.

The 1,000-page review claimed to find no justification for restricting hormonal transgender treatments for children, which the review's authors said posed a negligible risk to long-term health, like bone density and mental development.

A spokesperson for University of Utah Health defended the review in a statement to the Deseret News earlier this year, saying the group found "an extensive body of research regarding the safety and efficacy of these treatments."

"Our review also found that the consensus of that evidence is that the treatments are safe in terms of changes to bone density, cardiovascular risk factors, and metabolic changes; and they are effective in terms of positive mental health and psychosocial outcomes."

While the Utah review claimed to be one of the most "comprehensive" systematic reviews of transgender studies to date, the Society for Evidence-Based Gender Medicine report found that it had major gaps in its analysis.

Problems with Utah's review

Utah's review analyzed less than 40% of the eligible studies it mentioned, omitted important evidence reviews from the United Kingdom and excluded more than a dozen major clinical guidance documents, the report found.

The studies that the review did include were not synthesized, evaluated for quality or checked for bias, according to the report, which means Utah's review failed to meet the core markers of a truly systematic review.

The review also left out studies related to individuals who later wished to detransition — ignoring a mandate from the Legislature — and dismissed the impacts of hormonal transgender treatments on sexual function and fertility.

Utah's review also failed to fully disclose potential conflicts of interest, the report found, including that most advisory members were affiliated with the university's adolescent gender clinic, which was directly impacted by the state's law.

The report says Utah's review frames the evidence in a positive way, apparently as part of a "campaign by advocacy groups to supply a new evidentiary basis for lifting the Utah moratorium on pediatric gender transition."

A report published in December by Do No Harm — a group of doctors focused on "keeping identity politics out" of medical research — found the same problems as the report from the Society for Evidence-Based Gender Medicine.

Representatives from Do No Harm spoke at the Utah Capitol during the 2026 legislative session in favor of HB174, which would make Utah's moratorium on hormonal transgender treatments for minors a permanent ban with some exceptions.

Health care providers may not provide puberty blockers or cross-sex hormones to patients under the age of 18 unless they are already receiving hormonal treatments and were 16 years old at the time the bill was signed into law on March 18.

Utah Gov. Spencer Cox also signed into law HB258, which requires health insurance providers to cover procedures to reverse a sex transition if the benefit already covers treatments or procedures to initiate a sex transition.

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