A report released last month by the Department of Health and Human Services that claims to review the “evidence and best practices for promoting the health of children and adolescents with gender dysphoria” cites a study on a scientifically dubious diagnosis, “rapid-onset gender dysphoria,” that was retracted by its first publisher.
The report also cites dozens of studies from a controversial scientific journal that has been accused of bias. Thirty scientific papers and commentary pieces cited were published in the little-known journal Archives of Sexual Behavior — the most citations the report makes to any single publication. The journal’s editor-in-chief, Kenneth Zucker, has promoted a treatment that encourages gender dysphoric children to be comfortable with their sex assigned at birth, which critics claim amounts to a form of conversion therapy. Zucker disputes this characterization.
Traditional scientific publishing has drawn the ire of Health Secretary Robert F. Kennedy Jr., whose “Make America Healthy Again” Commission assessment dedicated several sections to what it described as prejudices inherent to the publishing community. Kennedy has even proposed a ban on government scientists publishing in some prestigious research publications, calling them “corrupt.”
The MAHA report was roundly criticized for including citations to fabricated studies. While HHS’s gender dysphoria report doesn’t appear to cite any nonexistent research, its many citations to sources not usually seen in scientific publications could indicate the direction the department will take when it comes to generating scientific recommendations.
In 2023, Archives of Sexual Behavior published a study on “rapid-onset gender dysphoria,” a hypothesis claiming that some children who identify as transgender do so because of peer influence. That paper was later retracted by the publisher, Springer Nature. It was subsequently republished in the recently founded Journal of Open Inquiry in the Behavioral Sciences, which was created to counteract the “progressive bias” of traditional journals, according to its founders.
The republished “rapid-onset gender dysphoria” paper is cited by the HHS report, as is a second paper published by the Journal of Open Inquiry about conversion therapy.
The 408-page HHS report, which was released in early May without listing any authors, claims to provide an overview of the field of pediatric gender care with sections like “ethical considerations” and “clinical realities.” But only about half of the report’s 850 citations link to peer-reviewed scientific papers. The other references are to news articles, blog posts, opinion pieces and books, including one authored by the new commissioner of the Food and Drug Administration, Marty Makary, titled “Blind Spots: When Medicine Gets It Wrong, and What It Means For Our Health.”
Leading scientific groups condemned the report when it was published. The American Academy of Pediatrics said in a statement that the report “misrepresented the current medical consensus” about transgender care for youth, and that it “prioritizes opinions over dispassionate reviews of evidence.”
“For such an analysis to carry credibility, it must consider the totality of available data and the full spectrum of clinical outcomes rather than relying on select perspectives and a narrow set of data,” the AAP statement reads.
Kennedy has proposed circumventing traditional scientific publishing practices by creating “in-house” publications for research conducted by government scientists. He told a podcast that if the government created its own journals, they would “become the preeminent journals, because if you get [NIH] funding, it is anointing you as a good, legitimate scientist.”
Other members of the Kennedy team at HHS have also made their gripes with the publishing industry known: National Institutes of Health director Jay Bhattacharya co-founded his own scientific journal earlier this year that uses unorthodox editorial practices that allow scientists to bypass traditional reviews once they become “members” of the journal. Makary was a member of the journal’s board, though he and Bhattacharya both took leave from the journal once nominated for government positions.
The MAHA report also claims that scientific peer review, the process by which papers submitted to journals are quality-checked by other scientists in the same field, is “ineffective and biased.”
“Reviewers at top journals are untrained, ineffective when tested, and many have financial ties to drug companies,” the report goes on.
It also criticizes scientific journals for “editorials and opinion pieces” that are “written by biased, industry funded authors.” The gender dysphoria report cites a number of letters to the editor and commentary pieces on gender care.
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Margaret Manto is a NOTUS reporter and an Allbritton Journalism Institute fellow.