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ASAN condemns the new report from the Department of Health and Human Services (HHS) on transgender health care. This report, produced under President Trump’s executive order from January 28th, rejects evidence-based medical care for transgender youth — care that is supported by every major U.S. medical association including the American Medical Association and the American Academy of Pediatrics and over 40 years of clinical best practice. Even more concerning, the report promotes conversion therapy by another name under the misleading label of “exploratory therapy.” We also strongly reject the report’s repeated implication that autism should be used as a reason to deny children gender-affirming care. While terms like “exploratory therapy” may sound reasonable or neutral, they are dog whistles for deeply harmful practices. There are decades of peer-reviewed research that shows medical care is the only safe and effective treatment for gender dysphoria — it is essential to the health and well-being of transgender youth. There’s nothing “therapeutic” about denying trans youth the medical care they need. This report denies the importance and benefits of essential health care for transgender youth, and treats conversion therapy as the only alternative. Conversion therapy is a dangerous and discredited practice that every major U.S. medical and mental health association has spoken out against. Conversion therapy uses operant conditioning — changing someone’s behavior using rewards and punishments. Talk therapy with the goal of making someone act cisgender is incredibly harmful. Conversion therapy has harmed countless gay youth and resulted in anxiety, depression, and increased risk of suicidal thoughts and attempts. These practices mirror those used against autistic people in Applied Behavior Analysis (ABA), which have been condemned by our community. It is not surprising that conversion therapy and ABA are so similar — they were developed together by the same people. O. Ivar Lovaas, considered the "founder" of ABA, also worked on a project which aimed to “cure” young boys of behavior that "put them at-risk of homosexuality." Conversion therapy and ABA use operant conditioning, often employing the same methods. ABA at its core is designed to try to make autistic people act “less autistic” for the purpose of meeting non-autistic norms, and causes short and long-term harm. Like conversion therapy, using calling these practices something else does not erase the problems, nor does it create a different or better solution. Harming children to change part of who they are, whether their disabilities, sexuality, or gender, is not medical care. The push from HHS toward conversion therapy matters deeply to autistic and other disabled people, especially autistic trans youth, who are often targeted by rhetoric that seeks to harm them into acting “normal.” The report repeatedly implies that autism is a root cause of gender dysphoria, quoting known conversion therapy practitioners to do so. This suggestion falsely twists what we know — that transgender and nonbinary people are up to six times more likely to be autistic. We have seen prior efforts at the state level to block autistic people specifically from accessing gender-affirming care. By implying that autistic people cannot “truly” be transgender, this report empowers that kind of harmful policymaking. When autistic trans youth question or explore their gender identities — something completely normal — some people question their competence and autonomy. Those people think that autistic people cannot be trans, but they are wrong and only do harm to our trans community members. This report clearly dehumanizes both trans and autistic people. The suggestion that being trans comes secondary to being autistic is meant to discredit the real experiences of both autistic and non-autistic trans youth. We cannot let this administration sanitize or reframe this report as anything other than what it is: a firm endorsement of conversion therapy. Autistic and disabled communities know firsthand the deadly consequences when marginalized identities are treated as problems to be "corrected." We will continue to stand beside our trans community members and push back against these hateful, unscientific attacks. The Autistic Self Advocacy Network seeks to advance the principles of the disability rights movement with regard to autism. ASAN believes that the goal of autism advocacy should be a world in which autistic people enjoy equal access, rights, and opportunities. We work to empower autistic people across the world to take control of our own lives and the future of our common community, and seek to organize the autistic community to ensure our voices are heard in the national conversation about us. Nothing About Us, Without Us!
Autistic Self Advocacy Network PO Box 66122
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