The US Department of Health and Human Services (HHS) has released areport linking “gender ideology” with leftwing authoritarianism and political violence. Scientists have criticised the study as poorly conducted and politically motivated, raising concerns over the politicization of science and health.
The publication comes amid continuing efforts by the Trump administration to restrict access to gender-affirming care.
The Department of Justice reached an agreement with a New York hospital under which the hospital will no longer provide pediatric gender-affirming care. Dozens of other hospitals have stopped providing such care after the administration began investigating institutions offering it.
Patients on Medicaid and government insurance plans have also been blocked from accessing care, and a proposed rule would block any health system offering gender-affirming care from receiving federal funding.
“It likely also violates federal law because it’s not peer-reviewed, and it’s essentially quite an influential dissemination of information,” which could mean it violates the Information Quality Bulletin, a federal regulation that requires peer review for influential scientific information from the US government, he said.
The HHS report also criticises medical organizations that provide guidance on gender-affirming care and argues that people who support transgender individuals may also show support for authoritarianism and political violence.
Gideon Meyerowitz-Katz, an epidemiologist at the University of Sydney, said the research contained several serious methodological problems.
He described it as a poorly conducted study and called it “nakedly political”, arguing that its conclusions appeared to be driven by a political agenda.
Daniel Aaron, an associate professor at the University of Utah’s SJ Quinney College of Law, also questioned the report’s publication and said it was an unusual document for a federal health agency.
Aaron argued that the research would probably not withstand peer review. He also raised the possibility that publishing influential scientific information without the appropriate review process could conflict with federal requirements.
HHS did not respond to questions about whether the report had been commissioned by the agency or whether its publication complied with federal regulations.
Aaron also questioned why HHS had published research that he regarded as primarily political rather than directly related to public health.
Craig Konnoth, a professor at the University of Virginia School of Law who co-authored a New England Journal of Medicine perspective on gender-affirming care policy, agreed that the report raised concerns.
Konnoth said he viewed it as an effort to undermine mainstream health and science organisations, including the American Psychological Association, American Psychiatric Association, World Professional Association for Transgender Health and American Academy of Pediatrics, all of which are named in the report.
He argued that the document represents a broader challenge to established medical guidance and scientific institutions.
Colin Wright, one of the report’s authors and a fellow at the Manhattan Institute, defended the research.
Wright said the study was released sooner than expected because a draft had been leaked. He said the researchers planned to publish additional information, including the survey figures, and intended to submit the study to an academic journal.
He also acknowledged that some of the wording could have been more precise.
Wright rejected the interpretation that the research was designed simply to connect support for transgender people with authoritarianism and political violence.
However, the report itself states that its findings suggest an association between gender ideology, leftwing authoritarianism and willingness to justify political violence.
The research measured “gender ideology” using statements concerning transgender identity and parental support for children exploring their gender identity.
Wright said the study was focused on guidance issued by medical organisations and argued that such guidance could encourage people to adopt more extreme ideological positions.
He said the researchers found a correlation between those attitudes and willingness to support political violence.
The research was based on an online survey involving 1,208 people. Participants responded to statements about support for transgender people, political ideology and political violence.
Meyerowitz-Katz criticised the questionnaire used to measure political ideology, arguing that it effectively measured whether respondents were Democrats rather than providing a reliable measure of authoritarianism.
One question concerned whether opposition to same-sex marriage was homophobic, while another asked whether attention given to terrorism should shift towards the far right.
Meyerowitz-Katz argued that the political violence section of the questionnaire also had significant limitations because it focused on violence directed at conservative figures or institutions.
He said that including political violence involving other groups could potentially produce a very different result and therefore questioned whether the survey could reliably measure support for political violence.
Research on terrorism in the US has found that approximately 75-80% of deaths from terrorist attacks have been linked to far-right actors, while some research has found rightwing attacks to be more lethal than leftwing violence.
Meyerowitz-Katz also pointed to the lack of detailed survey results released by the researchers.
He said the report currently provides correlations without showing the underlying numbers needed to determine how many participants supported particular acts, such as setting fire to US Immigration and Customs Enforcement buildings.
He described the research as pseudoscience and called the report poorly conducted.
Konnoth said the report also failed to adequately address existing research that does not support its central argument.
Aaron described the decision by HHS to present the research as its own report as highly unusual. He said the department generally publishes issue briefs and synthesised information rather than adopting an individual study in this way.
Meyerowitz-Katz argued that the report appears to associate leftwing political beliefs, particularly support for transgender people, with political violence.
Aaron went further, suggesting that the report could be intended to benefit a political group, discredit an opposing group and create what he described as a misleading evidence base around transgender issues.
He argued that HHS has a responsibility to protect the health and wellbeing of Americans and questioned whether the report serves that purpose.
Aaron compared the approach with recent federal actions involving vaccines, which he said have also raised concerns about the government’s relationship with established scientific evidence.
Konnoth described the report as an attempt to establish an alternative scientific narrative and warned that efforts to undermine major medical and scientific organisations could have consequences beyond the debate over transgender healthcare.
The controversy comes as the Trump administration continues to pursue policies affecting transgender healthcare across the US.
The report is now facing scrutiny over its methodology, the design of its survey, the absence of peer review and the decision by a federal health agency to publish research making politically contentious claims.
Its authors maintain that the research provides evidence of a relationship between ideological attitudes and support for political violence, while independent researchers and legal academics argue that the evidence presented so far does not adequately support those conclusions.
