Chairman Cassidy Investigates Biden Health Officials Allegedly Colluding with Radical Groups Promoting Gender Mutilation of Children

WASHINGTON - U.S. Senator Bill Cassidy, M.D. (R-LA), chairman of the Senate Health, Education, Labor, and Pensions (HELP) Committee, is investigating former Assistant Secretary for Health Levine and other Biden health officials for reportedly colluding with the far-left World Professional Association for Transgender Health (WPATH) to promote chemical and surgical mutilation of children based on politics and in contradiction to scientific evidence.

For the past two years, Cassidy has been investigating WPATH and major medical organizations, including the American Academy of Pediatrics (AAP) and the Endocrine Society, for promoting gender transition procedures for children without reliable scientific data. Many of these groups continue to defy President Trump's executive order to ensure children are not subjected to irreversible harm through gender transition procedures. To continue Cassidy and the Trump administration's joint efforts to protect children and hold radical Biden officials accountable, Cassidy is asking the Department of Health and Human Services (HHS) to provide past communications and documents between former Biden officials, WPATH, and other medical organizations.

"Gender transition procedures and surgeries in children and adolescents are highly consequential," wrote Dr. Cassidy. "They are irreversible, with damaging, long-lasting side-effects to a child or adolescent's immediate physical, mental, and emotional development and to their future well-being as an adult."

"Accordingly, it is crucial that Congress and the Executive Branch, including HHS, partner together to uncover any collusion or wrongdoing, including the suppression of evidence-based medicine by previous administrations, which can cause irrevocable harm to our country's children," continued Dr. Cassidy.

Cassidy recently joined HHS Secretary Robert F. Kennedy Jr. at an event announcing a new policy preventing tax dollars from funding these dangerous procedures for children. He also introduced the No Subsidies for Gender Transition Procedures Act to prohibit taxpayer funded gender transition procedures under Medicaid, Medicare, the Children's Health Insurance Program, and the Affordable Care Act.

Read the full letter here or below.

Dear Secretary Kennedy:

Last Congress, I sent letters to the World Professional Association for Transgender Health (WPATH), the American Academy of Pediatrics (AAP), and the Endocrine Society requesting information on the quality of evidence behind the standards of care and clinical practice guidelines published by these organizations for treating children and/or adolescents suffering from "gender dysphoria."¹ The letters were part of a larger investigation into the promotion of puberty blockers, cross-sex hormones, and irreversible gender transition surgeries on minors by these organizations.²

The responses from these organizations demonstrated a disturbing absence of evidentiary support for their own standards and guidelines, as they were unable to provide the systematic reviews, clinical trials, or expert consensus that led to the development and promulgation of these policies. These responses are especially disconcerting given reports that the Biden administration, particularly the former Department of Health and Human Services (HHS) Assistant Secretary for Health Admiral Levine and staff, exercised significant political influence over WPATH and possibly other medical and professional organizations. That influence appears to have been directed toward and ultimately resulted in the removal of age limits for adolescent gender transition surgical interventions, including mastectomies, breast augmentation, facial surgeries, genital surgeries, and hysterectomies, from WPATH's Standards of Care (SOC-8).³

According to the New York Times, emails exchanged between WPATH and Admiral Levine's staff raised concerns that keeping the age limits would result in setbacks to the progress made to the "fight against the conservative anti-trans agenda."⁴ According to the Times, in a conversation with Admiral Levine's chief of staff, Sarah Boateng, a member of WPATH recalled:

"She is confident, based on the rhetoric she is hearing in D.C., and from what we have already seen, that these specific listings of ages, under 18, will result in devastating legislation for trans care. She wonders if the specific ages can be taken out."⁵

In another email, Admiral Levine:

"was very concerned that having ages (mainly for surgery) will affect access to care for trans youth and maybe adults, too. Apparently the situation in the U.S.A. is terrible and she and the Biden administration worried that having ages in the document will make matters worse. She asked us to remove them."⁶

The Times article also referenced email communications from AAP that "warned WPATH that it would not endorse the group's recommendations if the guidelines set the new age minimums."⁷ As a result, the WPATH SOC-8, released in 2022, ultimately removed the age limits for these procedures.

My October 2024 letters discussed these partnerships and highlighted the Endocrine Society's close relationship with WPATH, specifically related to WPATH's involvement in the drafting the Endocrine Society's guidelines and adoption of the Endocrine Society's recommendations.⁸

Gender transition procedures and surgeries, particularly in children and adolescents, are highly consequential. They are irreversible, with damaging, long-lasting side-effects to a child or adolescent's immediate physical, mental, and emotional development and to their future well-being as an adult. In contrast to other organizations, I was pleased to note recent statements issued by the American Society of Plastic Surgeons and the American Medical Association backing limitations on gender-related surgical procedures for minors.⁹

Since taking office, President Trump has delivered on his promise to protect American children and families from the reckless decisions of certain medical organizations and interest groups who claim to act on the "science" and in the best interests of children.¹⁰ I also applaud the Department of Health and Human Services (HHS) for taking decisive action against providers and other entities who violate President Trump's Executive Order.¹¹

As a physician and Chairman of the Senate Health, Education, Labor, and Pensions (HELP) Committee, I am deeply committed to ensuring transparency and accountability in matters related to public health. Americans have every right to know the scientific rigor of the data behind policies and guidelines issued by medical and professional organizations, particularly given that these guidelines are widely used and relied upon by health care providers and patients, including minors.

Accordingly, it is crucial that Congress and the Executive Branch, including HHS, partner together to uncover any collusion or wrongdoing, including the suppression of evidence-based medicine by previous administrations, which can cause irrevocable harm to our country's children. To aid the Committee's ongoing investigation, therefore, I ask HHS to please provide the following requested documents, records, and communications by March 5, 2026. To the extent possible, I ask these documents and communications be unredacted and Bates stamped.

1. Please provide all communications, including but not limited to emails, internal messages, calendar invitations, meeting notes, text messages, and social media messages (herein, collectively, "communications"), and all documents, including but not limited to memoranda, presentations, reports, and records (herein, collectively, "documents"), between former Admiral Levine and/or staff members, including chief of staff Sarah Boateng, and WPATH, from January 20, 2021, through January 19, 2025.
2. Please provide all communications and documents between former Admiral Levine and/or staff members, including chief of staff Sarah Boateng, and AAP, from January 20, 2021, through January 19, 2025, that mention "gender affirming care," "transgender care," "trans[gender] agenda," "hormone therap[ies]," "cross-sex hormones," "puberty blockers," "sex change surger[ies]," or other related terminology.
3. Please provide all communications and documents between former Admiral Levine and/or staff members, including chief of staff Sarah Boateng, and the Endocrine Society, from January 20, 2021, through January 19, 2025, that mention "gender affirming care," "transgender care," "trans agenda," "hormone therap[ies]," "cross-sex hormones," "puberty blockers," "sex change surger[ies]," or other related terminology.
4. Please provide all communications and documents between former Admiral Levine and/or staff members, including chief of staff Sarah Boateng, and White House personnel, including former President Joe Biden, Vice President Kamala Harris, and staff, from January 20, 2021, through January 19, 2025 that mention "gender affirming care," "transgender care," "trans agenda," "hormone therap[ies]," "cross-sex hormones," "puberty blockers," "sex change surger[ies]," or other related terminology.
5. Please produce all communications and documents between former Admiral Levine and/or staff members, including chief of staff Sarah Boateng, with academic institutions, including Johns Hopkins University, from January 20, 2021, through January 19, 2025, that mention "gender affirming care," "transgender care," "trans agenda," "hormone therap[ies]," "cross-sex hormones," "puberty blockers," "sex change surger[ies]," or other related terminology.
6. Please produce all communications and documents between former Admiral Levine and/or staff members, including chief of staff Sarah Boateng, with any other professional and medical organizations and interest groups, from January 20, 2021, through January 19, 2025, that mention "gender affirming care," "transgender care," "trans agenda," "hormone therap[ies]," "cross-sex hormones," "puberty blockers," "sex change surger[ies]," or other related terminology.
7. Please produce all communications and documents between former Admiral Levine and/or staff members, including chief of staff Sarah Boateng, and former HHS Secretary Xavier Becerra; former Centers for Medicare and Medicaid Services (CMS) Director Chiquita Brooks-LaSure; former National Institutes of Health (NIH) Directors Francis Collins and Monica Bertagnolli; former NIH Acting Director Lawrence Tabak; former Centers for Disease Control and Prevention (CDC) Directors Rochelle Walensky and Mandy Cohen; former Assistant Secretary for Mental Health and Substance Use, Miriam Delphin-Rittmon; former Office of Refugee Resettlement (ORR) Director Robin Dunn Marcos; former Office of Civil Rights (OCR) Directors Melanie Fontes Rainer and Lisa Pino; former Assistant Secretary for Planning and Evaluation Rebecca Haffajee; former Agency for Healthcare Research and Quality (AHRQ) Director Robert Otto Valdez; former Acting AHRQ Director David Myers; former Health Resources and Services Administration (HRSA) Administrator Carole Johnson; former Acting HRSA Administrator Diana Espinosa; former Indian Health Service (IHS) Director Roselyn Tso; former Acting IHS Director Elizabeth Fowler; former Food and Drug Administration (FDA) Commissioner Robert Califf; former Acting FDA Commissioner Janet Woodcock; and former Administration for Children and Families (ACF) Assistant Secretary January Contreras, from January 20, 2021, through January 19, 2025, that mention "gender affirming care," "transgender care," "trans agenda," "hormone therap[ies]," "cross-sex hormones," "puberty blockers," "sex change surger[ies]," or other related terminology.
8. Please produce all material communications and documents between former Admiral Levine and/or staff members, including chief of staff Sarah Boateng, and any directly involved HHS personnel or contractors, related to the development of HHS rules and regulations and other resources associated with "gender affirming care," including, but not limited to:

1. Section 1557 of the Patient Protection and Affordable Care Act (ACA)¹²
2. The American Disabilities Act (ADA)¹³
3. Section 504 of the Rehabilitation Act of 1973¹⁴
4. Health Insurance Portability and Accountability Act of 1996 (HIPAA)¹⁵
5. Administration for Children and Families (ACF) Final Rule titled, Designated Placement Requirements Under Titles IV-E and IV-B for LGBTQI+ Children¹⁶
6. ACF Final Rule titled, Unaccompanied Children Program Foundational Rule¹⁷
7. ACF Office of Refugee Resettlement (ORR) Final Rule titled, Unaccompanied Children Program Foundational Rule¹⁸
8. Substance Abuse and Mental Health Services Administration (SAMHSA) resources titled, LGBTQI+ Youth - Like All Americans, They Deserve Evidence-Based Care¹⁹
9. HHS Office of Population Affairs (OPA) resource titled, Gender-Affirming Care and Young People²⁰
10. HHS Office of Civil Rights (OCR) guidance titled, HHS Notice and Guidance on Gender Affirming Care, Civil Rights, and Patient Privacy (2022)²¹

1. Please produce all material communications and documents between former Admiral Levine and/or staff members, including chief of staff Sarah Boateng, and members of WPATH, AAP, the Endocrine Society, and affiliated groups, related to the development of HHS rules and regulations and other resources associated with "gender affirming care," including, but not limited to:

1. Section 1557 of the Patient Protection and Affordable Care Act (ACA)²²
2. The American Disabilities Act (ADA)²³
3. Section 504 of the Rehabilitation Act of 1973²⁴
4. Health Insurance Portability and Accountability Act of 1996 (HIPAA)²⁵
5. Administration for Children and Families (ACF) Final Rule titled, Designated Placement Requirements Under Titles IV-E and IV-B for LGBTQI+ Children²⁶
6. ACF Final Rule titled, Unaccompanied Children Program Foundational Rule²⁷
7. ACF Office of Refugee Resettlement (ORR) Final Rule titled, Unaccompanied Children Program Foundational Rule²⁸
8. Substance Abuse and Mental Health Services Administration (SAMHSA) resources titled, LGBTQI+ Youth - Like All Americans, They Deserve Evidence-Based Care²⁹
9. HHS Office of Population Affairs (OPA) resource titled, Gender-Affirming Care and Young People³⁰
10. HHS Office of Civil Rights (OCR) guidance titled, HHS Notice and Guidance on Gender Affirming Care, Civil Rights, and Patient Privacy (2022)³¹

1. Please produce all material communications and documents between any HHS personnel or staff from January 20, 2021, through January 19, 2025, that mention "gender-affirming care," "transgender care," "trans agenda," "hormone therap[ies]," "cross-sex hormones," "puberty blockers," "sex change surger[ies]," or other related terminology not captured by the above requests.

Sincerely,

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