A coalition of 20 attorneys general from red states are pressuring the American Medical Association (AMA) to disavow puberty blockers for minors, calling the leading medical organization’s position inconsistent given its recent about-face on sex change surgeries for youth.
Alabama Attorney General Steve Marshall sent a letter on behalf of the coalition to AMA CEO Dr. John J. Whyte on Monday, asking the group to reconsider its position on sex change drugs for minors and to explain the evidence it is basing its current guidance on, Fox News reported.
The attorneys general first praised the AMA for concurring with the American Society of Plastic Surgeons that sex change surgeries for minors lack “clear evidence.” The attorneys general argued that evidence is also weak on puberty blockers and cross-sex hormones form sex-confused youth.
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“We thus find it concerning that the AMA continues to support the use of puberty blockers and cross-sex hormones to treat gender dysphoria in minors,” the letter reads. “The quality of evidence is the same as it is for surgeries: low and very-low quality.”
The chief legal officers cited systemic reviews from the Department of Health and Human Services and Dr. Hilary Cass finding a lack of quality evidence supporting sex change drugs for minors.
“So if you agree that there is insufficient evidence to support using surgical interventions to treat gender dysphoria in minors — as your recent statement indicates — we do not understand how you can find that there is sufficient evidence to support using hormonal interventions to treat gender dysphoria in minors,” the letter continues. “These interventions have not been shown to be any safer for children that surgeries are, and in fact may be all the more dangerous precisely because they are viewed as not as serious.”
“But hormones can leave a child sterilized just as surely as surgery can,” the attorneys general added.
The attorneys general provided a listed of question to the AMA about the safety and efficacy of sex change drugs for minors, per the report. They also asked the AMA whether they endorse the standards put forward by the World Professional Association for Transgender Health (WPATH), the Endocrine Society, and the American Academy of Pediatrics, which all support puberty blockers and hormones for transgender-identifying youth.
Other large medical organizations have embraced gender ideology and touted guidance from WPATH, enabling children to access sex mutilating drugs and surgeries. WPATH has suffered several scandals, including a leaked internal meeting in which an endocrinologist admitted that discussing long-term potential for infertility with a 14-year-old is like “talking to a blank wall,” and a pressure campaign from the Biden administration to remove age requirements for sex-change surgeries.
WPATH, while favored by the pro-transgender Biden administration, has been cast out by the current Trump administration and admonished by the Supreme Court. In January 2025, President Donald Trump signed an executive order called “Protecting Children from Chemical and Surgical Mutilation,” in which he tossed WPATH guidance into the dustbin, deeming it “junk science.”
“The blatant harm done to children by chemical and surgical mutilation cloaks itself in medical necessity, spurred by guidance from the World Professional Association for Transgender Health (WPATH), which lacks scientific integrity,” the order reads, before mandating all government agencies to rescind all policies relying on WPATH guidance.
Attorneys general warned the AMA that if its position on sex change drugs is inconsistent with high quality evidence, the group could face investigation for potentially violating consumer protection laws. They asked the AMA to respond to their letter by March 25.
“The American Medical Association has finally admitted what many have warned for years: its recommendations for surgeries on children were not grounded in solid evidence, despite telling doctors and families otherwise,” Attorney General Marshall said in a press release. “Yet the same weak science underpins puberty blockers and cross-sex hormones. You cannot dismiss one intervention as unsupported while continuing to push the rest. When children’s lives and futures are at stake, anything less than full scientific honesty is reckless. The AMA must follow the science completely, not selectively.”
Attorneys general from Arkansas, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Nebraska, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, and West Virginia joined the letter.
The AMA did not return the outlet’s request for comment by time of publication.
Earlier this month, the American Society of Plastic Surgeons (ASPS) became the first major medical organization to recommend against sex change surgeries for minors.
“Based on what we see today, we cannot endorse gender-related surgical intervention in minors and adolescent patients, given the uncertainties that we’ve discovered,” ASPS President Dr. Bob Basu previously told the outlet.
Last month, a jury in New York awarded a detransitioner $2 million in a lawsuit against her doctors. The detransitioner, 22-year-old Fox Varian, accused her doctors of pushing a double mastectomy on her when she was only 16 years old, and the jury found her psychologist and surgeon liable for medical malpractice, per the New York Post.
Katherine Hamilton is a political reporter for Breitbart News. You can follow her on X @thekat_hamilton.
