Just six weeks after his Senate confirmation, Mountain Brook urologist turned Assistant Secretary for Health Brian Christine's office published "Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices," a peer-reviewed study examining the well-documented and studied medical risks associated with attempts to change children's biological sex.

The report, a review of evidence and best practices, released through Christine's office, was commissioned pursuant to Executive Order 14187, which President Donald Trump signed on January 28, 2025.

It found that "the harms from sex-rejecting procedures — including puberty blockers, cross-sex hormones, and surgical operations — are significant, long-term, and too often ignored or inadequately tracked," according to the press statement by the Department of Health and Human Services (HHS).

"The American Medical Association and the American Academy of Pediatrics peddled the lie that chemical and surgical sex-rejecting procedures could be good for children," said HHS Secretary Robert F. Kennedy, Jr. "They betrayed their oath to first do no harm, and their so-called 'gender-affirming care' has inflicted lasting physical and psychological damage on vulnerable young people. That is not medicine — it's malpractice."

"What are we going to tell the young people who can't have children because the medical profession stole that from them?" said Christine. "Our report is an urgent wake-up call to doctors and parents about the clear dangers of trying to turn girls into boys and vice-versa."

The report reinforces the need for Alabama's Vulnerable Child Compassion and Protection Act, which passed in 2022, making it a felony for doctors to provide minors with puberty blockers, cross-sex hormone treatments, or surgeries for the purpose of gender transition.

The law was enacted in April 2022 and preliminarily enjoined by a federal district court that May. The U.S. Court of Appeals for the Eleventh Circuit vacated the injunction in August 2023, opening the door for Alabama to enforce its law. 

When the suit against the state was dropped in May 2025, Attorney General Steve Marshall released a statement that said, "This victory is not just for Alabama. This is a generational win for children, for families, and for reality itself. Alabama refused to be bullied. Now the rest of the country is seeing the truth. We are proud to lead that effort."

Discovery in the Alabama suit led the U.S. Supreme Court to uphold a similar ban in Tennessee.

"The political and legal scandal Alabama uncovered underscores why the Constitution places the authority to regulate medicine with the States, not with activist organizations like WPATH or their friends at the ACLU," said Marshall upon that victory.

"Laws like Alabama's and Tennessee's are unfortunately very necessary to protect vulnerable children from so-called medical 'standards' that were created for the express purpose of 'affecting policy' and 'winning lawsuits,' not to accurately reflect the science or help children. We are glad that the Supreme Court has upheld these laws, and glad that President Trump's administration is also taking steps to rid medicine of harmful gender ideology. I look forward to our partnership to root out these radical policies that are directly harming our children and their future."  

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