The evidentiary floor for pediatric gender medicine is a live question in federal policy. England's National Health Service paused cross-sex hormones for patients aged 16 and 17 after finding the supporting research "really weak," and a prior ban covering children under 16 was already in place. At a Friday rally at Michigan State University, Michigan Democratic U.S. Senate candidate Abdul El-Sayed argued that treatment decisions of this kind belong between patients and their providers, with no government role in the clinical room.
El-Sayed, the former head of the Detroit Health Department and a candidate who has built his Senate campaign around Medicare for All, responded to a student's question about protecting access to sex-change procedures. He invoked his medical training to ground the argument, pointing to the full arc of medical education: school, residency, fellowship, and licensing exams. The implicit claim was that credentialed clinicians, not legislators, are the appropriate decision-makers.
That credential claim faces a gap in the record. Fox News Digital previously reported El-Sayed holds no medical license in Michigan or New York. His office did not respond to a request for comment.
The Medicare for All tension
El-Sayed's position sits in tension with his signature policy. Medicare for All would install the federal government as the national payer, yet El-Sayed told the MSU audience that "the decision about what healthcare is necessary ought to be held between a patient and or their parents if they're under the age of 18 and their doctor." He pointed to the Right to Try Act, which allows terminally ill patients to access experimental drugs that have not received FDA approval, as evidence that conservatives already accept limits on government authority over treatment access. He argued the same logic should govern gender care.
The Trump administration is moving in the opposite direction. The Justice Department this week announced that Mount Sinai joined Texas Children's Hospital, the Cleveland Clinic Foundation, and Connecticut Children's Hospital in halting sex-change procedures for minors after reaching an agreement with the administration. Medicaid has separately ended funding for pediatric sex-change procedures.
The clinical evidence
The research underlying the policy debate is contested at an institutional level. The World Professional Association for Transgender Health, whose guidelines are referenced by the American Academy of Pediatrics, faces a Federal Trade Commission lawsuit. The FTC alleges WPATH misled parents about the consensus, necessity, safety, and effectiveness of sex-change procedures, and the agency specifically accuses the organization of failing to disclose side effects tied to cross-sex hormones, including incontinence, erectile pain, mood disturbances, pelvic pain, and vaginal pain.
England's NHS remains the sharpest international reference point. The pause on cross-sex hormones for 16- and 17-year-olds came in March; the ban for children under 16 had been in place before it.