Tennessee Joins Multi-State Push to Hold Major Medical Organization Accountable
Mar 4, 2026 by FACT
Tennessee Attorney General Jonathan Skrmetti joined 19 other state AGs in signing onto a 13-page letter penned by Alabama Attorney General Steve Marshall, expressing concern and requesting clarification from the American Medical Association (AMA) over its position on “gender transition” hormones and puberty blockers for minors.
In early February, AMA announced its opposition to “sex change” procedures for children, citing a lack of scientific evidence to support such operations. The letter urges the organization to similarly denounce the use of “gender transition” hormone treatments for minors, as a growing body of evidence indicates these interventions are not only unhelpful for gender-confused children, but they also carry serious and often lifelong consequences. The letter also “warns of a potential investigation of the AMA for possible violations of consumer protection laws for misleading providers, patients, and families about the safety and efficacy of hormonal sex-change procedures for minors.”
The letter explains:
This summation from HHS comes as no surprise to those who have closely followed the steady release of scientific studies illustrating the deeply damaging results of all “gender affirming care” practices – not just for minors, but for adults as well. Countless organizations worldwide have critically examined these bodies of research and adjusted their standards of care accordingly, often outlawing “gender transition” procedures for minors entirely. Why are American medical organizations failing to keep up? The answer is simple: politics.
The letter continued:
But hormones can leave a child sterilized just as surely as surgery can—and indeed, that is the near-guaranteed pathway for a boy who begins puberty blockers at Tanner stage 2 and progresses to cross-sex hormones.
Tennessee banned all forms of “gender affirming care” for minors in 2023 precisely because of the harms enumerated in Alabama’s letter. SCOTUS upheld that ban because states have the right and obligation to protect their most vulnerable residents from harm. Our state, along with 19 others, is calling on one of the largest medical organizations in the nation, the AMA, to publicly disavow hormone treatments for minors because they, too, have an obligation to protect vulnerable patients, and, moreover, “do no harm.”
“Gender-affirming care” – whether surgeries, hormone treatments, puberty blockers, or other methods – presents serious medical risks and often irreversible consequences that outweigh the short-lived “therapeutic benefits” the interventions promise to deliver. These vulnerable children need real solutions – not a band-aid.
It’s time for the AMA to come clean. All medical associations should recognize “gender-affirming care” for what it is – a scam.
In early February, AMA announced its opposition to “sex change” procedures for children, citing a lack of scientific evidence to support such operations. The letter urges the organization to similarly denounce the use of “gender transition” hormone treatments for minors, as a growing body of evidence indicates these interventions are not only unhelpful for gender-confused children, but they also carry serious and often lifelong consequences. The letter also “warns of a potential investigation of the AMA for possible violations of consumer protection laws for misleading providers, patients, and families about the safety and efficacy of hormonal sex-change procedures for minors.”
The letter explains:
“The American public has long viewed the American Medical Association as a trusted leader in the medical community. When the AMA makes a recommendation, it matters. Patients and doctors listen.
We thus read with appreciation the AMA’s recent statement concerning surgical procedures on minors to treat gender confusion: “In the absence of clear evidence, the A.M.A. agrees with [the American Society of Plastic Surgeons] that surgical interventions in minors should be generally deferred to adulthood.” According to the New York Times, the AMA’s position reflects the “sparse research on the risks and benefits of surgical procedures” to treat gender dysphoria in minors.
On that, we concur.
Our concern is that the evidence base is similarly lacking when it comes to the provision of puberty blockers and cross-sex hormones to treat gender dysphoria in minors. As for puberty blockers, [an] HHS review found that “the certainty of evidence is very low regarding the effect of PBs on [gender dysphoria], improvement in mental health, and safety,” while “[t]here is high certainty evidence that PBs exert physiological effects (such as sex hormone suppression) and often cause infertility when followed by [cross-sex hormones], depending on the patient’s pubertal stage and sex.”
“Overall,” the review concluded, “the absence of long-term, high-certainty evidence on these critical outcomes (including suicides, fractures, fertility, growth, and neurocognitive development) leaves substantial uncertainty about the effects of PBs.”
We thus read with appreciation the AMA’s recent statement concerning surgical procedures on minors to treat gender confusion: “In the absence of clear evidence, the A.M.A. agrees with [the American Society of Plastic Surgeons] that surgical interventions in minors should be generally deferred to adulthood.” According to the New York Times, the AMA’s position reflects the “sparse research on the risks and benefits of surgical procedures” to treat gender dysphoria in minors.
On that, we concur.
Our concern is that the evidence base is similarly lacking when it comes to the provision of puberty blockers and cross-sex hormones to treat gender dysphoria in minors. As for puberty blockers, [an] HHS review found that “the certainty of evidence is very low regarding the effect of PBs on [gender dysphoria], improvement in mental health, and safety,” while “[t]here is high certainty evidence that PBs exert physiological effects (such as sex hormone suppression) and often cause infertility when followed by [cross-sex hormones], depending on the patient’s pubertal stage and sex.”
“Overall,” the review concluded, “the absence of long-term, high-certainty evidence on these critical outcomes (including suicides, fractures, fertility, growth, and neurocognitive development) leaves substantial uncertainty about the effects of PBs.”
This summation from HHS comes as no surprise to those who have closely followed the steady release of scientific studies illustrating the deeply damaging results of all “gender affirming care” practices – not just for minors, but for adults as well. Countless organizations worldwide have critically examined these bodies of research and adjusted their standards of care accordingly, often outlawing “gender transition” procedures for minors entirely. Why are American medical organizations failing to keep up? The answer is simple: politics.
The letter continued:
As a result of these findings, healthcare authorities across the world have restricted access to puberty blockers and cross-sex hormones to treat gender dysphoria in adolescents or cautioned against their use. Scotland’s National Health Service “stopped all new prescriptions of puberty-blocking drugs and other hormone treatments for minors.” England’s National Health Service provides that “[p]uberty suppressing hormones are not available to children and young people for the treatment of gender dysphoria or gender incongruence” because “there is not enough evidence on their clinical safety and effectiveness.” Sweden’s “National Board of Health and Welfare currently assesses that the risks of puberty blockers and gender-affirming treatment are likely to outweigh the expected benefits of these treatments.” Finland’s healthcare authority concluded that, “[i]n light of available evidence, gender reassignment of minors is an experimental practice.” The Norwegian Healthcare Investigation Board found that “[t]he evidence base, especially research-based knowledge for gender-affirming treatment (hormonal and surgical), is insufficient and the long-term effects are not well known.” And New Zealand’s health ministry just recently prohibited new prescriptions of puberty blockers to treat gender dysphoria in minors because of the lack of “high-quality evidence that demonstrates the benefits or risks” of the treatments.
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 quality of evidence is the same as it is for surgeries: low and very-low quality. 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. These interventions have not been shown to be any safer for children than 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—and indeed, that is the near-guaranteed pathway for a boy who begins puberty blockers at Tanner stage 2 and progresses to cross-sex hormones.
Tennessee banned all forms of “gender affirming care” for minors in 2023 precisely because of the harms enumerated in Alabama’s letter. SCOTUS upheld that ban because states have the right and obligation to protect their most vulnerable residents from harm. Our state, along with 19 others, is calling on one of the largest medical organizations in the nation, the AMA, to publicly disavow hormone treatments for minors because they, too, have an obligation to protect vulnerable patients, and, moreover, “do no harm.”
“Gender-affirming care” – whether surgeries, hormone treatments, puberty blockers, or other methods – presents serious medical risks and often irreversible consequences that outweigh the short-lived “therapeutic benefits” the interventions promise to deliver. These vulnerable children need real solutions – not a band-aid.
It’s time for the AMA to come clean. All medical associations should recognize “gender-affirming care” for what it is – a scam.
