Bill of goods: FTC investigates transgender “medicine”

Editor’s note: This story contains descriptions of medical attempts to alter sex characteristics. It may not be suitable for all readers.

Parents whose children claim to be transgender often say that medical providers convinced them to approve so-called “gender-affirming care” by asking a startling question: “Do you want a living daughter or a dead son?”

The Federal Trade Commission said last week it may consider that claim—that puberty blockers, cross-sex hormones, and invasive surgeries could reduce suicide risk—and others as potentially “deceptive or unfair trade practices.” The commission is addressing the topic for the first time, just weeks after the Supreme Court upheld states’ rights to protect children from medical attempts to alter their sex characteristics.

In a speech at its headquarters on Wednesday, Federal Trade Commission (FTC) Chairman Andrew Ferguson announced the agency is soliciting public feedback on experiences with pediatric gender interventions, particularly whether medical providers misled patients about possible effects. The agency said it will issue a 60-day public comment period in the coming days.

“We are here to ensure that those who make claims about gender-affirming care are held to the same standard we apply to every other person engaged in commerce,” Ferguson said in his speech.

The Federal Trade Commission is the nation’s consumer watchdog, charged with documenting fraud, scams, and bad business practices while also enforcing consumer protection laws. It shares findings with law enforcement agencies and investigators. Typically, the commission’s consumer alerts focus on online scams, identity theft, and hidden fees.

The FTC is the third federal agency to question the benefits of prescribing puberty blockers and cross-sex hormones. Back in March, the Centers for Medicare & Medicaid Services issued a statement expressing serious concerns about the practice. In February, the Department of Health and Human Services stated it would “promote policies acknowledging that women are biologically female and men are biologically male.”

According to a 2019 study conducted by the LGBTQ youth advocacy group the Trevor Project, 35% of youth who identified as transgender said they attempted suicide in the past year, and 44% said they had “seriously considered” it. More recent research shows that youth identifying as transgender or non-binary are more likely to attempt suicide in states that passed legislation protecting minors from transgender interventions.

But U.K. pediatrician Hilary Cass—who reviewed the research behind the use of cross-sex hormones and puberty blockers—noted few completed suicides among youth identifying as transgender. She also said evidence showing that the medical interventions improved their mental health was “remarkably weak.”

On the same day that Ferguson made the announcement, the commission hosted a forum in which former patients and parents told members of the FTC about their negative experiences.

During the event, Claire Abernathy said doctors prescribed testosterone a week after she turned 14 and recommended removal of her healthy breasts so she could live as a male. “I was told if I didn’t do this, I would probably end up dead,” said Abernathy, now 20. Six months after she began taking testosterone, surgeons performed a double mastectomy. But Abernathy says she now suffers from pelvic floor dysfunction and urinary incontinence—complications she didn’t quite understand as a 14-year-old.

“When you sell a product, especially one that removes body parts and alters your life forever, the consumer deserves the whole truth,” she said. “At 14, I trusted the adults who were supposed to protect me. Instead, they sold me a dream that turned into a nightmare.”

Elvira Syed told attendees that providers prescribed testosterone to her daughter Ilene in June 2024. But Syed says they were unaware of Ilene’s past history of self-harm.

“There was no physical exam, no mention of the visible scars on her arms, no signs that her condition was truly assessed, and absolutely no indication of an endocrine disorder that would justify a prescription for hormones,” she said.

Four months after first being prescribed testosterone, Ilene took her own life. She was 18. Syed believes her daughter would be alive if doctors had done a full physical and hadn’t prescribed her testosterone.

Medical and legal experts also expressed their concerns about the lack of scientific evidence backing popular treatments for gender dysphoria in youth.

“Gender dysphoria is a legitimate psychological diagnosis,” stated Dr. Michael Laidlaw, an endocrinologist in California. But, he added that, “the majority—50 to 98 percent—will desist or grow out of this by adulthood.”

Dr. Miriam Grossman, a psychiatrist and senior fellow at the medical policy advocacy group Do No Harm, said that many youth transgender treatment guidelines encourage patients to alter their medical records to list the incorrect biological sex. Doing this, she said, could lead doctors to overlook serious health conditions.

She mentioned the case of “Sam,” a 32-year-old listed as a man in medical records. Sam came to the emergency room with intermittent lower abdominal pain and high blood pressure. Several hours later, doctors eventually determined that Sam was a biological female in labor with preeclampsia. Sam gave birth to a stillborn baby, stunning the doctors. Grossman said that if Sam had been listed as a female, the outcome might have been different.

“The language of medical records must be accurate,” Grossman said.

The FTC does not regulate medical practice, but Ferguson, the agency’s chairman, noted that it has weighed in on dubious health claims by medical providers. Much like other scams that the agency investigates, Ferguson explained that the FTC needs to understand what specific claims within pediatric gender medicine are deceptive, what risks providers don’t disclose, and whether the industry targets vulnerable populations.

Ferguson stressed that the law should protect children. “We are here to ensure that everyone can make an informed choice about their own path to healing without fear of being deceived by those who stand to profit from certain medical interventions,” he said.

What’s not clear, though, is what the commission will do after the 60-day comment period ends. A panel of legal experts at the conference offered a number of ideas, from removing phrases like “sex assigned at birth” and “gender identity” from the medical lexicon to investigating doctors and other practitioners.

At the event, the Department of Justice announced that it has already issued nearly 20 subpoenas to centers that prescribe transgender interventions across the country. The names of the providers have not been made public, noted Chad Mizelle, chief of staff at the department. But he says if they are found liable, they could face civil or criminal penalties.