One expert is sounding the alarm on a harsh reality that many already recognize: there’s no proof that puberty blockers, cross-sex hormones, or surgical interventions actually help children suffering from gender dysphoria. And yet, he went even further: the entire field of transgender medicine for youth? It’s fundamentally constructed on layers of fraud.

The expert in question is Leor Sapir, a senior fellow at the Manhattan Institute and one of the key architects of the Department of Health and Human Services (HHS) report, “Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices.” Sapir assembled a team of experts shortly after President Donald Trump’s January 2025 executive order, which was aimed at protecting “children from chemical and surgical mutilation.” The order directed HHS to conduct a comprehensive evidence review within 90 days, resulting in the 409-page document.

In a recent interview with American Thought Leader host Jan Jekielek, Sapir explained how doctors who push so-called “gender-affirming care” procedures are “relying on unproven gender-affirming guidelines” and misleading patients. Not only is there no solid evidence that these experimental interventions benefit the children they’re administered to, he argued, but there is evidence they cause harm. “Fraud is not just a feature, or, I should say, it’s not just something that happens in this field,” Sapir told Jekielek. “It’s almost fundamental to the field itself.”

To address this, Sapir and his team produced the HHS review, initially released in May 2025 as a detailed assessment of the scientific evidence and clinical practices. The report underwent post-publication peer review, with an updated, peer-reviewed version published in November 2025, including supplements and author identifications. It highlights significant long-term risks from puberty blockers, cross-sex hormones, and surgeries — such as infertility, impaired bone density, cardiovascular issues, and regret — while finding the evidence for benefits to be very uncertain or lacking.

Notably, the report explicitly concludes that psychotherapy, as opposed to unproven and experimental medical interventions, offers significantly greater benefits for children with gender dysphoria. According to Sapir, this only reinforces the need for truly evidence-based approaches to medicine and patient care. And yet, massive bodies that have veered away from evidence-based approaches, such as the World Professional Association for Transgender Health (WPATH), heavily influence the way guidelines and procedures are established.

Sapir and many others view WPATH as an activist organization rather than a neutral medical authority. In fact, WPATH has been criticized for pushing insurance coverage of trans-related procedures with taxpayer dollars while simultaneously not promoting mental health assessments for children with gender dysphoria. And furthering its influence, major U.S. medical entities like the American Academy of Pediatrics and the Endocrine Society, often reference one another’s standards (such as what’s coming from WPATH) in a circular manner, creating what critics view as an evidence-poor echo chamber.

In addition to unreliable resources fueling much of how trans-related practices are conducted, Sapir also stressed ethical concerns, namely, that children lack the maturity for informed consent on life-altering treatments. These interventions being deemed a civil rights issue suppresses debate and pressures providers to prioritize patient demands over the Hippocratic Oath and the principle of “do no harm.” So, while advocates of gender-affirming care argue these treatments are necessary and “lifesaving,” Sapir, the HHS review, and countless Americans concerned about the well-being of youth maintain that ethical medicine requires prioritizing approaches more likely to help than harm — especially for vulnerable minors.

Reflecting on this issue, a biblical perspective offers helpful insight into navigating the complexity of it all. If Sapir is right, and many would say he is, that the foundation of youth-oriented transgender “medicine” is fraud, how does that help us understand the nature of sin as a whole?

All rebellion against Christ, who is truth Himself, is rooted in deception. Scripture teaches that sin is fundamentally built on lies and falsehoods, tracing back to the Garden of Eden where Satan, the “father of lies” (John 8:44), deceived Eve with twisted truths. This moment ultimately led all of humanity into rebellion against God. And what do we see throughout the rest of the Bible? A condemnation of deceit: “Lying lips are an abomination to the Lord” (Proverbs 12:22), and God hates “a false witness who breathes out lies” (Proverbs 6:16-19).

And so, perhaps it’s reasonable to conclude that just as sin entered the world through cunning distortion — Satan adding a single “not” to God’s command in Genesis 3:4 — the transgender medical industry for youth is founded on strikingly similar deceptions. Those pushing the harmful ideology promote overstated benefits, suppressed evidence of harm, and circular endorsements that mislead desperate families and vulnerable children. This echoes the very promises of sin, which deliver nothing but destruction.

Sin leads to long-term harm and a life of regrets — the biggest of all being eternity apart from Christ. Likewise, transgenderism has proven to leave children and adults with not only long-term regrets, but failing health, irreversible changes to their body, and lifelong pain and suffering. Yet, praise God that true healing, biblically, comes not from altering His created order (Genesis 1:27; Psalm 139:14) but from confronting and repenting of falsehoods and seeking restoration through Christ, who is “the way, the truth, and the life” (John 14:6).

In a world rife with deception, believers are called to “put away falsehood” (Ephesians 4:25) and stand for integrity, just as Sapir and his team of medical experts are doing through the science. The goal couldn’t be simpler: protecting the innocent from industries built on lies that ultimately harm the soul as much as the body.