A 409-page report released Thursday by the U.S. Department of Health and Human Services challenges the ethics of medical interventions for youth experiencing gender dysphoria, the treatments that are often collectively called gender-affirming care, instead advocating for psychotherapy alone.

The document comes in response to President Donald Trump’s executive order barring the federal government from supporting gender transitions for anyone younger than 19.

“Our duty is to protect our nation’s children — not expose them to unproven and irreversible medical interventions,” National Institutes of Health Director Dr. Jay Bhattacharya said in a statement. “We must follow the gold standard of science, not activist agendas.”

While the report does not constitute clinical guidance, its findings nevertheless conflict with not just the recommendations of LGBTQ advocacy groups but also those issued by organizations with relevant expertise in science and medicine.

The American Medical Association, for instance, notes that “empirical evidence has demonstrated that trans and non-binary gender identities are normal variations of human identity and expression.”

Gender-affirming care for transgender youth under standards widely used in the U.S. includes supportive talk therapy along with — in some but not all cases — puberty blockers or hormone treatment.

“The suggestion that someone’s authentic self and who they are can be ‘changed’ is discredited junk science,” GLAAD President and CEO Sarah Kate Ellis said in a statement. “This so-called guidance is grossly misleading and in direct contrast to the recommendation of every leading health authority in the world. This report amounts to nothing more than forcing the same discredited idea of conversion therapy that ripped families apart and harmed gay, lesbian, and bisexual young people for decades.”

GLAAD further notes that the “government has not released the names of those involved in consulting or authoring this report.”

Janelle Perez, executive director of LPAC, said, “For decades, every major medical association–including the American Medical Association and the American Academy of Pediatrics–have affirmed that medical care is the only safe and effective treatment for transgender youth experiencing gender dysphoria.

“This report is simply promoting conversion therapy by a different name – and the American people know better. We know that conversion therapy isn’t actually therapy – it isolates and harms kids, scapegoats parents, and divides families through blame and rejection. These tactics have been used against gay kids for decades, and now the same people want to use them against transgender youth and their families.

“The end result here will be a devastating denial of essential health care for transgender youth, replaced by a dangerous practice that every major U.S. medical and mental health association agree promotes anxiety, depression, and increased risk of suicidal thoughts and attempts.

“Like being gay or lesbian, being transgender is not a choice, and no amount of pressure can force someone to change who they are. We also know that 98% of people who receive transition-related health care continue to receive that health care throughout their lifetime. Trans health care is health care.”

“Today’s report seeks to erase decades of research and learning, replacing it with propaganda. The claims in today’s report would rip health care away from kids and take decision-making out of the hands of parents,” said Shannon Minter, legal director of NCLR. “It promotes the same kind of conversion therapy long used to shame LGBTQ+ people into hating themselves for being unable to change something they can’t change.”

“Like being gay or lesbian, being transgender is not a choice—it’s rooted in biology and genetics,” Minter said. “No amount or talk or pressure will change that.” 

Human Rights Campaign Chief of Staff Jay Brown released a statement: “Trans people are who we are. We’re born this way. And we deserve to live our best lives and have a fair shot and equal opportunity at living a good life.

“This report misrepresents the science that has led all mainstream American medical and mental health professionals to declare healthcare for transgender youth to be best practice and instead follows a script predetermined not by experts but by Sec. Kennedy and anti-equality politicians.”

President Donald Trump on Thursday announced he will nominate Mike Waltz to become the next U.S. ambassador to the U.N.

Waltz, a former Florida congressman, had been the national security advisor.

Trump announced the nomination amid reports that Waltz and his deputy, Alex Wong, were going to leave the administration after Waltz in March added a journalist to a Signal chat in which he, Defense Secretary Pete Hegseth, and other officials discussed plans to attack Houthi rebels in Yemen.

“I am pleased to announce that I will be nominating Mike Waltz to be the next United States ambassador to the United Nations,” said Trump in a Truth Social post that announced Waltz’s nomination. “From his time in uniform on the battlefield, in Congress and, as my National Security Advisor, Mike Waltz has worked hard to put our nation’s Interests first. I know he will do the same in his new role.”

Trump said Secretary of State Marco Rubio will serve as interim national security advisor, “while continuing his strong leadership at the State Department.”

“Together, we will continue to fight tirelessly to make America, and the world, safe again,” said Trump.

Trump shortly after his election nominated U.S. Rep. Elise Stefanik (R-N.Y.) to become the next U.S. ambassador to the U.N. Trump in March withdrew her nomination in order to ensure Republicans maintained their narrow majority in the U.S. House of Representatives.

Kabelo Seseli, a gay crossdresser and LGBTQ activist in Lesotho, was murdered over the weekend in a suspected homophobic attack.

According to the People’s Matrix Association, a LGBTQ rights organization, Seseli’s body was found with stab wounds on their neck and genitals.

“This was not just a murder, it was a hate-driven, dehumanizing act meant to send a message of fear and rejection to our community,” said the People’s Matrix Association in a statement posted to its Facebook page on April 29. “Kabelo deserved to live. Kabelo deserved dignity, safety, and the freedom to exist without fear, just like every Mosotho.”

The LGBTQ rights group also said it is demanding action, justice, and protection from the government, especially given the fact authorities have arrested a suspect.

“We strongly condemn this act of violence and call on the government of Lesotho and law enforcement authorities to conduct a thorough investigation and ensure that those responsible are held fully accountable,” said the People’s Matrix Association. “We also urge leaders and the public to reflect on the role of hate speech and social stigma, which continue to incite violence against LGBTI individuals across our country. We demand action.”

Victor Mukasa of Trans and History Intersex Africa also condemned Seseli’s murder.

“Death is a fact of life, but murder is criminal,” said Mukasa. “Murder of people because they are LGBTIQA+ or for belonging to a particular social group is a hate crime.”

Thato Motsieloa, a gay crossdresser and LGBTQ activist, said he was “deeply distraught to learn about the brutal murder of Kabelo Seseli.” Motsieloa said he and Seseli met on Facebook.

“Although we never met in person, we had plans to do so,” said Motsieloa. “The manner of his death is particularly heartbreaking, and the fact that his killers desecrated his body by removing his private parts is utterly heinous. I hope justice is served, and those responsible face the consequences of their horrific actions. My sincerest condolences go out to Kabelo’s family, may his soul rest in eternal peace.”

Lesotho in 2012 decriminalized consensual same-sex sexual relations. Marriage, however, remains limited to heterosexual couples. There have also been sporadic reports of anti-LGBTQ hate crimes since 2012.

The International Commission of Jurists, in partnership with Outright International, a New York-based LGBTQ advocacy group, in 2022 held a workshop with the Lesotho judiciary that focused on human rights for the LGBTQ community.

The judiciary noted LGBTQ people exist, but acknowledged there is no local jurisprudence on their rights, even though the country’s constitution guarantees the right to respect private and family life and freedom from discrimination.

Religious and cultural norms, like in many African countries, play a pivotal role in how society perceives the LGBTQ community. Many people in Lesotho disregard the existence of LGBTQ people, even though the government is trying to make room for the acknowledgment of LGBTQ rights.

Outright International Africa Advocacy Officer Khanyo Farise says the judiciary’s active engagement with the LGBTQ community is an important step towards ensuring LGBTQ rights are upheld.

“Judges and judicial officers play an important part in ensuring access to justice for LGBTIQ+ people, but also have an important role in producing judgments which can advance their human rights,” said Farise.

ICJ Africa Communications and Legal Officer Mulesa Lumina said though the ICJ is encouraged by these developments, particularly the willingness of judiciary members to understand the plight of the community, LGBTQ people continue to face harassment, discrimination, abuse and violence because of their actual or perceived sexual orientation and gender identity.

“We will continue working with partners, such as the People’s Matrix and Outright International, to ensure the enforcement of the country’s obligations under international human rights law, which entitle LGBTIQ persons to the full range of human rights without discrimination,” said Lumina.