State Attorneys General and Medical Regulation

A coalition of 20 state attorneys general led by Alabama’s Steve Marshall has sent a formal letter to American Medical Association CEO Dr. John J. Whyte, accusing the AMA of relying on 'selective' and low‑quality evidence to support puberty blockers and cross‑sex hormones for minors while recently opposing gender‑related surgeries for children. The AGs praise the AMA’s move, aligned with the American Society of Plastic Surgeons, to defer surgeries to adulthood for lack of 'clear evidence,' but argue systematic reviews by HHS and Dr. Hilary Cass show the same weak evidence base for hormonal interventions and similar risks of sterilization and long‑term harm. The letter poses detailed questions about the safety and efficacy of these treatments, presses the AMA to clarify whether it endorses WPATH, Endocrine Society and AAP standards, and warns that its current stance may violate state consumer‑protection laws that bar deceptive claims about the benefits of medical services. Marshall sets a March 25 deadline for answers and publicly suggests the organization could face investigation if it does not reconcile what he calls an inconsistent, evidence‑poor position. The move marks a sharp escalation in the legal and political fight over youth gender medicine, signaling that red‑state law‑enforcement leaders are preparing to treat major medical associations’ guidance itself as a potential target under false‑advertising and fraud statutes.