The study further reported that both stronger endorsement of those clinical positions and higher levels of left-wing authoritarianism were associated with greater acceptance of political violence in a series of hypothetical situations.
“This study raises important questions about what happens when ideology is given the authority of medicine,” HHS Assistant Secretary for Health Admiral Brian Christine said in a statement. “The association between sex-rejecting clinical beliefs, authoritarian attitudes, and the justification of political violence warrant serious scientific scrutiny. HHS will continue to pursue rigorous research that examines these relationships and gives the American people the evidence they deserve.”
The findings are likely to fuel an already heated national debate over transgender policy, medical treatment and the influence of ideology in American institutions.
But the researchers included important limitations that complicate any attempt to interpret the findings as evidence that gender-related beliefs cause political violence.
According to the study’s accompanying release, the research does not establish which factor comes first. It “does not determine whether belief in radical gender ideology contributes to authoritarian attitudes or vice versa, nor whether an outside factor may contribute to both predispositions.”
The researchers added that “experimental research is needed to determine causality.”
That distinction is significant. The survey identified statistical relationships between the variables it measured, but it did not demonstrate that one directly produced another.
The research also did not examine whether participants had actually engaged in political violence or planned to do so. Instead, respondents were asked how justified they believed six hypothetical or described acts of political violence would be.
The study “did not measure whether respondents committed or intended to commit political violence,” according to the release. Rather, it measured “how justified respondents considered six hypothetical or described acts of political violence.”
As a result, the researchers emphasized that their conclusions should not be interpreted as evidence that supporters of gender-affirming medicine are violent.
The study’s findings “therefore establish associations with the justification of political violence, not violent behavior,” the release states.
The research was conducted by scholars affiliated with Rutgers University, the Manhattan Institute and the Network Contagion Research Institute. The survey was preregistered and included 1,208 U.S. adults.
The report has nevertheless prompted immediate criticism from LGBTQ advocacy organizations.
The Human Rights Campaign, a prominent LGBTQ advocacy group, accused the administration and researchers of attempting to portray transgender Americans as dangerous.
HRC said Thursday that the HHS-funded research was a “junk report trying to paint trans Americans as a threat.”
“And let us all be absolutely clear on this point: political violence is not, and must never become, acceptable in our society,” HRC president Kelley Robinson said in a statement. “But neither should demonizing entire groups of people for political gain. Trans people are not an ideology, they are human beings and our fellow Americans who deserve the same dignity as anyone else.”
The controversy comes amid a broader political fight over how schools, government agencies and medical institutions should approach sex and gender.
During the Biden administration, disputes surrounding gender identity became increasingly prominent nationwide. Critics of previous policies argued that government agencies had gone too far in incorporating gender-identity policies into schools, healthcare and child welfare systems.
One example emerged in Ohio, where a child welfare agency reportedly maintained a “confidential spreadsheet” tracking the sexual orientation and transgender status of children, including some as young as five. The Daily Caller News Foundation first reported on the matter in October 2024.
The issue has taken a different direction under President Donald Trump.
Shortly after returning to office in January 2025, Trump issued an executive order directing the federal government to adopt policies recognizing sex as biologically based. The order stated that the administration intended to “defend women’s rights and protect freedom of conscience by using clear and accurate language and policies that recognize women are biologically female, and men are biologically male.”
The administration has subsequently pursued policies aimed at rolling back federal recognition of gender ideology and changing how government agencies address sex, gender and transgender issues.
The new HHS-backed research arrives in that politically charged environment, making its conclusions especially likely to attract scrutiny from both supporters and opponents of the administration’s approach.
For now, the study establishes an association—not a cause-and-effect relationship—between the attitudes it measured. Its authors explicitly caution that further experimental research will be required to determine whether any causal connection exists.
That caveat is central to understanding the findings. The research may provide new material for the continuing debate over ideology, medicine and political extremism, but it does not establish that transgender Americans or people who support gender-affirming care are more likely to commit violence.
What it does report is a measurable relationship among several attitudes in the survey population—one that researchers say deserves further scientific examination as the national argument over gender policy continues.
