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Utah Gov. Spencer Cox (R) ratified legislation in January 2023 prohibiting health care providers from providing sex-altering surgeries or drugs to minors.
The law, which enraged gender ideologues and other non-straight activists, also required the Utah Department of Health and Human Services to conduct a "systematic review of the medical evidence regarding hormonal transgender treatments and provide recommendations to the Legislature."
The HHS' statutorily mandated review, which was completed last year then submitted in May 2025 to the legislature, painted the ruinous trans-drugs — which are also used to sterilize sex offenders — in a positive light, characterizing them as "effective."
According to a damning new report from the medical advocacy group Do No Harm, however, the Utah review — which was conducted on behalf of the HHS by the University of Utah College of Pharmacy's Drug Regimen Review Center — "is filled with falsehoods and serves as an aid to push harmful medical interventions as the answer to minors’ confusion, all while blatantly ignoring the associated risks."
'Utah legislators must not rely on a report that clearly undermines the safety and well-being of minors.'
While the executive summary for the review states that the HHS "does not take a position on whether to lift the moratorium" and the authors were not contracted to include a synthesis of the evidence they came across, the over-1,000-page review nevertheless delivers what is effectively an endorsement of sex-altering drugs for minors:
After having spent many months searching for, reading, and evaluating the available literature, it was impossible for us to avoid drawing some high-level conclusions. Namely, the consensus of the evidence supports that the treatments are effective in terms of mental health, psychosocial outcomes, and the induction of the body changes consistent with the affirmed gender in pediatric GD patients. The evidence also supports that the treatments are safe in terms of changes to bone density, cardiovascular risk factors, metabolic changes, and cancer.
Do No Harm indicated that the Utah review "deviates from established standards for systematic reviews, emphasizes the volume of evidence over its quality, relies uncritically on guidelines from self-proclaimed experts, neglects significant life-altering adverse effects, and includes input from advisers, some of whom demonstrate bias in favor of 'gender-affirming care' for minors."
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Do No Harm noted, for instance, that the review glossed over some of the worst, most life-changing effects of gonadotropin-releasing hormone agonists, known as "puberty blockers," and cross-sex hormones — namely infertility, sterility, and sexual dysfunction. While admitting that "infertility is a known risk," the authors of the review didn't bother including it as an outcome of focus in their report. The risk of sexual dysfunction, meanwhile, was apparently not mentioned once.
Extra to leaning heavily on low-quality scientific literature, much of which was observational and not trial-based, the review may have also been ideologically contaminated. After all, among the advisers who consulted on the project were Nikki Mihalopoulos, chief of the division of adolescent medicine for the department of pediatrics at the University of Utah School of Medicine, and Brooks Keeshin, a professor of pediatrics at the university. Both have written positively about "gender-affirming care" for minors in recent years.
Mihalopoulos co-authored a 2021 paper that stated, "Pediatric health care providers can play a critical role in building solutions in policy and advocacy ... to improve the health of transgender/gender diverse youth. Many government entities, especially at the state and local level, actively resist efforts promoting equal rights."
Keeshin wrote in an article published last year that "as states pass adolescent bans on gender-affirming care across the country, Utah offers a potential pathway forward in restrictive states to help maintain or open access to care." Keeshin also suggested that some adolescents could benefit from radical sex-rejecting medical interventions.
Do No Harm concluded on the basis of these and other issues with the review that Utah lawmakers are better off turning to the U.S. Department of Health and Human Services' thorough and peer-reviewed report, which was released last month.
The federal HHS' report underscored that "the harms from sex-rejecting procedures — including puberty blockers, cross-sex hormones, and surgical operations — are significant, long-term, and too often ignored or inadequately tracked."
Michelle Havrilla, Do No Harm's director of programs, said in a statement, "This Utah Report is unreliable, unscientific, and fails to meet the standards of a systematic review."
"The Report’s inaccuracies and bias diminish its credibility and allow left-wing activists to weaponize it for their political machinations. Utah legislators must not rely on a report that clearly undermines the safety and well-being of minors," added Havrilla.
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Let's face it: Halloween is only fun if you're a kid. If I had my way, I'd spend the evening at home with all the lights off and a pile of newspapers on the doorstep so nobody thinks there's any free candy to be had.
But I have children of my own, which means I've got to roam the streets with all the other middle-aged walking dead and their spawn. Now I can either do this in the time-honored dad uniform of jeans and quarter-zip sweater, or I can dispense with pretensions to dignity and wear a costume of my own. Years of experience has taught me that option number two is the only way to go.
Investing in a basic theatrical makeup kit can ensure that your costume is at least as frightening as the obsessive amounts of time and energy that clearly went into it.
Look, I hate dressing up for Halloween. It's not so much that I mind wearing a costume; it's the hassle of deciding upon one and then procuring the necessary pieces to make it happen. School just started and "the holidays" loom; who needs another decision to make?
But I've come to see it as my duty. You see, every adult standing around like a dork in their street clothes makes the occasion that much less Halloween-y. You get a critical mass of such wallflowers, and the night is ruined. So each year, a certain number of us must take it upon ourselves to do what other parents can't or won't.
I'm no hero. Or if I am, I'm a reluctant one. Every time Halloween comes around, I tell myself I'm going to sit this one out. But in the end, I always suit up. I like having a job to do. Over time, I've compiled a list of simple rules to help me do that job. Maybe they can be of use to you.
1. DON'T pick something you have to explain
I threw this together at the last minute with an old dress shirt and and my son's debate trophy. The key is confidence. Walk around with an indifferent swagger, NOT as if you're pleading with people to guess who you are. They know who you are — and if they don't, that's their problem. The startled laughs and nods of appreciation that trailed in my wake as I moved through the crowd told me all I needed to know. Remember: A good Halloween costume is all punchline, no setup.
Here's an example of a costume that didn't work because I violated this rule:
New York City, 2008 (that's my friend Robin as "Sarah Palin" next to me), and I'm dressed as ... what? An Islamic terrorist? Well, yes, but he's also an Obama supporter, as explained by the cover of "Rolling Jihad" taped to my chest. Instead of going with something timeless and elegant like "Jäger bomber" I've turned myself into a walking political cartoon (the ones that nobody gets). Do this, and you'll have people puzzling over your little commentary (or threatening to beat the s**t out of you on the F train) all night.
2. DO team up with your kids while you still can
That kid in the striped shirt? He's 12 now. This year, he's going as a disgusting zombie and hanging out with his boys. But once upon a time, we were best friends, just like the duo we portray in this picture. Enjoy it while it lasts: At a certain point, childhood ends, and Hobbes has to step aside.
Here's an even older one with my daughter. She's applying to college this year as I quietly sob into my laptop.
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3. DON'T prioritize 'originality' over recognizability
You may pride yourself on your refined taste in music, art, and movies, but Halloween is not a time to show it off. Nothing kills a costume concept like the desire to be "original." I thought I had a brilliant idea for my wife a few years back: Stevie Nicks. Not too mainstream or obvious but oh so clever and niche. And who doesn't love Stevie Nicks? A better question to ask would have been who recognizes Steve Nicks? Nobody who saw the above ensemble (right) did, that's for sure. I thought this look would hit like the opening arpeggiated synth bass line of "Stand Back," but my ego wrote a check my eye for scarf-and-hat coordination couldn't cash.
Unlike Stevie's Prince-inspired 1983 banger, "Bohemian Rhapsody" is not a song I ever need to listen to again. But like I said, when it comes to costumes, it helps to go for the big hits.
Do I like Queen? They're OK. I'd rather listen to Steely Dan, but Donald Fagen isn't going to make for much of a costume, now is he? So Freddie Mercury it is. He's like Donald Trump: You may not like him, but there's no mistaking his signature style.
Not a huge "grunge" fan, but the same thinking guided my choice to be Nirvana frontman Kurt Cobain. In this case, it helped that I, too, have fair skin and hair. Also this particular image is well-known enough that you can type in "Kurt Cobain sunglasses," for example, and the internet knows exactly what you're talking about.
Admittedly, Sid Vicious and Nancy Spungen is a bit of a "deep cut," but anyone who didn't get it just assumed we were generic punks — itself a valid costume. Although sharp-eyed readers will notice that I nailed the details.
4. DO get way too into it
Let's zoom out on that Stevie Nicks photo:
That "authentic Gene Simmons KISS demon" costume cost me something like $300; it had reviews from professional KISS cover band guys raving about how it gets "every last grommet" correct.
I also spent an hour and a half figuring out how to do my own face paint, hunched over the bathroom sink while watching Simmons himself demonstrate on his daughter.
Overkill? You bet. But sometimes you have to take one for the team. Plus now I have an heirloom-quality codpiece to pass down to my children and grandchildren.
Investing in a basic theatrical makeup kit can ensure that your costume is at least as frightening as the obsessive amounts of time and energy that clearly went into it:
5. DON'T overshadow your wife
When the Gene Simmons idea got ahold of me, I was planning to do something to go along with my wife's Stevie Nicks. Tom Petty? I can't remember, but the result would no doubt have been uninspiring. I'm glad I made the choice I did, but I do regret leaving her in the lurch. While there's no rule that says couples have to coordinate costumes, I did have a responsibility to make sure she was properly sorted before getting myself ready. It's like in those airline safety videos when the oxygen masks drop.
My showboating tendency is still kind of an issue in this Boy George/Cyndi Lauper combo, but I like to think I did right by her — and the "Girls Just Wanna Have Fun" songstress.
And the year we showed up as these two, I think she got the better part of the deal (that mask was hot):
Some people say my wife's clenched fist and rigid posture is a sign of distress; I just a see a woman grateful to submit to her husband's God-given role as Halloween creative director:
When you marry a marine biologist's daughter:
One year, I had an idea of being a head louse. Didn't quite come off (see rule 1 above) ...
... but I did get this photo of my wife as a school nurse that I will treasure until my dying day:
6. DO strut your stuff
As the father of two daughters, I'll be the first to say that Halloween costumes have gotten way too revealing. But that doesn't mean all nudity is gratuitous; sometimes the "role" calls for a little sex appeal.
You're not going to have this lithe, youthful body forever — if you've got it, flaunt it! That said, keep in mind that you will be around children and old people. When my wife wanted to leave the house in this "sexy squirrel" getup, I had to put my foot down. Some looks need to stay in the strip club.
Happy Halloween to you and yours.
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