These unaccompanied minors, who came to the United States without their parents, had already passed through government custody upon arrival and were placed with family or friends who federal officials deemed fit to care for them. 

All four ended up in detention again — a 16-year-old girl was followed home from the laundromat, a 14-year-old boy was a passenger in a traffic stop, according to the complaint — and held for months, missing their families and school despite having vetted caretakers at home. 

Some of these teens may be forced to enter the foster care system because their guardians, many of whom are their parents, cannot meet stricter new identification and other government requirements, according to Democracy Forward and The National Center for Youth Law, the two groups that filed the class action Monday in Washington, D.C.

“The government already vetted these sponsors, approved these reunifications, and sent these children home,” Skye Perryman, president and CEO of Democracy Forward, said in a statement. “Now, without any justification, it is ripping children from their homes and families, subjecting them to detention, and forcing families through an endless bureaucratic process.” 

The advocates note Congress requires unaccompanied children to be placed in the “least restrictive setting,” but that the Trump administration’s increased immigration enforcement has resulted in hundreds being detained and separated from their families as their asylum requests are considered. 

They say the administration is forcing previously approved sponsors to reapply “through a new, confusing, months-long process that many cannot complete due to their immigration status.” It’s as if these sponsors had never been approved in the past, the lawsuit alleges, adding there is no process through which the federal government’s policies can be challenged.  

The lawsuit seeks the teens’ release from detention, prompt reunification with their previously approved sponsors and due process moving forward.

“Children are missing school, milestones, and time with loved ones because of a blanket policy that ignores their rights and their humanity,” Perryman added. “Once again, we are in court to stop this unlawful practice and ensure that children are not treated as collateral damage in the president’s power grab.”

The Administration for Children and Families, which oversees the Office of Refugee Resettlement and is under the Department of Health and Human Services, said in a statement Wednesday it does not comment on ongoing litigation. The Department of Homeland Security did not answer questions about its detention policies. 

There were at the end of January according to government records. The agency operates a network of and programs across 24 states. While the number of children and the facilities that house them have decreased in recent years, the average length of stay for young people from 38 days in fiscal year 2015 to 117 days a decade later.

The office became more stringent in its sponsorship requirements last winter when it began refusing foreign passports as acceptable forms of identification. It also expanded fingerprinting, DNA testing and home study requirements — and changed the means through which families must prove financial stability and their address.

It now demands in-person appointments to verify identification, often with federal immigration agents present, and eliminated protections against sharing applicants’ citizenship status with DHS, increasing sponsors’ risk of detainment.

The Office of Refugee Resettlement has said its regulations are designed to protect children “from smugglers, traffickers, or others who might seek to victimize or otherwise engage the child in criminal, harmful or exploitative activity.”

The lawsuit notes children in government care can’t participate in outside extracurricular activities and are not permitted to leave the facilities where they are housed except for occasional outings accompanied by staff.

“With the exception of children placed in long-term foster care, children in ORR custody do not attend public school and instead attend class within the facility,” the lawsuit states. “These education programs are designed for short-term stays and generally do not provide academic credit.” 

The lawsuit said, too, that “sudden and unexpected inability to attend school, see their friends, and regularly see and speak to their family compounds the trauma of detention.”

Immigrant advocates filed Tuesday to stop U.S. Customs and Border Protection agents from urging newly arrived unaccompanied minors to self deport.

Adam Strom, co-founder and executive director of Re-Imagining Migration, said the impact of the government’s actions are profound. 

“The research is clear that separating children from their families, friends, and supportive school communities does real and lasting harm,” he said. “Instead of removing young people from those who care for them, we should be working to ensure all young people get the support they need to thrive — in their schools, in their families, and in their communities.”

The four students in the lawsuit are identified by their first name and last initial. Diego N., 14, was living with his father, stepmother, and siblings in South Texas until he was detained in November by Border Patrol as a passenger in a traffic stop. His father’s application as a sponsor “has been continually delayed by a seemingly never ending list of requirements.”

The boy’s education has suffered.

“Diego also does not feel that he is learning anything while he is in ORR custody because the lessons are too easy and basic,” the lawsuit said. “He is being taught how to name fruits in English when he should be a freshman at his public high school.”

Renesme R., 16, was living with her father for two years in Tennessee and “was thriving in school, playing volleyball, and participating in Junior ROTC in the hopes of serving in the U.S. military after graduation.” 

Forced back into the Office of Refugee Resettlement’s care after being detained on her way home from the laundromat, she has spent months in custody. 

“Renesme feels imprisoned at the shelter where she’s been held for three months in Texas, far from her home in Tennessee,” the lawsuit states. “She is particularly concerned that she’s not receiving academic credit for school and that she will need to repeat 11th grade and will not be able to finish her three-year Junior ROTC certificate.”

Mario C., 17, had been living happily with his mother in Texas since 2023 when he was a passenger in a car pulled over by police last year. He spent three nights in jail and, before his mother could bail him out, was detained by ICE and sent to an Office of Refugee Resettlement shelter in New York.  

“Mario longs to taste his mom’s cooking again and see his baby brother grow up,” the advocacy groups say. “Now back in ORR custody, he is considering foster care placement because his mother does not have the type of U.S.-issued identification newly required by ORR as part of the sponsorship application.”

The boy worries his mother will be detained herself if she pursues the matter.

Benito S., 17, was living with his aunt in Louisiana for more than two years and enjoyed cooking, playing basketball, and spending time with his cousins. He was detained shortly before Christmas. 

His aunt can’t reapply to sponsor him because she also can’t meet the new ID requirements. As a result, Benito is seeking foster care placement and is likely to remain in government custody until he turns 18.

“Benito says that being in ORR custody again is awful,” the lawsuit states. “He is bored and it is difficult for him to focus on anything other than how much he misses his family. He is allowed to listen to some music, like country music, but he is not allowed to listen to the music he loves, like . He is sad and lonely and wants to go home.”

The decision came just a day after another U.S. district court judge in Rhode Island granted a that offered similar protections to preschoolers That ruling also means undocumented residents can still access adult and career and technical education and won’t be cut off from a range of federally funded emergency services, including for domestic violence and homelessness.

Linda Morris, an ACLU attorney representing the plaintiffs in the Washington state case, said she was elated by the decision, noting its sweeping scope. 

“This is an incredible victory, especially for Head Start providers and Head Start children and families,” she said. “Today’s ruling makes clear that every child, no matter their immigration status, deserves access to early educational support. We are extremely pleased with the court’s decision.” 

In issuing the national injunction, U.S. District Court Judge Ricardo Martinez strongly rebuked the Health and Human Services Department, which oversees Head Start and funds 80% of its costs, for changing a longstanding legal interpretation and classifying it for the first time as a federal public benefit. 

Undocumented immigrants are not eligible for these supports, including food assistance and non-emergency Medicaid. The move to restrict Head Start access is part of a wider Trump administration effort to exclude the undocumented from all taxpayer-funded services and programs, including several that involve education and job training.

The ruling restores Head Start eligibility to children and families who have student visas and other temporary statuses and were also excluded by HHS’s . The move affected the eligibility of more than 500,000 kids, according to the agency’s own analysis, and impacted approximately 115,000 children currently enrolled in the program.

Andrew Nixon, the HHS communications director, said Friday his office disagrees with the injunctions and is evaluating next steps. 

Head Start associations from four states and two parent and caregiver groups sued the agency and Secretary Robert F. Kennedy Jr. in the Washington case. 

Joel Ryan is executive director of one of , the.

“I feel relief. I feel like people can breathe a little bit more,” said Ryan, whose organization’s other legal claims against the administration are focused on confusion over its anti-diversity, equity and inclusion mandates and the mass firings of Head Start staff.

Martinez rejected the Trump administration’s assertion that Head Start is a welfare program because it provides other means of support, including meals. Public schools do the same and no one would argue they are not educational in nature, he wrote. 

“Providing services such as health care, nutrition and other social services does not make Head Start non-educational but, as the Head Start Act states, ‘promotes the school readiness of low-income children by enhancing their cognitive, social and emotional development,’” he wrote, noting, too, that Head Start funds do not provide payments of benefits to individual households or families. 

In court Tuesday, U.S. Department of Justice attorney Micheal Velchik tried to parse the degree of learning and instruction that takes place in Head Start from what’s taught at the K-12 level. 

“It’s technically not school or education because it’s preschool. It’s what you do before school and so it’s not really education in that sense,” said Velchik, who mistakenly referred to the program as Head First several times.

Jannesa Calvo-Friedman, the plaintiffs’ attorney, said undocumented parents, families of mixed immigration status and others with full legal standing but who lack documentation told Head Start operators they were keeping their kids away out of fear or confusion.

“The children who are losing education at this time [in their lives] can never get it back,” Calvo-Friedman said, citing studies on the critical nature of early learning. “Unless the directive is stayed or enjoined, defendants will continue to communicate the message that immigrant families need not apply.”

Martinez agreed that allowing the directive to go into effect while the underlying case was being argued would impose imminent and irreparable harm.

“While actual loss of funding from under enrollment might be down the road, families losing access to Head Start due to the Directive’s unclear guidance and chilling effects appears anything but speculative and exists even prior to enforcement,” he notes.  

The judge expressed disbelief at the government’s contention that implementing the restriction immediately would discourage illegal immigration.

“The Court is floored by this argument,” he wrote. “Nothing on the record provides any means for this Court to infer that access to Head Start ‘incentivizes’ illegal immigration.”

Head Start was established in 1965 to help improve kindergarten readiness for low-income children and to support their families. It has served young learners  and their families in the 60 years since. 

The Health and Human Services Department illegally withheld payments from Head Start for the first months of President Donald Trump’s term, a government watchdog reported Wednesday.

HHS payments for Head Start this year were significantly behind schedule compared with 2024. That violated the Impoundment Control Act, a law governing the president’s duty to spend congressionally appropriated funds, according to a report from the nonpartisan Government Accountability Office.

Get stories like this delivered straight to your inbox. Sign up for ����Ӱ�� Newsletter

The law, sometimes called the ICA, allows the president to withhold appropriated funds in some circumstances. But the publicly available data did not show those conditions were met and HHS did not mount any defense prior to the report’s publication, according to the GAO.

“Because that evidence indicates that HHS withheld appropriated funds from expenditure, and because the burden to justify such withholdings rests with HHS and the executive branch, we conclude that HHS violated the ICA by withholding funds,” the report said.

Before the report’s publication, HHS did not provide the GAO with information requested by the watchdog or a legal analysis, according to the report, which was signed by GAO General Counsel Edda Emmanuelli Perez.

However, an HHS spokesperson told States Newsroom in a Wednesday email that it would respond to the GAO and disputed the report’s conclusion.

“HHS did not impound Head Start funds and disputes the conclusion of the GAO report,” the spokesperson wrote. “GAO should anticipate a forthcoming response from HHS to incorporate into an updated report.”

How Head Start works

Head Start is a federal grant program to fund pre-kindergarten services for low-income families. The federal government provides up to 80% of a local program’s eligible costs, the report said. As of last year, 1,600 organizations received Head Start funding for education, nutritional, health and social services.

Organizations receiving Head Start funding generally win grant approvals for five years at a time. Programs in good standing are automatically renewed, according to the report.

Mere days after Trump took office in January, dozens of Head Start grant recipients found they were unable to access funds they’d expected from HHS, according to a Jan. 28 statement from the National Head Start Association, a coalition of grantees.

GAO’s analysis showed the department disbursed about one-third less grant funding in the first three months of the Trump administration than it had over the same period in 2024. The difference amounted to $825 million less for Head Start grants over those months.

The law does allow for HHS to stop funding for grantees before the end of the five-year period under certain circumstances, such as for failing to meet performance standards or becoming under-enrolled.

In those cases, though, HHS must warn the programs of potential cuts in grants, provide a detailed plan the organization can implement to avoid grant cancellation and give the grantee a fair hearing as well as the ability to apply for refunding — all before funding can be cut off, according to the GAO report.

There is no indication HHS took any of those steps before abruptly cutting funds in January, according to the report.

‘The president is not a king’

Sen. Patty Murray, the top Democrat on the U.S. Senate Appropriations Committee, blasted President Donald Trump and his HHS in a lengthy statement that asserted Congress’ power over spending decisions and admonished the administration for harming an important program for working families.

“Trump has signaled he would like to eliminate Head Start—but that’s not his choice to make,” Murray said. “Congress delivered this funding for Head Start on a bipartisan basis, and instead of trying to destroy preschool programs and breaking our laws to hurt working families, President Trump needs to ensure every penny of these funds get out in a timely, consistent way moving forward—and he must also finally get out the rest of the investments he has been robbing the American people of.”

Oregon Democrat Jeff Merkley, the ranking member of the Senate Budget Committee, highlighted Congress’ role in directing federal funding, calling on Trump and White House Budget Director Russell Vought to comply with appropriations laws.

“The President is not a king, and laws are not suggestions,” Merkley said in a statement. “Once again, we’re seeing proof that this administration is in clear violation of the law under the Impoundment Control Act. The funds appropriated by Congress are not merely suggestions for Donald Trump and Russ Vought to ignore – these are funds that hardworking families rely on, and Head Start is essential to making sure the doors of opportunity are open to every child in our country.”

ACLU lawsuit

The GAO report did not list any further action the agency would take but did note that litigation over the withheld funding is ongoing.

The American Civil Liberties Union filed a suit in April in federal court in Seattle that included parents and Head Start grant recipients.

The suit described widespread confusion that Head Start organizations experienced when they could not access expected federal funding, compounded by cuts to support staff in regional offices.

No cooperation

The report detailed the lack of participation by HHS in the GAO’s investigation and tied it to a separate legal fight involving a public website.

“HHS has not provided the information we requested regarding factual information and its legal views concerning the potential impoundment of appropriated funds,” the report said.

Without information from the administration, the watchdog based its findings on publicly available data.

The White House Office of Management and Budget added an obstacle to that task, the watchdog said.

The office “removed agency apportionment data from its public websites, which is both contrary to OMB’s duty to make such information publicly available and to GAO’s statutory authority to access such information,” the GAO report said.

On that question, a federal judge on Monday ordered the Trump administration to once again publish details about the pace at which it plans to spend money approved by Congress.

U.S. District Court for the District of Columbia Judge Emmet Sullivan wrote in his ruling that Congress “has sweeping authority” to require the president to post a website detailing how it doles out taxpayer dollars throughout the year.

A trained doctor, he spent 26 years working in pediatric infectious disease and studying the rotaviruses before ultimately creating the strain that became the RotaTeq vaccine. That breakthrough saves 165,000 lives globally each year, he said, and has essentially eliminated the 70,000 annual U.S. hospitalizations caused by the contagious diarrhoeal virus common in young kids.

Now the director of the and an attending physician in the Division of Infectious Diseases at Children’s Hospital of Philadelphia, Offit also serves as a member of the Food and Drug Administration’s . And about 20 years ago, he spent half a decade on the committee responsible for making recommendations on the safety, efficacy and clinical need for vaccines to the Centers for Disease Control and Prevention.

That committee, also known as the , or ACIP, experienced an unprecedented upheaval earlier this month when Robert F. Kennedy Jr. fired all 17 advisory members via a Wall Street Journal — after promising he would leave the committee’s recommendations intact.

“The committee has been plagued with persistent conflicts of interest and has become little more than a rubber stamp for any vaccine,” wrote Kennedy, the head of the U.S. Department of Health & Human Services and a longtime vaccine skeptic.

In a statement released by HHS, Kennedy said he was “prioritizing the restoration of public trust above any specific pro- or anti-vaccine agenda,” and later promised via that none of the replacement members would be “ideological anti-vaxxers.” Public health experts are now disputing that claim in light of his eight recent appointments.

“This is a slate that lacks a balanced viewpoint,” said Richard Hughes, a George Washington University law professor and leading vaccine law expert. “And it’s deeply concerning that many of them are outright anti-vaccine and have their own very concerning conflicts of interest, despite the fact that the secretary claims that he’s trying to avoid conflicts of interest on the committee.”

This could be particularly dangerous for children, some warn, as the committee’s recommendations often dictate which vaccines are covered by insurance and which are mandated for school-aged kids. Programs that provide free vaccines for kids could also see their funding cut.

����Ӱ��’s Amanda Geduld recently spoke with Offit to better understand the implications of the mass firing, what kids and their families can expect moving forward and how future administrations might work to rebuild trust in the public health vaccine system. 

This interview has been edited for length and clarity. 

����Ӱ��: Are you in touch with any of the folks who were fired from ACIP? If so, how did they receive that news and what was the mood among the members?

Offit: Well, they found out about it, typically, from reading the newspaper and learning that they had been fired from that position. The mood was one of sadness, because obviously there was no good reason to do it. 

The reason given by Robert F Kennedy Jr. was that all the members were horribly conflicted with pharmaceutical companies [and] that their financial ties to pharmaceutical companies made it such that they couldn’t give advice that would be beneficial to the American public, and that wasn’t true.

I mean, they have very strict conflict of interest rules at the ACIP whereby you have to make it very clear that you have no association with the pharmaceutical industry and no association with the government, which then allows you to be an independent advisor. And should there be a conflict … then you can’t vote on that company’s product, and you can’t vote on any product that that company makes. That’s very clear. That’s been clear ever since I was on the committee back 25 years ago.

So it sounds like there was confusion, disappointment and a feeling that the reasons given for the firing weren’t based in reality? 

They were angry. They were angry that they felt that they’d been dismissed for no good reason and that their willingness to serve the American public had been set aside. I mean, it’s not like you’re paid to do this. It’s just a voluntary position for the most part.

In your knowledge, has anything like this ever happened before?

No, but we’ve never had a secretary of Health and Human Services that was an anti-vaccine activist, science denialist and conspiracy theorist before.

Zooming out a little bit, what’s the significance of these firings? And what impacts can we anticipate?

I think we can anticipate that Robert F. Kennedy Jr. will put people on that committee who are like minded to him. We’re already seeing evidence of that with the first eight people that he picked. 

So I think what’s going to happen is that there are going to be groups that look elsewhere from the ACIP to try and get information that they think is reliable and up to date and informative. 

What I imagine is that, for example, the American Academy of Pediatrics has its so-called Red Book committee, or . I would imagine that that committee will start to speak with insurance companies to make sure that their recommendations would then have kind of the force of law … Because I can’t imagine the insurance companies are going to be looking to ACIP, given its current members.

My understanding is, up until this point, insurance companies and states — when they’re trying to determine school vaccination policies — have looked to ACIP for guidance. You’re saying that maybe insurance companies will look elsewhere for that information, but is there any concern that this will just mean vaccines are no longer covered by insurance, or that school-age vaccine policies are undermined altogether?

Yes, there’s concern, but it is to the financial advantage of insurance companies to pay for vaccines. I mean, you’d much rather pay for an HPV vaccine than to pay for the care of a woman who has cervical cancer. You’d much rather pay for a measles-containing vaccine than to pay for measles hospitalization.

So there isn’t necessarily concern here that suddenly these vaccines won’t be accessible to families from lower-income backgrounds?

I don’t know. I mean, I think it’s a frantic, chaotic time, and it’s really hard to know. Everything that you sort of counted on to make sense doesn’t make sense anymore. 

It used to be that solid, good science was how we made decisions, and that’s not true anymore with the ACIP. You can tell when Robert F Kennedy Jr. says we want gold standard science, that’s not what he means. What he really means is he wants quote, unquote scientific studies that support his fixed, immutable belief that vaccines cause more harm than good.

In a post on recently Kennedy wrote, “The most outrageous example of ACIP’s malevolent malpractice has been its stubborn unwillingness to demand adequate safety trials before recommending new vaccines for our children.” Has there been an unwillingness to demand adequate safety trials for new vaccines for children in America?

The opposite is true. I had the fortune of working with a team that created the rotavirus vaccine. Before that vaccine was put on the infant immunization schedule, it was tested in a prospective, placebo-controlled trial of more than 70,000 infants. It was done over four years in 11 countries to prove that that vaccine was safe and effective. That was a 70,000- person prospective, placebo-controlled trial that probably cost $350 million. 

I don’t know what he’s talking about. Name the vaccine. Name a new vaccine that hasn’t been tested in a large, prospective, placebo-controlled trial. They all are. 

The problem is that when they’re shown to work and they’re safe, he doesn’t believe it, because he’s a science denialist. That’s what he really means.

Are there any other ways this could impact school-aged kids in particular?

Now what worries me is, I think if RFK Jr. really wants to bring down vaccines, he can do it through the What he could do is he could hold up a paper and say, “Look, aluminum adjuvants cause autism or multiple sclerosis or diabetes or asthma, and now I’m going to add that to the list of compensable injuries.”

So anybody with asthma who’s gotten a vaccine that contains an — and there are seven different vaccines that contain aluminum adjuvants [an ingredient that helps create a stronger immune response] — is now on the list of compensable injuries. 

Or [he could say] “I’m going to take these vaccines out of the Vaccine Injury Compensation Program and then just subject them to civil litigation.” That would really disrupt vaccines in this country. I think companies would then do what they did in the 1980s … They’d leave the market. We had 18 companies that made vaccines in 1980. By the end of the decade, we only had four. 

So does that mean that while this ACIP move might introduce anger and distrust there are no real trickle-down effects that you think we’ll see yet in terms of what vaccines are available or what vaccines are covered?

I think you’ll know a lot when you watch the June [advisory committee] meeting, to hear that discussion, and to hear how pharmaceutical companies react to that discussion and how insurers react to that discussion. I think you’ll learn a lot in the next couple of weeks.

Can you tell me a little bit about the folks who replaced the 17 members? Eight people have been announced so far.

They’re who you would most fear. 

You have people like Robert Malone, in front of Marjorie Taylor Green’s committees … that the mRNA vaccines cause cancer and heart disease and autoimmune disease. Robert Malone has been an expert witness on behalf of Robert F. Kennedy Jr. in a lawsuit against the mumps component of the MMR vaccine. 

You have somebody like Martin Kulldorff who has represented — for — Robert F. Kennedy Jr. in a lawsuit against Merck’s Gardasil [HPV] vaccine. 

You have people who have published papers claiming that the mRNA vaccines caused heart attacks and sudden death in healthy, young people. You have Vicky Pebsworth, who is a member of the , which is an anti-vaccine group that has lobbied against state vaccine mandates for years. 

This is exactly the cavalcade of stars that you would expect RFK Jr. to feel comfortable with: people who are — like him — anti-vaccine activists, who are science denialists. 

It’s the worst of all worlds. It’s like a bad Saturday Night Live skit.

During Kennedy’s HHS confirmation hearings back in January, Republican Sen. Bill Cassidy — a former physician — expressed a lot of trepidation around the nomination, but ultimately voted to confirm, citing various commitments he had received from the administration. One of those promises, Cassidy was that “if confirmed [Kennedy] will maintain the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices recommendations without changes.”’

Critics have since argued that Kennedy’s move to fire all members amounts to a broken promise, a claim Cassidy himself has since disputed. Is this a broken promise?

He’s been breaking promises right from the beginning. I think Cassidy put out a list of 10 or so things [Kennedy] promised he wouldn’t do. And he proceeded to do it.

I’m reading: He has committed that he would work within current vaccine approval on safety monitoring systems. That he hasn’t done. 

He’ll maintain the CDC Advisory Committee Immunization Practices recommendation without changes, and he hasn’t done that either. 

He’s already, for example, changed the recommendation on pregnancy, changed the routine recommendation for young children to get COVID vaccines. And now Cassidy also put out saying that for those of you who think [Kennedy] may just put vaccine skeptics on [the committee], he’s not gonna do that. Then he proceeds to do that. 

What Cassidy does is he draws a line. He says, “Don’t cross this line.” Then Kennedy crosses the line, and he doesn’t do anything — just draws another line. I think he is weak and ineffectual. And I think his legacy will be the harm that’s caused to children and adults in this country because of this massive disruption of the public health vaccine system. I think that will be Sen. Cassidy’s legacy.

Have you spoken to Sen. Cassidy? If you could speak to him today, what would you say to him?

I spoke to him four times before that second confirmation hearing, and once afterwards. I said to him exactly what you would think I would say to him, which is, “Don’t hire this guy. She knows. She told you exactly who he is.”

It’s really frustrating. I was sure [Cassidy] was a “no” vote. He clearly had problems with him. But in the end, politics trump science. I think when you mix politics and science, you always get politics.

My last question is around this idea of trust. Kennedy has said that he removed all these members and is replacing them in response to a “crisis of public trust.” On the other side, there are folks who do not at all trust Kennedy. Looking forward, what will it take to rebuild trust in these systems?

I think there was a tremendous loss of trust in the first two years of the pandemic … I think people saw [many COVID-era policies as] a real impingement on their freedom, and that’s what you’re seeing now. 

I think that RFK Jr. represents the disdain that people ended up having for the CDC and for Dr. Fauci, unfortunately. I think that’s what happened …To the point that there were states that were trying to ban mRNA vaccines. The term “mRNA vaccines” has become a dirty word, even though it probably saved 3 million lives and probably cost more than 250,000 people their lives when they chose not to get the vaccine. But somehow that all got linked with sort of stepping on our medical freedom, and that’s what you’re seeing now. 

So what’s it going to take to get that back? I think slowly, we’re just going to have to make sure that we — as scientists and clinicians and academicians and public health people — explain in careful detail why we do everything.

But public health is also about the public. I mean, you have to care about your neighbor in order to have public health. I think right now, we’re sort of at a point where people go, “Don’t tell me what to do. If I want to catch and transmit a potentially fatal infection, that’s my right.” And I don’t think we used to be like that.

Is there anything else I haven’t asked you that you want readers to understand, specifically through an education- and child-centered lens?

What’s that line from Bette Davis in All About Eve? “Buckle up. It’s going to be a bumpy night” — although everybody says bumpy ride.  …

I think it is going to be a bumpy ride for a while, and then we’ll just see. I believe that the forces of good will prevail. I do. 

I think that there’s a basic feeling among virtually everyone that vaccines are a good thing, and that as people see them erode or maybe become less available or less affordable or more feared that people will rally on behalf of children. I do.

was originally reported by Orion Rummler of . .

On Thursday, the Department of Health and Human Services (HHS) published a of research on gender-affirming care for transgender youth, as directed by President Donald Trump. The agency used the release of the report to that available science does not support providing gender-affirming care to trans youth. LGBTQ+ advocacy groups worry the report will be used to further restrict gender-affirming care and to change medical guidelines in ways that harm trans youth.

The president mandated the report in an condemning the medical treatment — without evidence — as a form of mutilation, amid a broader push by the administration to from public life. Trump’s order asked the health agency to review the “best practices for promoting the health of children who assert gender dysphoria,” while to halt treatment or lose federal funding.

Now, the HHS has produced that report. The agency combed through research on the outcomes of puberty blockers, hormone replacement therapy, social transition, psychotherapy, and the rare cases of surgeries on adolescents and young adults diagnosed with gender dysphoria. 

Gender dysphoria, the reason that most trans people undergo , is a strong and persistent distress felt when one’s body is out of sync with their gender identity. Without treatment, gender dysphoria can lead to severe negative impacts in day-to-day life. 

The agency states in its of the report that the document is not meant to provide clinical practice guidelines or issue legislative or policy recommendations. However, the report does imply that health care providers should refuse to offer gender-affirming care to adolescents and young adults on the basis that such care comes with the potential for risk — despite little evidence for that risk actually being found in the report. 

“The evidence for benefit of pediatric medical transition is very uncertain, while the evidence for harm is less uncertain,” the executive summary states. “When medical interventions pose unnecessary, disproportionate risks of harm, healthcare providers should refuse to offer them even when they are preferred, requested, or demanded by patients.”

In its research review, the HHS determined that evidence measuring the effects of gender-affirming care on psychological outcomes, quality of life, regret and long-term health is of “very low” quality. This conclusion ignores decades of research, as well as a recent survey of in the United States that found an overwhelming majority report more life satisfaction after having transitioned. Access to gender-affirming care has been linked to and depression in trans youth, while gender-affirming surgeries have been found to for adults.

Even when analyzing research that the administration deemed low-bias, the HHS found “sparse” to no evidence of harm from gender-affirming care. What’s more, the report frequently found evidence demonstrating the benefits of gender-affirming care — though it ultimately downplays those findings as not significant. 

Available research on puberty blockers found high satisfaction ratings and low rates of regret. A systematic review of hormone replacement therapy described improved gender dysphoria and body satisfaction. Another found that hormone treatment leads to improved mental health. Two before-and-after studies reported reduced treatment needs or lower levels of suicidality and self-harm after hormone treatment. When measuring safety outcomes of hormone treatment, side effects did not have a major impact on treatment and complications were limited. 

Despite these findings, the Department of Health and Human Services advertised the report in a Thursday as one that “highlights a growing body of evidence pointing to significant risks” of gender-affirming care. At the White House briefing room Thursday, deputy chief of staff for policy Stephen Miller touted the new report and attributed the idea of being transgender as part of a “cancerous communist woke culture” that is “destroying this country.” 

There are side effects to many of the medications that transgender people — and cisgender people — take to receive gender-affirming care, as is the case with most medical treatments. These side effects, like the risk of decreased bone density when taking puberty blockers, are and communicated to patients.

LGBTQ+ advocacy organizations denounced the report as a political attack on transgender youth. Multiple groups said that the report’s endorsement of psychotherapy as a “noninvasive alternative” to puberty blockers and hormone treatment amounts to an endorsement of conversion therapy — a practice wherein mental health professionals try to change a youth’s sexual orientation or gender identity.

“It is already clear that this report is a willful distortion of the evidence intended to stoke fear about a field of safe and effective medicine that has existed for decades, in order to justify dangerous practices which amount to conversion therapy,” said Sinead Murano Kinney, health policy analyst at Advocates for Trans Equality. 

The Human Rights Campaign, the country’s largest LGBTQ+ rights organization, accused the HHS of producing a report that is attempting to lay the groundwork to replace medical care for trans and nonbinary people with conversion therapy. 

“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,” said Jay Brown, chief of staff at the Human Rights Campaign. “This report … lays the groundwork to push parents and doctors aside and allow politicians to subject our kids to the debunked practice of conversion therapy.” 

No authors or contributors are named in the report or in its executive summary. The agency says these names are being initially withheld to “maintain the integrity of this process,” and states that chapters of the document were subject to peer review.

Diana Diaz-Harrison, whose son is autistic, said that in she hopes to continue her efforts to help others launch autism charter schools throughout the country. Her schools, she said in remarks captured on , are a testament to what happens “when parents like me are empowered to create solutions.”

“My vision is to expand school choice for special needs families — whether through charter schools, private options, voucher programs, or other parent-empowered models,” she said in a statement to ����Ӱ��. .

The five-school network uses a controversial intervention that attempts to train children to appear and behave like their neurotypical peers. Created by the researcher behind LGBTQ conversion therapy, applied behavior analysis, or ABA, is widely depicted as the gold standard despite scant independent evidence of its effectiveness and mounting research documenting its harms. 

Diaz-Harrison opened the network’s first school in 2014 as a free, public alternative to private schools for autistic children, which are popular in Arizona but typically charge tens of thousands of dollars a year in tuition. Her Arizona charter schools are a 501(c)3 nonprofit financed by state and federal per-pupil funds. ABA is specifically endorsed by Arizona education officials as a strategy to use with autistic students.

In the time since those charters opened, ABA has grown to be a national, multi-billion-dollar industry, with for-profit companies tapping public and private insurance to pay for as much as 40 hours a week of one-on-one therapy. The intervention uses repeated, rapid-fire commands that bring rewards and punishments to change a child’s behavior and communication style.

A 74 investigation last year showed that most data supporting ABA’s effectiveness is drawn from research conducted by industry practitioners. Independent analyses, including a years-long U.S. Department of Defense review, found little evidence the intervention works. Former patients who underwent the therapy as children reported severe, lasting mental health effects, including PTSD.

Diaz-Harrison told ����Ӱ�� the therapy is both valuable and sought-after. “For the autism community, specifically, many families seek schools that integrate positive behavioral strategies,” she says. “The evidence supporting behavioral therapy is extensive and well-established. It has been endorsed by the U.S. surgeon general and the American Academy of Pediatrics as an effective, research-backed approach for individuals with autism.”

During her visit, McMahon told students and staff she was eager to tell President Donald Trump about the schools. “He doesn’t believe any child, whether they have neuro-difficulties or any other problems, should be trapped in a school and not have the facilities that they need,” she said. 

Since Trump’s second inauguration, he has issued numerous orders that have alarmed disability advocates and the autistic community. Though both edicts contradict longstanding federal laws, in March he ordered the closure of the Education Department and said responsibility for special education will be transferred to the U.S. Department of Health and Human Services.

About half of the Education Department’s staff has been fired, including most of the people responsible for investigating what had been a backlog of some 6,000 disability discrimination complaints. Though it’s unclear whether Trump and McMahon may legally disregard special education funding laws and allow states to spend federal dollars as they see fit, both have said they favor giving local officials as much decision-making power as possible.

Meanwhile, HHS Secretary Robert F. Kennedy Jr. has stoked fear in the autistic community by announcing a new effort to tie autism to vaccines or other “environmental toxins” — a hypothesis discredited by dozens of studies. The man he appointed to head the study has been cited for practicing medicine without a license and prescribing dangerous drugs to autistic children. 

Last week, the new head of the National Institutes of Health announced that an unprecedented compilation of medical, pharmaceutical and insurance records would be used to create an autism “disease registry” — a kind of list historically used to sterilize, institutionalize and even “euthanize” autistic people. HHS later walked back the statement, saying the database under construction would have privacy guardrails.

Among other responsibilities, the offices Diaz-Harrison will head identify strategies for improving instruction for children with disabilities and ensure that as they grow up, they are able to be as independent as possible. The disability community has raised concerns that the administration is retreating from these goals.   

Advocates have said they fear the changes pave the way for a return to the practice of separating students with disabilities in dedicated special ed classrooms rather than having them attend class with typically developing peers. The Individuals with Disabilities in Education Act guarantees special education students the right to instruction in the “least restrictive environment” possible.          

Families’ preferences vary widely, with some parents of autistic children refusing any form of behavior therapy, while others want their kids in settings with children who share their needs. Many insist on grade-level instruction in general education classrooms 

Diaz-Harrison has a master’s degree in education and worked as a bilingual teacher in California early in her career. From the late 1990s until she began supporting her son full time, she worked as a public relations strategist and a reporter and anchor for the Spanish-language broadcast network Univision. 

In 2014, frustrated with her son’s school options, she who applied for permission to open what was then a single K-5 school serving 90 children. The network now has about 1,000 students in all grades and features an online program. 

At the end of the 2023-24 academic year, of the network’s students scored proficient or highly proficient on Arizona’s annual reading exam, while 4% passed the math assessments.      

In December 2022, the network won a $1 million , an award created by Jeff and Janine Yass. The billionaire investors have a long track record of donating to Republican political candidates and organizations that support school choice. 

One of the award’s creators, Jeanne Allen, is CEO of the Center for Education Reform. The center nominated Diaz-Harrison for the federal role. 

Yass award winners were featured at the 2023 meeting of the American Legislative Exchange Council, or ALEC, a conservative forum where state lawmakers are given model bills on education and other policies to introduce in their respective statehouses. 

Diaz-Harrison has partnered with a Florida autism school to create a national to help people start schools like hers throughout the country. She told ����Ӱ�� the effort has so far supported teams of hopeful school founders from Louisiana, Texas, Florida, Alabama and Nevada. 

Parents of young autistic children and autistic adults often disagree about ABA. Told by their pediatrician or the person who diagnosed their child as autistic that they have a narrow window in which to intervene, families fight to get the therapy. Adults who have experienced it, however, report lasting trauma and have lobbied for research — much of it now at risk of being defunded by Kennedy — into more effective and humane alternatives.

Last week, National Institutes of Health Director Dr. Jay Bhattacharya announced that his office would draw on an unprecedented array of public and private records to establish a “disease registry” centralizing information on autistic people’s prescription drug use, insurance claims, Medicare and Medicaid records, genetic and lab tests and even data from smartwatches. 

In response to the strong pushback that followed, the department attempted to walk back the announcement — and blame the media for the furor.

“The original narrative incorrectly suggested that HHS was creating an autism registry to track individuals using personal data,” the department said in a statement to ����Ӱ��. “This is not accurate. The NIH is developing a secure data repository that will allow researchers to analyze large-scale, de-identified data. The director did not misspeak; rather, the term ‘registry’ was misused by the media, implying an unethical method of data collection.”

However, using video of the NIH announcement, the fact-checking site Snopes that the original reporting was accurate. 

Bhattacharya’s initiative followed a promise by U.S. Secretary of Health and Human Services Robert F. Kennedy Jr. that by September, new research sponsored by his department would responsible for what he called an autism epidemic. That theory contradicts mainstream science that links autism to genes and the increasing number of diagnoses to better testing — particularly in low-income households and among children of color. 

Though many autistic children are able to prepare for college and a career when given the proper supports, “These are kids who will never pay taxes,” Kennedy said. “They’ll never hold a job. They’ll never play baseball. They’ll never . They’ll never go out on a date. Many of them will never use a toilet unassisted.”

To head the study, Kennedy appointed a man cited by Maryland officials for practicing medicine without a license. David Geier was also found to have improperly prescribed puberty blockers for autistic children and administered a harmful drug used to treat lead poisoning that is not approved for use in the U.S. 

Given Kennedy’s public proclamations, advocates said they would take a wait-and-see stance to the announcement that the new database would not contain a registry.  

“This is positive news, but given this administration’s previous actions and comments, particularly those related to autism over the last several weeks, we are not assuming that there is no longer anything to worry about,” leaders of the Autistic Self Advocacy Network said in a statement. “Given everything this administration is saying and doing about autism,  and public health, we have every reason to distrust this initiative under current leadership at HHS.”

The word “registry” is particularly polarizing to disability advocates, who note that such lists — which still exist in some U.S. states — were used to identify autistic children who were killed in Nazi Germany’s experimental “euthanasia clinics,” as well as people to be sterilized and institutionalized in the United States.  

“ ‘Registry’ and ‘data collection’ can mean many things,” the network said, adding that if advocates had been included in discussions about the proposed research, they could have asked for clarity: “Under previous administrations led by both Democrats and Republicans, we and other organizations had direct lines of communication with autism policy experts inside HHS.”

Several days before the NIH announcement was reported, four dozen organizations that advocate for autistic people issued a rare collective statement criticizing Kennedy’s repeated, disproven claims about a condition many scientists agree is a naturally occurring neurotype. 

“We are deeply concerned by growing public rhetoric and policy decisions,” said . “Claims that autism is ‘preventable’ [are] not supported by scientific consensus and perpetuate stigma. Language framing autism as a ‘chronic disease,’ a ‘childhood disease’ or ‘epidemic’ distorts public understanding and undermines respect for autistic people.”

Unknown is whether the NIH plan will indeed merge records that contain sensitive personal details with datasets that don’t include people’s identifying information. “HHS will … spend tens of millions of dollars linking existing federal databases,” the trade publication , attributing the information to a department statement. “The National Institutes of Health (NIH) working to partner with the Centers for Medicare & Medicaid Services, the Centers for Disease Control & Prevention, the Department of Defense, the Department of Veterans Affairs and other agencies to create ‘a comprehensive real-world health dataset that maintains the highest standards of security and patient privacy.’ ”

In its statement to ����Ӱ��, the department said the dataset being assembled “would be fully compliant with these laws and regulations to protect Americans’ sensitive health information.” 

“Data science can advance our understanding of biomedical and behavioral phenomena and contribute to breakthroughs that improve health by mining large sources of data, such as databases and datasets, for information,” said the statement. “Researchers can use techniques like machine learning and AI in data science to help analyze data and make predictions about health outcomes and disease incidence.”

As of press time, more than 150 researchers belonging to the recently formed Coalition of Autism Scientists had signed a letter calling on HHS and NIH to observe rigorous standards. Kennedy’s controversial dismissal of mainstream beliefs that better diagnosis is a major factor behind the rise in autism rates, and his plans to find, within a few months, an environmental toxin that causes autism, have . 

“We were deeply troubled to hear [Kennedy] dismiss past research, downplay the causal role of genes and portray autistic people in ways that counter our experiences and demean their value to society,” the letter says.  

Among other measures, researchers urged Kennedy to pre-register the protocol for any planned study. This voluntary practice — creating a time-stamped, public document outlining what the study will attempt to determine — is what is sometimes referred to as “hypothesizing after results are known.” The scholars also want HHS’ researchers to share their data with independent analysts for verification. 

In 2011, the Maryland Board of Physicians , who is not a physician and has only a bachelor’s degree, with illegally practicing medicine alongside his father, Mark Geier, a doctor who died last month. The two treated children with Lupron, a drug used to lower testosterone or estrogen levels in patients with prostate cancer, endometriosis and other diseases, along with chelation therapy, which leaches heavy metals from the body, as in lead poisoning.

Those treatments follow a widely discredited theory that blames autism on exposure to mercury in preservatives used in vaccines. Kennedy has promulgated that theory even though more than two dozen large, rigorous studies have discredited any link between vaccines and autism.

Autistic advocates decried Kennedy’s appointment, fearing his refusal to give up on efforts to establish one would refocus federal resources on finding a “cure” for what most scientists now believe is a naturally occurring human neurotype.  

“Anyone who would fleece families with fake cures should not be trusted to interpret a scientific study, let alone conduct one,” the Autistic Self Advocacy Network said in David Geier’s hiring. “This move toward conspiracy theories and junk science puts all our lives at risk.”

A request for comment from the U.S. Department of Health and Human Services was not immediately answered. The Geiers’ Institute of Chronic Illnesses, Inc., does not have a website.   

The network’s statement calls Kennedy’s selection of Geier “a clear indication that the Trump administration plans to rig the upcoming study and claim that it proves vaccines cause autism. This will set public health back decades at a time when vaccine hesitancy and infectious disease are both spreading at alarming rates.”

Among other claims, the Maryland board found that the Geiers diagnosed precocious puberty — a medical condition where children’s bodies mature too early — in an unusually large number of patients, did so without using the standard protocol for establishing whether the children in fact had the condition and failed to tell their families that the chelation drug prescribed was not authorized for use in the United States. 

Mark Geier’s medical licenses eventually were suspended by the seven states where he and his son operated autism treatment centers under a variety of names, including the Genetic Centers of America. The Geiers conducted several studies linking vaccines to autism, only to have them from publication by scientific journals. They in hundreds of lawsuits brought by people who claim to have been injured by immunizations. 

Lupron is a brand name for a GnRH analogue drug that pauses puberty without causing permanent physical changes. The drugs are for children who experience gender nonconformity or gender dysphoria at the onset of puberty. 

In January, a published in JAMA Pediatrics found the drugs were prescribed for fewer than 0.1% of youth in an insurance claims database covering more than 5 million patients ages 8 to 17. Only 926 youth with a gender-related diagnosis received puberty blockers from 2018 through 2022. No patient under the age of 12 was given the drugs.

Nonetheless, in recent years, 26 states have banned gender-affirming care for young people. The U.S. Supreme Court is expected to rule soon on challenges to the laws. In a January executive order, President Donald Trump to restrict such care.  

Mary Koslap-Petraco, a pediatric nurse practitioner who exclusively treats underserved children, said when she heard the news Thursday morning she was immediately filled with “absolute dread.”

“I have been following him for years,” she told ����Ӱ��. “I’ve read what he has written. I’ve heard what he has said. I know he has made a fortune with his anti-vax stance.”

She is primarily concerned that his rhetoric might “scare the daylights out of people so that they don’t want to vaccinate their children.” She also fears he could move to defund a program under the Centers for Disease Control and Prevention that provides vaccines to kids who lack health insurance or otherwise wouldn’t be able to afford them. While the program is federally mandated by Congress, moves to drain its funding could essentially render it useless.

Koslap-Petraco’s practice in Massapequa Park, New York relies heavily on the program to vaccinate pediatric patients, she said. If it were to disappear, she asked, “How am I supposed to take care of poor children? Are they supposed to just die or get sick because their parents don’t have the funds to get the vaccines for them?” 

And, if the government-run program were to stop paying for vaccines, she said she’s terrified private insurance companies might follow suit. 

Vaccines for Children is “the backbone of pediatric vaccine infrastructure in the country,” said Richard Hughes IV, former vice president of public policy at Moderna and a George Washington University law professor who teaches a course on vaccine law.

Kennedy will also have immense power over Medicaid, which covers low-income populations and provides billions of dollars to schools annually for physical, mental and behavioral health services for eligible students.

If Kennedy moves to weaken programs at HHS, which experts expect him to do, through across-the-board cuts in public health funding that trickle down to immunization programs or more targeted attacks, low-income and minority school-aged kids will be disproportionately impacted, Hughes said. 

“I just absolutely, fundamentally, confidently believe that we will see deaths,” he added.

Anticipating chaos and instability

Following a contentious seven hours of grilling across two confirmation hearings, Democratic senators Kennedy’s confirmation on the floor late into the night Wednesday. The following morning, all 45 Democrats and both Independents voted in opposition and all but one Republican — childhood polio survivor Mitch McConnell of Kentucky — lined up behind President Donald Trump’s pick.

James Hodge, a public health law expert at Arizona State University’s Sandra Day O’Connor College of Law, said that while it was good to see senators across the political spectrum asking tough questions and Kennedy offering up some concessions on vaccine-related policies and initiatives, he’s skeptical these will stick.

“Whatever you’ve seen him do for the last 25 to 30 years is a much, much greater predictor than what you saw him do during two or three days of Senate confirmation proceedings,” Hodge said. “Ergo, be concerned significantly about the future of vaccines, vaccine exemptions, [and] how we’re going to fund these things.”

Hodge also said he doesn’t trust how Kennedy will respond to the consequences of a dropoff in childhood vaccines, pointing to the current in West Texas schools.

“The simple reality is he may plant misinformation or mis-messaging,” he said.

During his confirmation hearings, Kennedy tried to distance himself from his past anti-vaccination sentiments stating, “News reports have claimed that I am anti-vaccine or anti-industry. I am neither. I am pro-safety … I believe that vaccines played a critical role in health care. All of my kids are vaccinated.”

He was confirmed as Linda McMahon, Trump’s nominee to head the Department of Education, was sitting down for her first day of hearings. At one point that morning, McMahon signaled to possibly shifting enforcement to HHS of the — a federal law dating back to 1975 that mandates a free, appropriate public education for the with disabilities — if Trump were to succeed in shutting down the education department.

This would effectively put IDEA’s under Kennedy’s purview, further linking the education and public health care systems.

In a post on the social media site BlueSky, Randi Weingarten, president of the American Federation of Teachers, she is “concerned that anyone is willing to move IDEA services for kids with disabilities into HHS, under a secretary who questions science.”

Keri Rodrigues, president of the National Parents Union and a parent of a child with ADHD and autism, told ����Ӱ�� the idea was “absolutely absurd” and would cause chaos and instability. 

Kennedy’s history of falsely asserting a link between childhood vaccines and autism — a disability included under IDEA coverage — is particularly concerning to experts in this light.

“You obviously have a contingent of kids who are beneficiaries of IDEA that are navigating autism spectrum disorder,” said Hughes, “Could [we] potentially see some sort of policy activity and rhetoric around that? Potentially.”

Vaccines — and therefore HHS — are inextricably linked to schools. Currently, all 50 states have vaccine requirements for children entering child care and schools. But Kennedy, who now has control of an agency with a $1.7 trillion budget and 90,000 employees spread across 13 agencies, could pull multiple levers to roll back requirements, enforcements and funding, according to ����Ӱ��’s previous reporting. And Trump has signaled an interest in that mandate vaccines.

“There’s a certain percentage of the population that is focused on removing school entry requirements,” said Northe Saunders, executive director of the pro-vaccine SAFE Communities Coalition. “They are loud, and they are organized and they are well funded by groups just like RFK Jr.’s .”

Kennedy will also have the ability to influence the makeup of the committees that approve vaccines and add them to the federal vaccine schedule, which state legislators rely on to determine their school policies. Hodge said one of these committees is already being “re-organized and re-thought as we speak.”

“With him now in place, just expect that committee to start really changing its members, its tone, the demeanor, the forcefulness of which it’s suggesting vaccines,” he added.

Hughes, the law professor, said he is preparing for mass staffing changes throughout the agency, mirroring what’s already happened across in Trump’s first weeks in office. He predicts this will include Kennedy possibly asking for the resignations “of all scientific leaders with HHS.” 

Kennedy appeared to confirm that he was eyeing staffing cuts Thursday night during on Fox News’s “The Ingraham Angle.”

“I have a list in my head … if you’ve been involved in good science, you have got nothing to worry about,” Kennedy said.