By GEOFF MULVIHILL, CARLA K. JOHNSON and AMANDA SEITZ, Associated Press

President Donald Trump’s administration released a lengthy review of transgender health care on Thursday that advocates for a greater reliance on behavioral therapy rather than broad gender-affirming medical care for youths with gender dysphoria.

The Health and Human Services report questions standards for the treatment of transgender youth issued by the World Professional Association for Transgender Health and is likely to be used to bolster the government’s abrupt shift in how to care for a subset of the population that has become a political lightning rod.

File – Supporters of transgender rights rally by the Supreme Court, Dec. 4, 2024, in Washington. (AP Photo/Jacquelyn Martin, File)

This new “best practices” report is in response to an executive order Trump issued days into his second term that says the federal government must not support gender transitions for anyone under age 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.”

The report sharply contradicts guidance from the American Medical Association, which has urged states not to ban gender-affirming care for minors, saying that “empirical evidence has demonstrated that trans and non-binary gender identities are normal variations of human identity and expression.”

HHS said its report, however, is not clinical guidance and does not make any policy recommendations. The report is also limited to children and does not address treatment for adults.

Gender-affirming care for transgender youth under standards widely used in the U.S. includes supportive talk therapy and can — but does not always — involve puberty blockers or hormone treatment. Gender-affirming surgeries for transgender minors are rare.

“It’s very chilling to see the federal government injecting politics and ideology into medical science,” said Shannon Minter, the legal director at the National Center for Lesbian Rights. Minter said the report could create fear for families seeking care and for medical providers.

“It’s Orwellian. It is designed to confuse and disorient,” Minter added.

A judge has blocked key parts of Trump’s order, which includes denying research and educational grants for medical schools, hospitals and other institutions that provide gender-affirming care to people 18 or younger. Several hospitals around the country ceased providing care. The White House said Monday that since Trump took office, HHS has eliminated 215 grants totaling $477 million for research or education on gender-affirming treatment.

Most Republican-controlled states have also adopted bans or restrictions on gender-affirming care. A U.S. Supreme Court ruling is pending after justices heard arguments in December in a case about whether states can enforce such laws.

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The Jan. 28 executive order is among several administration policies aimed at denying the existence of transgender people. Trump also has ordered the government to identify people as either male or female rather than accept a concept of gender in which people fall along a spectrum, remove transgender service members from the military, and bar transgender women and girls from sports competitions that align with their gender. This month, HHS issued guidance to protect whistleblowers who report doctors or hospitals providing gender-affirming care. Judges are blocking enforcement of several of the policies.

This latest HHS report, which Trump called for while campaigning last year, represents a reversal in federal policy. The U.S. Substance Abuse and Mental Health Services Administration, which is part of HHS, found that no research had determined that behavioral health interventions could change someone’s gender identity or sexual orientation. The 2023 update to the 2015 finding is no longer on the agency’s website.

The administration says this new report will go through a peer-review process. In the meantime, it’s not saying who contributed to it, “in order to help maintain the integrity of this process.”

The report says that medical groups have relied on medical treatment rather than behavioral therapy for transgender youth partly because of a “mischaracterization of such approaches as ‘conversion therapy,’” which about half the states have banned for minors.

The American Academy of Child & Adolescent Psychiatry has said that evidence shows conversion therapies inflict harm on young people, including elevated rates of suicidal ideation. And the American Medical Association has urged states not to ban gender-affirming care for minors, saying that “empirical evidence has demonstrated that trans and non-binary gender identities are normal variations of human identity and expression.”

By STAN CHOE, Associated Press Business Writer

NEW YORK (AP) — Microsoft and Meta Platforms are driving Wall Street higher on Thursday after profits for the Big Tech companies at the start of the year turned out to be even bigger than analysts expected.

The S&P 500 was up 0.8% and heading for an eighth straight gain, which would be its longest winning streak since August. The Dow Jones Industrial Average was up 124 points, or 0.3%, as of 9:35 a.m. Eastern time, and the Nasdaq composite was 1.9% higher.

Microsoft jumped 10.2% after the software giant said strength in its cloud computing and artificial intelligence business drove its overall revenue up 13% from a year earlier.

Meta, the parent company of Facebook and Instagram, also topped analysts’ targets for revenue and profit in the latest quarter. It said artificial intelligence tools helped boost its advertising revenue, and its stock climbed 6.4%.

CVS Health and a bevy of other companies also joined the growing stream of better-than-expected profit reports that have been helping to steady Wall Street over the last week. The S&P 500 is back to within 9% of its record set earlier this year, after briefly dropping nearly 20% below the mark.

Still, plenty of uncertainty remains about whether President Donald Trump’s trade war will force the economy into a recession. Several reports have recently shown the U.S. economy is weaker than expected, and the latest arrived Thursday showing that more U.S. workers filed for unemployment benefits last week than economists had forecast. It’s setting the stage for a more comprehensive report on the job market arriving Friday.

And even though companies have been reporting better profits for the first three months of the year than analysts expected, many CEOs are remaining cautious about the rest of the year.

General Motors cut its forecast for profit in 2025, for example. It said it’s assuming it will feel a hit of $4 billion to $5 billion because of tariffs, and it expects to offset at least 30% of it. GM’s stock slipped 0.3%.

McDonald’s fell 1.3% after reporting weaker revenue for the latest quarter than analysts expected, even though its profit was slightly above forecasts. An important underlying measure of performance at its U.S. restaurants had its worst decline since 2020, when COVID shuttered the global economy.

McDonald’s joined Chipotle and other restaurant chains that have seen customers get more cautious amid all the uncertainty about the economy and inflation that’s still higher than many people would like.

Such conditions are raising the threat of a worst-case scenario called “stagflation,” where the economy stagnates yet inflation remains high. It’s so hated because the Federal Reserve has no good tools to fix both problems at the same time. If the Fed were to try to help one problem by adjusting interest rates, it would likely make the other worse.

Some encouraging news on inflation arrived Wednesday, when a report said that the measure of inflation the Fed likes to use slowed in March.

That’s raising expectations among traders that the Fed may resume cutting interest rates later this year in order to prop up the economy. Those expectations in turn are helping to drive down Treasury yields in the bond market.

The yield on the 10-year Treasury fell to 4.14% from 4.17% late Wednesday.

In stock markets abroad, trading was closed in many countries for May Day, or international Labor Day holidays.

Tokyo’s Nikkei 225 rose 1.1% after the Bank of Japan kept its benchmark interest rate unchanged, as many investors expected.

AP Business Writers Yuri Kageyama and Matt Ott contributed.

By ERIC TUCKER and ALANNA DURKIN RICHER, Associated Press

WASHINGTON (AP) — To understand the Justice Department’s struggles in representing President Donald Trump’s positions in court, look no further than a quick succession of losses last week that dealt a setback to the administration’s agenda.

In orders spanning different courthouses, judges blocked a White House plan to add a proof-of-citizenship requirement to the federal voter registration form, ruled the Republican administration violated a settlement agreement by deporting a man to El Salvador and halted directives that threatened to cut federal funding for public schools with diversity, equity and inclusion programs.

That’s on top of arguments in which two judges expressed misgivings to a Justice Department lawyer about the legality of Trump executive orders targeting major law firms and a department lawyer’s accidental filing of an internal memo in court questioning the Trump administration’s legal strategy to kill Manhattan’s congestion toll — a blunder the Transportation Department called “legal malpractice.”

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The Trump administration’s effort to reshape American civil society, including a crackdown on illegal immigration and downsizing of the federal government, is encountering resistance from judges across a broad spectrum of philosophical leanings as lawyers for the Justice Department in some cases have strained to answer straightforward questions from judges about the basis or rationale for a particular policy or about the mechanics of its implementation. In at least one instance, a government lawyer who became openly exasperated in court at the lack of information he’d been given from the administration was soon after fired by the Justice Department.

Compounding the problem is an ongoing exodus from the department of experienced career lawyers accustomed to representing the federal government in court. Some of the key arguments in recent weeks have been handled by lawyers newly hired into political, rather than career, positions.

Justice Department leadership has in recent months hired lawyers with conservative credentials from law firms in Washington and with past experience at state and local government agencies.

“This is quite rare, if not unprecedented,” said Boston College law professor Kent Greenfield. “I can’t think of another instance in which the Justice Department has lost so many cases in a short period of time and the reason they’re losing is because they’re wrong — and obviously wrong.”

According to an Associated Press tally, about 50 Trump executive actions have been partially or fully blocked by the courts while about 40 have been left in effect. Dozens of others are pending.

Trump administration officials, including Attorney General Pam Bondi, have attributed the losses to what they call “activist” judges bent on impeding his agenda. Some White House allies have called for impeaching judges, with adviser Elon Musk describing it as a “judicial coup.”

But that belies the reality that some of the most blistering rebukes of Justice Department arguments have come from conservative judges like J. Harvie Wilkinson III, an appointee of Republican President Ronald Reagan who said in an April opinion that the idea the government could not return to the U.S. a man it had deported to El Salvador was “shocking not only to judges, but to the intuitive sense of liberty that Americans far removed from courthouses still hold dear.”

Jonathan Turley, a George Washington University law professor, cautioned against making too much so soon in the administration of its legal track record. The Supreme Court with its conservative 6-3 majority, including three Trump appointees, has yet to weigh in on the vast majority of the cases.

“This Department of Justice will continue to defend President Trump’s agenda in court, and we remain confident that we will ultimately prevail,” Justice Department spokesperson Chad Gilmartin said in an email.

The Trump administration has also succeeded in some cases in beating back legal challenges, and some early defeats at the trial court level have been subsequently overturned by a federal appeals court, such as when a panel cleared the way for the administration to fire thousands of probationary workers in spite of a judge’s earlier opinion.

In another case, the Supreme Court overturned a lower judge’s order that had blocked the administration from using an 18th-century wartime law to deport Venezuelan migrants, though the court said they must get a chance to challenge their removals before they’re taken from the United States. The Supreme Court also recently granted the Trump administration’s plea to cut hundreds of millions of dollars in teacher training money while a lawsuit continues.

“There’s over 600 District Court judges, any one of which can issue limited or national injunctions,” Turley said. The rulings may be important, he added, “but there’s a great deal of runway between a U.S. district court and the United States Supreme Court.

The challenges, however, were laid bare in a Washington courtroom just last week when Richard Lawson, a newly minted deputy associate attorney general, repeatedly struggled to provide what the judge said was “basic” information about one in a series of executive orders targeting a major law firm with punishing sanctions.

“So you don’t know whether the firm or the individuals whose security clearances were suspended have been given any notice about the timing of the review, who the decision-maker is, the information that’s being reviewed as part of this review, whether they’re going to have an ability to see that information, comment on the information, correct the information, object to the information?” Howell asked pointedly. “You can’t tell me anything about that?”

“I can’t speak to that, Your Honor,” replied Lawson, who before recently joining the Justice Department had worked with Bondi in the Florida attorney general’s office and was also a lawyer at a pro-Trump think tank called the America First Policy Institute.

Lawson fared no better weeks earlier when pushed to explain the administration’s national security rationale for punishing a different law firm, Jenner & Block, because one of its former partners, Andrew Weissmann, had years earlier been a prosecutor on the team of special counsel Robert Mueller that investigated Trump.

“You’re not going to really tell me that having someone employed four years ago poses some kind of national security threat?” asked U.S. District John Bates, an appointee of George W. Bush, a Republican.

“Not per se, no,” replied Lawson.

In another case, Judge Colleen Kollar-Kotelly scolded the Justice Department in court papers last week over what she described as the “contradiction” between statements made in court by one of its lawyers “and the facts on the ground.” While the judge did not contend that the lawyer “intentionally misrepresented the facts,” the appointee of Democratic President Bill Clinton added: “The Court must remark that this exchange does not reflect the level of diligence the Court expects from any litigant — let alone the United States Department of Justice.”

Stuart Gerson, who led the Justice Department’s civil division under Republican President George H.W. Bush and later served briefly as acting attorney general, said it appeared the Trump administration was sending lawyers into court” without adequate information and instructions.”

“I sympathize greatly with these folks who are arguing some of the cases, who are just parroting what they’ve been told to say without being able to answer questions about their ramifications, the what-ifs and the background information,” Gerson said.

Warm spring weather and numerous requests from boaters have prompted Minnesota Department of Transportation officials to start the 2025 schedule of the Stillwater Lift Bridge this week.

The Lift Bridge is now staffed from 8 a.m. to midnight each day, and the bridge will lift every half hour if boat traffic is present.

The lift schedule is expected to stay in effect through late October.

Bridge tenders will respond to special requests to lift the bridge after midnight if given a two-hour notice; requests can be made by calling MnDOT’s 24-hour dispatch at 651-234-7110.

For more information, go to: dot.state.mn.us/stillwaterliftbridge.

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