Department of Health and Human Services (HHS) Secretary Xavier Becerra repeatedly dodged questions Wednesday from Sen. Mike Braun, R-Ind., regarding particulars of the department’s stance on “gender-affirming care” for children.

“A subject that is really creating controversy across the country would be gender-affirming care for young people, and it’s on the HHS website,” Braun told Becerra, referencing definitions laid out in a fact sheet from HHS in March that said “gender-affirming care” for young people includes social affirmation at any age, puberty blockers during puberty and hormone therapy starting during early adolescence.

Irreversible surgery is “typically used in adulthood or case-by-case basis in adolescence,” according to the agency.

“I’d like to work through what gender-affirming care actually means and do it with a couple of subjects in mind: drugs and surgeries,” Braun continued.

Explaining how doctors who prescribe puberty-blocking drugs do so off-label because the Food and Drug Administration (FDA) has not approved them for such use, the senator first asked Becerra if he would agree that off-label prescriptions of puberty blockers for uses not approved by the FDA could potentially be dangerous, especially for children.

“What I would simply say to you is that the FDA would raise alarms if they saw that a particular medicine or treatment were being misused. And at this stage, what we know is that for a drug to be out there available, it has to be safe and effective as FDA has found,” Becerra replied.

“And so, what I would simply say with regard to this particular subject is when individuals go in for care, it is their physician who is making that decision with them about what type of medicine or treatment they should receive,” Becerra added.

After noting that such logic did not prevail regarding COVID-19 treatments, Braun moved on to the issue of irreversible surgeries, which the HHS lists as a gender-affirming treatment for adolescents on a “case-by-case basis.”

“I’m not going to mention the particulars here,” Braun said. “It’s almost grotesque to imagine what could occur. Could you explain what irreversible top and bottom sex change surgeries are and why that is on the [HHS] portal, as well?”

Saying there are “many different types of procedures that can be deployed,” Becerra reiterated that “in any case, no individual, no patient will proceed forward unless his or her doctor has advised of the procedure. And it is considered by the FDA and others who have to go ahead and certify a medicine or procedure to be safe and effective.”

“So I’ll try to distill it into a more simple form,” Braun cut in. “In what case would it be appropriate to perform irreversible sex change surgery on kids?”

“Those decisions are made by that individual in consultation with physician and caregivers, and no decision would be made without having consulted appropriately,” Becerra replied.

Braun concluded the exchange by asserting that the federal government shouldn’t be pushing irreversible sex change surgery on the HHS website, but focus instead on helping kids suffering from gender dysphoria with mental health solutions.

“And I think we just need to think about it carefully, because we’re navigating into territory that we’ve never done before as a government. Kids going through this are having a hard time. We should be maybe focusing more on mental health and not things that are irreversible.”

Becerra acknowledged Braun’s point before mentioning trans suicide rates.

“I believe that we should help those have the life-affirming care that they need,” he said. “There are many transgender youth who have actually gone in the opposite direction and taken their life. If we can make life better for someone in America, we should. Especially if in consultation with their physician, they approve of those procedures.”

HHS did not respond to request for further comment.

Braun’s line of questioning comes a week after Assistant Secretary of Health Rachel Levine, the highest-ranking transgender person in the U.S. government, made headlines for claiming during a recent interview with NPR that “there is no argument” about gender-affirming care among pediatricians and doctors who specialize in adolescents.

“There is no argument among medical professionals – pediatricians, pediatric endocrinologists, adolescent medicine physicians, adolescent psychiatrists, psychologists, etc. – about the value and the importance of gender-affirming care,” Levine told NPR.