Flowers' injury a concern for the Ravens after their AFC North-clinching victory over Cleveland

BALTIMORE (AP) — Baltimore's division-clinching victory over Cleveland was about as routine as expected.

Except for one second-quarter play that could be a major problem for the Ravens' dynamic offense.

Zay Flowers, the team's top receiver, went down with a knee injury and didn't return to the game Saturday. Coach John Harbaugh sounded somewhat optimistic afterward but said there would be an MRI.

Baltimore finished the regular season 12-5 despite dropping its first two games. It's just one game worse than the record that gave the Ravens the league's best mark in 2023, but this time there will be no first-round bye. Baltimore will be the No. 3 seed in the AFC playoffs, facing Pittsburgh in the first round.

So Flowers doesn't have much time to recover. The Pro Bowl receiver caught 74 passes for 1,059 yards and four touchdowns in the regular season.

Baltimore trailed Pittsburgh by two games in the AFC North with four to play. Then the Ravens went 4-0 and the Steelers went 0-4 the rest of the way.

“It’s a week-to-week league, and you really just have to take it one week at a time, one day at a time, one play at time, and our guys have done a really good job of holding onto that,” Harbaugh said. “That 1-0 T-shirt that we all wear around is real, and so, four wins later, we’re the AFC North champions.”

You wouldn't think there'd be enough plays or enough footballs or enough yards on the field for both Lamar Jackson and Derrick Henry to put up these numbers, but here are the final totals for the regular season. For Jackson: 4,172 yards passing and 915 rushing. For Henry: 1,921 yards rushing.

The Ravens became the first team in NFL history with 4,000 yards passing and 3,000 rushing in one season. Obviously, the regular season is a bit longer now than it used to be — but Jackson and Henry both seem to have made each other better, and they've taken the offense to another level.

“We’ve won four in a row. I feel like everybody’s been doing a great job of doing their jobs so we can execute on offense, and it’s been fun," Henry said. "We’ve got to keep it going, stay locked in (and) hold each other accountable so we keep that same momentum in the playoffs.”

The wide receiver group could be thin if Flowers is limited. Rashod Bateman had a good game against Cleveland, and so did the tight end tandem of Mark Andrews and Isaiah Likely, but receiver Tylan Wallace played 51 offensive snaps and finished with one target and no catches.

Michael Pierce's first career interception was a late highlight in this game, and it also underscored how healthy he looks after four games back from an injured reserve stint.

Pierce, listed at 355 pounds, had some running room on his interception but was about 80 yards from the end zone and gave himself up with a slide.

“There’s a long history of turning big-guy interceptions and fumbles into memes, so at the risk of turning myself into one of those, I decided it was just time to go home,” he said. "Plus, I was out of gas, so it was good.”

Defensive back Brandon Stephens was targeted with some success by the Browns, and he can expect similar treatment in the playoffs after all the big defensive plays teammates Marlon Humphrey and Nate Wiggins have made.

Bateman and safety Kyle Hamilton were both shaken up but returned to the field, so Flowers is the lone significant injury concern coming out of the game for the Ravens.

Baltimore's last two games of the regular season were its best in terms of total yards allowed. The Ravens allowed just 211 in a 31-2 win at Houston, then 230 against the Browns.

Baltimore's first-round playoff opponent depended on the result of the Chargers-Raiders game Sunday. When the Chargers won, that meant the Ravens would face the Steelers. Baltimore and Pittsburgh split their regular-season matchups.

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Baltimore Ravens running back Derrick Henry (22) is congratulated by teammate Lamar Jackson (8) after scoring during the second half of an NFL football game against the Cleveland Browns Saturday, Jan. 4, 2025, in Baltimore. (AP Photo/Nick Wass)

Baltimore Ravens wide receiver Zay Flowers grabs his leg after being injured during the first half of an NFL football game against the Cleveland Browns Saturday, Jan. 4, 2025, in Baltimore. (AP Photo/Stephanie Scarbrough)

As U.S. lawmakers debate issues around health care for transgender youth, it’s been difficult to determine the number of young people receiving gender-affirming medications, leaving room for exaggerated and false claims.

Now, a medical journal has published the most reliable estimate yet and the numbers are low, reflecting more clearly on medical practices now being weighed by the U.S. Supreme Court.

Fewer than 1 in 1,000 U.S. adolescents with commercial insurance received gender-affirming medications — puberty blockers or hormones — during a recent five-year period, according to the study released Monday.

At least 26 states have adopted laws restricting or banning gender-affirming medical care for transgender minors, and most of those states face lawsuits. A decision by the Supreme Court in a Tennessee case is expected later this year. President-elect Donald Trump has promised to roll back protections for transgender people.

“We are not seeing inappropriate use of this sort of care," said lead author Landon Hughes, a Harvard University public health researcher. “And it’s certainly not happening at the rate at which people often think it is.”

The researchers analyzed a large insurance claims database covering more than 5 million patients ages 8 to 17.

Only 926 adolescents with a gender-related diagnosis received puberty blockers from 2018 through 2022. During that time, 1,927 received hormones. The findings, published in JAMA Pediatrics, suggest that fewer than 0.1% of all youth in the database received these medications.

The researchers found that no patients under age 12 were prescribed hormones, an indication that doctors are appropriately cautious about when to start such treatments, Hughes said.

“I hope that our paper cools heads on this issue and ensures that the public is getting a true sense of the number of people who are accessing this care,” he said.

The database included insurance plans in all 50 states, but did not include youth covered by Medicaid, the federal-state health insurance program for low-income people.

The study did not look at surgeries among transgender adolescents. Other researchers have found those procedures are extremely rare among young people.

Not all transgender youth proceed with medical treatments, said Dr. Scott Leibowitz, co-lead author of the adolescent standards of care for the World Professional Association for Transgender Health, a leading transgender health group.

Transgender adolescents “come to understand their gender at different times and in different ways,” he said, noting that the best care should include experts in adolescent identity development who can work with families to help figure out what’s appropriate for each young person.

Leibowitz, who has worked in gender clinics in several U.S. cities, said the study “adds to the growing evidence base about best practices when serving transgender and gender diverse youth.”

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

FILE - A vial of testosterone is prepared for injection at a home in Florida, on May 29, 2023. (AP Photo/Laura Bargfeld)