I would be interested to see how these studies are set up. The gold standard for interventional therapies are randomised controlled trials. I can't see how these are possible as i cant see participants being willing to be randomised between affirmative and exploratory therapy. Also, as the harms of puberty blockers and the inevitably x sex hormones, i cant see an ethics board agreeing to give kids a treatment regimen known to be harmful for anything less than a life threatening/limiting condition, which gender distress is not.
Then there are the end points. What would be measured? If the measure is the resolution of gender distress, given the known harms of medical intervention versus the lack of harm from talking therapy or doing nothing, medical intervention would have to be massively more efficacious to ever be considered as the gold standard, and unresolved gender distress would have to be viewed to be as risky as the issues with puberty blockers and x sex hormones .
Also, these are complex kids. If medical intervention is shown to relieve gender distress, but they are still not fully functioning members of society because they are depressed/anxious/ND, then does it realllly matter and is it worth losing fertility and sexual function over?
This is why the TRAs have pushed for trans not to be medically defined, but metaphysically. For the TRAs aligning the inner gender essence with with the body is just making kids who they were meant to be. Any and all harms are justified in this noble pursuit. Going to be a fucker to capture in a trial protocol and to get it through ethics tho. Sunlight.