Medical Treatment for gender identity evidence archive thread

[Helleofabore]

Hi everyone

I am creating this thread as an archive thread just for statistics and polling links and information that we can all access and refer to. With the option for saving threads so we can find them easily, I figure it is a good way to gather specific types of information into one place.

Please post studies, papers, media articles that pull together references, or informative articles, tweets, videos, and interviews. Just on statistics and polling about the topic of Sex & Gender. Please post with a summary of the article, study, papers, etc so people can also use Advanced Search to locate the information and it will make it easier to read through to find the information again too.

I don't want to be the thread police, but ask that we keep this free of discussion. Getting into discussion on this thread will mean it will fill up quickly and not serve the purpose of being simply an archive.

Can I ask that if you want to discuss something you see here, you start a thread to do so and link and refer to a post on this thread? If a post has been presented with commentary that people disagree with, can that be discussed on a new thread please..

Keep this thread free just for the information.

Here is the link to the previous Break it down for me thread and the new General Break it Down archive thread.

The specific archive threads (including this one) are:

Save female sports evidence thread
Statistics & poll evidence archive thread
Medical treatment archive thread
It will never happen - resource thread
Court cases/Judicial Reviews/ET/ETAs

Thank you.

Guys. Could we please keep this as just for the stashing of links so they are easy to find. ( I am going to work through the FP stuff tomorrow). ☺️

https://www.dailywire.com/news/florida-brings-down-the-hammer-on-medical-groups-that-pushed-trans-procedures-on-children

Florida Brings Down The Hammer On Medical Groups That Pushed Trans Procedures On Children

Leif Le Mahieu. Dec 9, 2025

Florida took legal action on Tuesday against a trio of medical organizations that promote transgender procedures on children, The Daily Wire has learned.

Republican Attorney General James Uthmeier filed a suit against the World Professional Association for Transgender Health (WPATH), the Endocrine Society, and the American Academy of Pediatrics over their support of transgender procedures on kids. The suit accuses the organizations of pushing irreversible medical procedures on gender-confused children for financial benefit.

“For years, these groups insisted the recommendations were settled science, but behind closed doors, they knew the evidence was weak,” Uthmeier said in a video shared with The Daily Wire. “They knew the outcomes [were] uncertain, and the risks very real. Parents were not told the full story. In fact, some parents were told that if they didn’t put their kids through permanent, life-altering, sick procedures, like double mastectomies and castration, their child would commit suicide. Not only is that unethical and dangerous medicine, but it is against the law.”

and

The suit was filed in the 19th Judicial Circuit Court in Saint Lucie County, Florida. It accuses the organizations of violating Florida’s Deceptive and Unfair Trade Practices Act and engaging in racketeering by misleading “patients, parents, insurers, regulators, and courts about the reversibility and efficacy of pediatric sex interventions.”

and

“Defendants have a problem: there is no credible evidence that sex interventions alleviate pediatric gender dysphoria. To convince patients, insurance companies, regulators, and judges otherwise, Defendants initiated a coordinated campaign to develop ‘clinical guidelines’ recommending sex intervention for pediatric gender dysphoria,” the suit reads.

Uthmeier wants the court to rule that the organizations’ promotion of transgender procedures constitutes unfair trade practices, impose a civil penalty of $1 million against each defendant, block the organizations from advertising the procedures as safe and reversible, and impose a $10,000 penalty for each time a false claim about the safety of transgender procedures was made.

(Here is some background in this video from earlier 2025:

)

FOI ESTABLISHED CHILD SELF MEDICATION RATES FOR SEX HORMONES - HANNAH BARNES

https://www.newstatesman.com/investigation/2025/12/one-in-ten-children-receiving-nhs-gender-care-are-self-medicating-with-sex-hormones

archive.is/KTMVl

16th December 2025

One in ten children receiving NHS gender care are self-medicating with sex hormones

Almost one in ten children currently being seen by NHS Children and Young People’s Gender Services have disclosed that they self-medicate with masculinising or feminising hormones. The figures, exclusively seen by the New Statesman and revealed through freedom of information requests, come from all three regional gender clinics currently open to young people, serving London, the south-west and north-west England.

In total, 84 children (all under 18 years old) have told staff they are taking either testosterone (for females wishing to masculinise) or oestrogen (for males wishing to feminise), out of a total open caseload of 891. These hormones cause irreversible changes to the body, helping someone who wants to transition to develop characteristics associated with their preferred gender. For example, testosterone use in a biological female can stimulate growth of facial hair (and other body hair), a drop in the pitch of their voice, and other typically male characteristics such as pattern baldness.

The south-west, Bristol-based children’s gender service has the highest proportion of its caseload self-medicating – at 13 per cent – though these numbers may be an underestimate. In its FOI response, the London-based service (where 11.8 per cent of patients are taking hormones from non-NHS suppliers) acknowledged that the totals provided “may not be a true reflection of the number in receipt of hormone therapy without an NHS prescription as some patients under our care may not have disclosed this information to us”.

All of the NHS Children and Young People’s Gender Service clinics said that they were recording the source of the hormones in patients’ medical notes, for example, whether it has been obtained from an online pharmacy, overseas supplier, or elsewhere. The Bristol and London-based services said that whenever a child disclosed they are self-medicating with hormones, they and their parents or carers would be advised “about the known and unknown risks of this, as well as informing the patient’s GP in writing”.

The service for the north-west region, which had the lowest proportion of its caseload self-medicating (5.2 per cent), said that when staff become aware of patients self-medicating, they followed their own guidelines developed to deal with the issue of children accessing hormones from non-NHS sources. Further advice is given to clinicians in the service specification which underpins the operation of all the youth gender clinics.These NHS services will not work alongside unregulated providers who are supplying hormones, and in some circumstances might suggest that a GP or local health professional consider whether safeguarding measures are necessary to protect the child in question.

The article goes on...

SOME BACKGROUND OF THE HORMONAL TREATMENT OF CHILDREN

This is Michael Biggs speech from a Medico Legal Society meeting on the 13 October 2025.

History of and evidence for puberty suppression as intervention for children experiencing gender dysphoria

Published 9th December 2025

https://journals.sagepub.com/doi/10.1177/00258172251392357?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed

This is the final two paragraphs of an extensive recounting of the history of children’s treatment. There is a lot in the speech to take in.

“One final speculative reflection. It’s true that only a small number of adolescents who are going through a transition or identify as transgender undergo early puberty suppression. Even if you look at the ones who go for medical intervention, the typical patient would be a 17-year-old girl who thinks she’s non-binary or thinks she’s a boy, and of course puberty suppression is irrelevant in that case. However, even though only a small number of children have undergone early puberty suppression, they dominate media portrayals and they help to construct the image of the transgender child. It’s very telling that all the media-friendly trans kids have had early puberty suppression: Jazz Jennings in America and Jackie Green in the UK; there was also a trans boy called Leo who was featured on BBC Children’s television; and Valentijn de Hingh, a very famous transgender woman in the Netherlands. So actually they have an outsized role in constructing this idea of a transgender child. Moreover, the availability of puberty blockers becomes a kind of self-fulfilling prophecy because it makes social transition feasible. Before puberty blockers, it was not really possible to socially transition in school because, obviously, your emerging sex characteristics would become visible to everyone. But the availability of puberty blockers makes social transition in school possible; consequently, social transition becomes a self-fulfilling prophecy because it locks in the transgender identity.

I think the final broader cultural ramification of puberty suppression is that you begin to conceive puberty not as a crucial life stage that we all have to go through in order to become adults – but as literally a disease or almost like a disease. As de Vries, the most published Dutch gender clinician, says, ‘Disallowing puberty suppression, resulting in irreversible development of secondary sex characteristics, may be considered unethical’.This is why she said we can never have a randomised control trial because it’s actually unethical not to stop puberty. So the broader social and cultural implications of puberty suppression are very wide.

Here is an expert discussion panel on this report.

In this episode of The Director’s Desk, NIH Director Dr. Jay Bhattacharya hosts a roundtable with the primary authors of the newly released HHS peer-reviewed report, “Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices.” This landmark review evaluates the scientific evidence behind pediatric gender dysphoria treatments — including puberty blockers, cross-sex hormones, and surgical interventions — and concludes that these “sex-rejecting procedures” carry substantial and long-term risks for children and adolescents.

Featured Authors / Contributors:

• Evgenia Abbruzzese, Society for Evidence-Based Gender Medicine
• Alex Byre, PhD, Massachusetts Institute of Technology
• Farr Curlin, MD, Duke University
• Moti Gorin, PhD, MBE, Colorado State University
• Kristopher Kaliebe, MD, DFAACAP, University of South Florida
• Michael K. Laidlaw, MD, Michael K. Laidlaw MD, Inc.
• Kathleen McDeavitt, MD, Baylor College of Medicine
• Leor Sapir, PhD, Manhattan Institute for Policy Research

Together, they break down the report’s major findings, discuss long-term outcomes, examine the strength and limitations of current evidence, and outline implications for clinical best practices, research, and policy.

GENSPECT’S TIMELINE SUMMARY FOR THE DEPATHOLOGISATION OF GENDER DISTRESS TREATMENT

Depsychopathologization Campaign Timeline

https://genspect.org/depathologization-campaign-timeline/

Late 80s-91- Houston “Roundtable Years”▼
Houston trans-identified attorney Phyllis Fryeconvenes grassroots meetings of trans activists and legal experts that form the precursor for the International Conference on Transgender Law and Employment Policy.

1992-1994 International Conference on Transgender Law and Employment Policy (ICTLEP)▼
Early trans activists view psychiatry itself as the main obstacle to accessing medical interventions. At the annual ICTLEP conferences, activists and legal experts reframe transgender identities as healthy in order to circumvent psychiatric “gatekeeping” and advance self-declaration of “gender identity” as a human right.

December 1995 - International Bill of Gender Rights▼
At the 4th ICTLEP conference in Houston, the International Bill of Gender Rights is adopted. This declaration asserts the right to self-declare gender identities and access medical interventions, stating that “individuals should not be subject to psychiatric diagnosis…on the basis of their gender identity.”

2004 - The Transgender Emergence by Arlene Istar Lev▼
Social worker Arlene Istar Lev’s book The Transgender Emergencebecomes foundational in the movement to depsychopathologize transgender identities, arguing that clinicians should treat transgender identification as a healthy variation to be affirmed. Lev is a prominent HBIGDA member and later contributes to WPATH’s Standards of Care 7.

2006 - Yogyakarta Principles▼
Drafted by human-rights lawyers and trans activists, the Yogyakarta Principles draw on the 1995 International Bill of Gender Rights, asserting the right to self-declaration of gender identity without psychiatric approval. While not legally binding, it forms the blueprint for modern trans activism

2007- HBIGDA Rebrands as WPATH▼
The Harry Benjamin International Gender Dysphoria Association rebrands as the World Professional Association for Transgender Health(WPATH). Trans-identified legal scholar Stephen Whittle, a strong proponent of depsychopathologization, is WPATH president at the time.

2010 - WPATH Depsychopathologization Statement▼
The WPATH Board of Directors strongly urges the depsychopathologisation of “gender variance” worldwide, framing transgender identities as healthy and psychopathologisation as stigmatizing. This is a political move with no grounding in scientific discovery.

2012 - WPATH Standards of Care 7▼
SOC7 frames transgender identities as healthy and shifts the goal of psychotherapy to facilitating medical transition.

2012 - Depsychopathologization Introduced to Pediatrics▼
Psychologist and prominent WPATH member Diane Ehrensaft introduces depsychopathologization for children and adolescents with her article “From gender identity disorder to gender identity creativity: true gender self child therapy.”

2013 - American Psychiatric Association Publishes DSM-5▼
This pivotal moment shifts the pathology from the identity to the distress felt because body and mind are misaligned. This revision is the result of activist pressure on the APA, largely from WPATH, to depsychopathologize transgender identities.

2014 - Time Magazine: “The Transgender Tipping Point”▼
Laverne Cox appears on the cover of Time magazine, launching the modern trans rights movement. This marks the beginning of an aggressive international messaging campaign pushing trans identities as healthy and celebrated

2014 - Pediatric Gender Clinics See Surge of Referrals▼
Coinciding with the widespread media promotion of transgender identities as healthy, a new cohort of adolescents, most girls, starts to appear in pediatric gender clinics. The inflection point strongly indicates a social contagion.

2015 - APA Calls for Depsychopathologization in Schools▼
In its Resolution on Gender and Sexual Orientation Diversity in Children and Adolescents in Schools, the American Psychological Association urges educators to treat “diverse gender identities” as “normal and positive variations of the human experience.”

2016 - WPATH Position Statement on Medical Necessity▼
This statement frames transgender identity as healthy and declares all hormonal and surgical interventions “essential” to the well-being of trans-identified people. This becomes a key document used to pressure insurance companies to cover gender-related medical procedures.

2018- Gender Identity Disorder▼
Under pressure from trans activists, WHO reclassifies gender identity disorder (ICD-10) as gender incongruence in ICD-11, moving it out of Mental and Behavioral Disorders into the newly created Conditions Related to Sexual Health—a chapter created specifically for depsychopathologization

2018 - AAP Endorses Depsychopathologization for Minors▼
The American Academy of Pediatrics statementcalls for affirmation and social and medical transition for minors, calling watchful waiting “outdated” and pathologizing.

2018- AACAP Defines Psychotherapy as Conversion Therapy▼
The AACAP policy on “Conversion Therapies”states defining “gender diverse identities” as pathological is a “false premise,” urging that therapeutic intervention for gender identities be considered conversion therapy

2022- WPATH Standards of Care 8▼
SOC8 asserts transgender identities are natural and must not be considered pathological. It removes almost all lower age restrictions for hormones and surgeries and expands medical treatment to “eunuchs” and “nonbinary” identities

2023- Genspect Calls for Repathologization▼
Genspect’s repsychopathologization campaign recognizes that a trans-identified person’s compulsive pursuit of hormonal and surgical body modification reflects a pathological condition driven by an extreme overvalued belief—an all-consuming, culturally reinforced conviction that compels harmful behavior. This new framing recognizes that cultural and social reinforcement mechanisms are central to how this belief develops and spreads

PAPER BY MARCUS EVANS

Beyond affirmation: Lessons from Tavistock —A psychoanalytic critique of identity certainty and institutional defence

https://onlinelibrary.wiley.com/doi/10.1111/bjp.70011

Abstract

This paper offers a psychoanalytic critique of the affirmation model in gender identity care, drawing on clinical experience from the Tavistock Gender Identity Development Service (GIDS). It argues that institutional and therapeutic responses to gender distress in young people are increasingly shaped by pressures to affirm rather than to reflect. Drawing on psychoanalytic concepts including symbolic thinking, identity foreclosure, claustro-agoraphobic anxieties and the “third position”, the paper explores how certainty and identity fixity can function as defences against psychic pain, rather than signs of psychological integration. The paper critiques the avoidance of transference, the foreclosure of thought and the emotional pressure placed on clinicians and institutions. It concludes by advocating for a model of care that restores reflective capacity and supports the difficult psychological work of identity development, rather than bypassing it through premature affirmation.

CONCLUSION: THOUGHT, MOURNING AND ETHICAL CARE

The development of Tavistock's GIDS marks a transition from psychoanalytic approaches to procedural affirmation, shifting the emphasis within both individual and institutional frameworks.

The service began to emphasise efficiency and certainty rather than exploration and interpretation.
These changes appeared in three related areas: on the intra-psychic level, adolescents' distress was frequently managed through established identity beliefs that addressed ambiguity or trauma; in interpersonal settings, therapeutic relationships experienced pressures such as countertransference and reduced reflective containment; and institutionally, systems responded with increased reliance on policy and compliance over deliberation and inquiry.
Wilfred Bion's concept of “attacks on linking” describes ways in which psychic and organisational structures may affect the capacities for integration, reflection and psychological growth. When institutions focus on managing anxiety at the expense of symbolic functions, they may influence conditions relevant to care.

The Cass (2024) recommends a model that is developmentally informed and psychologically reflective, supporting clinical judgement, accommodating uncertainty and valuing thoughtful engagement. It suggests that new regional hubs should reserve space for reflection, allowing patients, clinicians and organisations to avoid repeating previous challenges.

According to this perspective, ethical care is associated not only with addressing distress but also with creating environments that facilitate integration and symbolic thought. Affirmation alone does not eliminate psychological pain. Supporting young people in developing the ability to manage contradictions, navigate uncertainty and seek meaning is suggested as a way to offer adequate care.

IPSOS POLL REGARDING US OPINION ON MEDICALISED TREATMENT FOR CHILDREN

NY Times poll - IPSOS
Interview dates: January 2 to January 10, 2025
Number of interviews: 2,128

static01.nyt.com/newsgraphics/documenttools/f548560f100205ef/e656ddda-full.pdf

https://archive.is/jWgkV

Q 32. Thinking about medications used for transgender care, do you think doctors should be able to prescribe puberty blocking drugs or hormone therapy to minors between the ages of 10 and 18?

Results

Yes, minors ages 10 to 18 should have access - 10% (Rep 2% | Dem 19% | other 2%)

Yes, but only minors aged 15 to 18 should have access - 16% (Rep 7% | Dem 24% | other 10%)

No one under age 18 should have access - 71% (Rep 90% | Dem 54% | other 61%)

refused 4% (Rep 1% | Dem 3% | other 27%)

(lots of other interesting questions asked)

NEWSWEEK ARTICLE ON US HHS REPORT ON PUBERTY BLOCKERS

https://archive.is/ZFK2n

Liberals Should Read the HHS Review of Pediatric ‘Gender Affirming’ Care

Moti Gorin and Kathleen McDeavitt
26 December 2025

“The Department of Health and Human Services (HHS) recently published Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices. Given current widespread distrust of HHS, especially regarding vaccines, we knew this review, which we co-authored, would be met with skepticism. So, it is worth noting that we, along with most of the other authors, are liberals.

While everyone should be concerned when vulnerable populations do not receive appropriate medical care, those of us on the left side of the political spectrum need to pay special attention. This is because many of the organizations and individuals we trust have gotten this issue wrong.”

and

“While it may sound jarring to readers who have, reasonably, deferred to U.S. medical societies and civil rights advocacy groups on this issue, there is no longer any legitimate scientific controversy about the weak evidence underlying the purported benefits of the “gender affirming” model for youth. Readers may also be surprised to learn that the first countries to restrict these practices were politically progressive Finland and Sweden, whose socialized health care systems are widely admired. It was these Scandinavian social democracies—not U.S. red states—that were first to conduct systematic reviews and conclude there is no reliable evidence supporting pediatric medical transition. Finland sharply restricted the practice in 2020, followed by Sweden in 2022. The U.K. was next, and other nations are pulling back, too.

The HHS review’s evidence analysis arrives at the same conclusion regarding the sorry state of the evidence. Weighing the purported benefits against the risks (which include not only infertility and sexual dysfunction but also decreased bone density, delayed cognitive development and inability to breastfeed after mastectomy) the review concludes that the harms of pediatric medical transition far outweigh the unproven mental health benefits."

And

"While recent polling shows that a majority of Democratic voters oppose pediatric medical transition, the issue remains intensely polarized among politicians and policymakers. Conservatives and liberals alike can agree that all people, and especially children, deserve ethical, evidence-based care. We recognize that liberals distrust anything coming from the current administration, but we hope they will take the time to read this review and see that it puts science first".

Moti Gorin, PhD, MBE, is a bioethicist and philosopher at Colorado State University. He was a contributor to HHS’ Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices and has published on issues at the intersection of pediatric medical transition and medical ethics.

Kathleen McDeavitt, MD, is a psychiatrist and associate professor at Baylor College of Medicine. She was a contributor to HHS’ Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices and has published on topics related to the evidence base and clinical guidelines in pediatric gender medicine.

DETRANSITIONER CASES IN THE USA

Here is a list from Ben Ryan of the court cases that have been lodged already about the medical treatments for people with transgender identities.

The first that is going to trial starts week commencing 5th January 2026 and is in New York State. At this stage, Camille Keifel's suit will be going ahead in Oregon also in January 2026.

There are several sites now tracking these law suits and much depends on the outcomes of these initial trials.

https://www.mumsnet.com/talk/womens_rights/5469068-detransitioner-legal-cases-going-to-trial-in-usa-january-2026?reply=150222055

The thread.

SOME OF THE IMPACTS OF TESTOSTERONE ON FEMALE BODIES

Pelvic Floor Dysfunction in Transgender Men on Gender-affirming Hormone Therapy: A Descriptive Cross-sectional Study

Lyvia Maria Bezerra da Silva et al. Int Urogynecol J. 2024 May.

Abstract

Introduction and hypothesis: The objective of this research is to explore the effects of hormone therapy using testosterone on pelvic floor dysfunction (PFD) in transgender men. We hypothesize that PFD might be prevalent among transgender men undergoing hormone therapy. Therefore, this study was aimed at verifying the frequency of these dysfunctions.

Methods: A cross-sectional study was conducted between September 2022 and March 2023 using an online questionnaire, which included transgender men over 18 years old who underwent gender-affirming hormone therapy. Volunteers with neurological disease, previous urogynecology surgery, active urinary tract infection, and individuals without access to the internet were excluded. The questionnaire employed validated tools to assess urinary symptoms, such as urinary incontinence (UI), as well as sexual dysfunction, anorectal symptoms, and constipation. The data were analyzed descriptively and presented as frequencies and prevalence ratios with their respective confidence intervals (95% CI), mean, and standard deviation.

Results: A total of 68 transgender men were included. Most participants had storage symptoms (69.1%), sexual dysfunction (52.9%), anorectal symptoms (45.6%), and flatal incontinence (39.7%). Participants with UI symptoms reported moderate severity of the condition.

Conclusions: Transgender men on hormone therapy have a high incidence of PFD (94.1%) and experience a greater occurrence of urinary symptoms (86.7%).

An article about the study with some commentary from Elaine Miller (gussiegrips)

Trans men taking testosterone getting ‘postmenopausal’ problems aged 28’

The Telegraph
26 May 2024

www.telegraph.co.uk/news/2024/05/26/trans-problems-urinary-bowel-incontinent-young-detransition/

https://archive.is/wNl3q

“Elaine Miller, a pelvic health physiotherapist and member of the Chartered Society of Physiotherapy, said: “A lot of women are absolutely fine until the menopause and then they start to get leaky. That appears to be exactly the same trajectory for female people who take cross-sex hormones, but there hasn’t been much in the way of research.”

She said she had worked with around 20 detransitioners who sought help for pelvic floor issues - and many more from around the world had been in touch - but that there was a “stigma” around incontinence and that people were “embarrassed” and minimised the issue.

“Wetting yourself is something that just is not socially acceptable, and it stops people from exercising, it stops them from having intimate relationships, it stops them from travelling, it has work impacts,” she said.

“The impact a bit of leaking has on these young people’s lives is huge. It really needs to be properly discussed within gender clinics because I would expect that almost 100 per cent of female people that take cross-sex hormones will end up with these problems,” she added, noting that the study was “robust” and probably underplayed the issue.

“It’s really sad when we hear people say, ‘nobody ever told me this’, and they should have been informed of the risks in gender clinics.”

“The menopause causes a loss of muscle mass and body strength, which affects the pelvic floor and can cause incontinence.

Women who start the menopause early or prematurely, under the age of 45, should be offered Hormone Replacement Therapy (HRT) on the NHS because the oestrogen can help prevent the onset of conditions such as coronary heart disease, osteoporosis and dementia.

Taking testosterone may accelerate the menopausal process because it stops the ovaries from functioning and reduces the amount of oestrogen the body produces.

Testosterone is also known to affect muscle mass and hair loss, and has been linked to blood clots and gallstones, but there has been little research into pelvic floor issues and incontinence.”

Relevant current thread https://www.mumsnet.com/talk/womens_rights/5483941-us-detransitioner-wins-medical-malpractice-lawsuit-and-receives-2-million?utm_campaign=thread&utm_medium=app_share

STATEMENT FROM THE AMERICAN SOCIETY OF PLASTIC SURGEONS - Feb 2026

www.plasticsurgery.org/for-medical-professionals/health-policy/position-statements

"Consistent with ASPS’s August 2024 statement that the overall evidence base for gender-related endocrine and surgical interventions is low certainty, and in light of recent publications reporting very low/low certainty of evidence regarding mental health outcomes, along with emerging concerns about potential long-term harms and the irreversible nature of surgical interventions in a developmentally vulnerable population, ASPS concludes there is there is
insufficient evidence demonstrating a favorable risk-benefit ratio for the pathway of gender-related endocrine and surgical interventions in children and adolescents. ASPS recommends that surgeons delay gender-related breast/chest, genital, and facial surgery until a patient is at least 19 years old."

and

ASPS’s Understanding of the Evidence Base and Related Ethical Considerations

"In August 2024, ASPS communicated to members that the Society had not endorsed any external organization’s clinical practice guidelines or recommendations for the treatment of children or adolescents with gender dysphoria. At that time, ASPS recognized that the evidence base informing medical and surgical interventions in this population was limited and characterized as low quality/low certainty (i.e., there was limited confidence that the intervention’s reported effects reflected the true effects). This understanding was informed by new systematic reviews published in Europe as well as the 2024 Independent Review of Gender Identity Services for Children and Young People: Final Report commissioned by NHS England and authored by Dr. Hilary Cass.

ASPS’s understanding has continued to evolve in light of additional comprehensive evidence reviews, including the 2024 Plastic and Reconstructive Surgery article Mastectomy for individuals with gender dysphoria younger than 26 years: a systematic review and meta-analysis and the 2025 report from the U.S. Department of Health and Human Services (HHS) titled Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices. These reviews have not resolved earlier uncertainties regarding treatment benefit; in some areas they have contributed to a clearer understanding of potential harms, while also highlighting limitations of the available evidence, including gaps in documenting long-term physical, psychological, and psychosocial outcomes. For an evidence summary, ASPS directs members to Appendix 4 of the HHS report, which details the types of interventions (medical, surgical, psychological), reported outcomes, magnitude and direction of effects, and overall certainty of evidence available in the published literature."

Puberty blockers for gender dysphoric youth: A lack of sound science
LETTER TO THE EDITOR
JACCP: JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACYVolume 5, Issue 9Sep 2022Pages929-1020

Sarah C. J. Jorgensen Pharm.D., MPH, Patrick K. Hunter M.D., M.Sc. Bioethics, Lori Regenstreif M.D., M.Sc., Joanne Sinai M.D., M.Ed., William J. Malone M.D.

Opening para:
The medical transition of children and adolescents with genderdysphoria remains highly debated and there is significant divergencein policy internationally.1-7 Mills and colleagues' review the interven-tions that comprise the “gender-affirmative” care pathway, anapproach currently promoted by many medical organizations in NorthAmerica.6-8 We strongly agree with the authors that pharmacists havea responsibility to “understand the evidence,” and “place thewell-being of the patient over any personal cultural beliefs.”8 However,we think the use of evidence to support the authors' claim that gonado-tropin releasing hormone (GnRH)-analogs are fully reversible and havebeen shown to improve mental health, requires critical appraisal.

AMA REACTION TO ASPS POSITION

“The AMA said in a statement to National Review that because “the evidence for gender-affirming surgical intervention in minors is insufficient for us to make a definitive statement . . . the AMA agrees with ASPS that surgical interventions in minors should be generally deferred to adulthood.””

https://www.nationalreview.com/news/first-major-medical-org-comes-out-against-trans-surgeries-for-minors/amp/

3 Feb 2026

GENDER TRANSITION SURGERY IS NOT A FORM OF SUICIDE PREVENTION

https://x.com/benryanwriter/status/2018183879035629603?s=46

”Dr. Loren Schechter, the head of gender-affirming surgery at Rush University Medical Center in Chicago and the president-elect of the World Professional Association for Transgender Health (WPATH), testified that gender-transition surgery is not form of suicide prevention.”

This quote below is from Ryan’s reporting of the testimony in the Fox Varian case.

” Schechter, the plastic surgeon, testified that Einhorn had misconceived the purpose of gender-transition mastectomies. "Surgery in and of itself is not a treatment or a mechanism to prevent suicide," he said.”

Trans athletes have no advantage over women, study claims
Researchers argue there is no evidence to justify a blanket ban on transgender athletes competing against women. This is seriously flawed research. I thought it might be useful on this thread as it shows how difficult, nay impossible to justify men being able to compete with women, no matter what. The flaws in the research are unbelievable. Putting the name research to the 'study' is very wide of the mark.

Op, I can remove if you think it doesn't work in the thread. A lot of work on this one @Helleofabore thanks

https://www.telegraph.co.uk/gift/8a27f9cac257a640

MALE PEOPLE WITH TRANSGENDER IDENTITIES HAVE DISTINCT PATTERNS OF BRAIN FUNCTION WHILE BEING MORE ALIGNED WITH THE MALE RANGE

Comparing local brain activity and distant functional connectivity in transgender women compared to cisgender controls

https://www.nature.com/articles/s41598-026-40083-8

16 February 2026

Xiongyu Li, Zhibiao Xiang et al

Abstract
To date, the knowledge about the neurobiological mechanisms associated with transgender populations, especially transgender women (TW), remains limited and lacks consensus. This study aims to fill such gaps using the functional magnetic resonance imaging (fMRI) method. Resting-state fMRI data was obtained from 16 TW, 16 cisgender men (CM), and 16 cisgender women (CW). Measures of local brain activity and distant functional connectivity (FC) were compared among groups. Several corresponding dynamic measures were also explored based on the assumption of fluctuating brain functional organizations over time. For local brain activity, TW showed higher amplitude of low-frequency fluctuation within the cerebellum, precentral gyrus, and thalamus, as well as lower regional homogeneity in the precuneus than cisgender participants. For FC measures, TW showed weaker FCs mainly involving the ventral attention and sensorimotor networks, as well as lower local efficiency than cisgender participants. In most of these measures, CM were intermediate among the three groups (i.e., TW < CM < CW, or TW > CM > CW). Our results suggest that TW have distinct patterns of brain function compared with cisgender people, while they are more aligned with those of CM (their sex assigned at birth) rather than CW.

https://www.nature.com/articles/s41598-026-40083-8_reference.pdf

Noted within the review : ”Another limitation regarding the sample is that we did not control for the impact of hormones.” and I also noted “Finally, given the higher risk of depression andmood disorders in TW, absence of emotional assessment as a control variable limits the robustness of our conclusions”.

Really interesting.

Not a techie-medical article but relevant to this thread I think?
The Tide Goes Out on Youth Gender Medicine - The Atlantic
Thanks to ThreeLocusts who spotted it:
'The tide goes out on pediatric gender medicine' - Atlantic article | Mumsnet

The original GIDS study into pubertal suppression by GIDS at the Tavistock Clinic, 2011
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0243894

The Health Research Authority investigation into above study, including details of the route to ethical approval
https://www.hra.nhs.uk/about-us/governance/feedback-raising-concerns/investigation-study-early-pubertal-suppression-carefully-selected-group-adolescents-gender-identity-disorders/

Deborah Cohen and Hannah Barnes BMJ article about the 2011 GIDS study (unfortunately requires BMA or OpenAthens login) https://www.bmj.com/content/366/bmj.l5647.long

https://genderstats.substack.com/p/doped-then-transitioned-now - references research into the effects of testosterone-like steroids on female East German athletes

https://biologyinmedicine.substack.com/p/summary-of-levy-review-concerns-regarding -summary of Levy Review findings by Biology in Medicine which is a group of doctors and other medical professionals who want to put a stop to 'gender affirming' medical interventions, knowing the harms involved.

Levy Review of adult gender dysphoria clinics in England https://www.england.nhs.uk/long-read/operational-and-delivery-review-of-nhs-adult-gender-dysphoria-clinics-in-england/