ReviewInternational journal of transgender health2024
Randomized-controlled trials are methodologically inappropriate in adolescent transgender healthcare.
Review in International journal of transgender health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Endocrine Management of Transgender and Gender-Diverse Adolescents: Expert Opinion of the ESPE Working Group on Gender Incongruence and the Endo-ERN Main Thematic Group on Sexual Development and Maturation.Hormone research in paediatrics · 2026Guideline
- A critical response to recent publications on gender affirming care.Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists · 2026Article
- Editorial: Towards Context-Responsive, Evidence-Informed Care for Transgender and Gender Diverse Young People.JAACAP open · 2026Article
- Rapid review of gender-affirming healthcare for children and adolescents: Evidence synthesis (2021-2025) and recommendations for South Africa.Southern African journal of HIV medicine · 2026Review
- Rapid Review of Gender-Affirming Healthcare for Children and Adolescents: Evidence Synthesis (2021-2025) and Recommendations for South Africa.Research square · 2025Article
- Pubertal Suppression for Transgender Youth: A Right to an Open Future Approach in Support of a Youth-Empowered Legal Framework.Journal of bioethical inquiry · 2025Article
- Leveraging community engagement and human-centered design to develop multilevel implementation strategies to enhance adoption of a health equity intervention.Implementation science communications · 2025Article
- Disentangling the biopsychosocial effects of gender-affirming hormone therapy on social health: A protocol for a multi-arm prospective cohort study (AFFIRM Relationships).Comprehensive psychoneuroendocrinology · 2025Article
- Cass Review does not guide care for trans young people.The Medical journal of Australia · 2025Article
- Psychological and Physical Health Outcomes Associated with Gender-Affirming Medical Care for Transgender and Gender-Diverse Youth: A Critical Review.Healthcare (Basel, Switzerland) · 2025Review
- Qualitative research in family medicine.Canadian family physician Medecin de famille canadien · 2025Article
- Mental Health during Medical Transition in a US and Canadian Sample of Early Socially Transitioned Transgender Youth.The Journal of adolescent health : official publication of the Society for Adolescent Medicine · 2025Article
- The Cass Review: Cis-supremacy in the UK's approach to healthcare for trans children.International journal of transgender health · 2025Article
- Gender-affirming medical treatment for adolescents: a critical reflection on "effective" treatment outcomes.BMC medical ethics · 2024Article
- Gender Affirming Hormone Treatment for Trans Adolescents: A Four Principles Analysis.Journal of bioethical inquiry · 2024Article
- Recognizing and responding to misleading trans health research.International journal of transgender health · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Despite multiple rigorous observational studies documenting the association between positive mental health outcomes and access to puberty blockers, hormone therapy, and transition-related surgeries among adolescents, some jurisdictions have banned or are attempting to ban gender-affirming medical interventions for minors due to an absence of randomized-controlled trials (RCTs) proving their mental health benefits. Methods: This article critically reviews whether RCTs are methodologically appropriate for studying the association between adolescent gender-affirming care and mental health outcomes. Results: The scientific value of RCTs is severely impeded when studying the impact of gender-affirming care on the mental health of trans adolescent. Gender-affirming interventions have physiologically evident effects and are highly desired by participants, giving rise to concerns over adherence, drop-out, response bias, and generalizability. Complementary and well-designed observational studies can instead be used to ground reliable recommendations for clinical practice and policymaking in adolescent trans healthcare, without the need for RCTs. Conclusion: The lack of RCTs on the mental health impacts of gender-affirming care for trans adolescents does not entail that gender-affirming interventions are based on insufficient evidence. Given the methodological limitations of RCTs, complementary and well-designed observational studies offer more reliable scientific evidence than RCTs and should be considered of sufficient quality to guide clinical practice and policymaking.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.