Quote:On July 13, a letter signed by Twenty-one clinicians and researchers from nine countries, including Finland, the United Kingdom, Sweden, Norway, Belgium, France, Switzerland, South Africa, and the United States, was published in the Wall Street Journal, stating that the “best available evidence” doesn’t support the prevailing treatment methods of gender dysphoria, namely sex-change procedures, in the US.

“Every systematic review of evidence to date, including one published in the Journal of the Endocrine Society, has found the evidence for mental-health benefits of hormonal interventions for minors to be of low or very low certainty,” the group of endocrinologists wrote, taking exception to the endorsement by the Endocrine Society, the professional organization for physicians who specialize in hormones, of minors receiving hormone treatments that block puberty.

These experts were prompted to speak out following criticism by the Endocrine Society of an op-ed published in the WSJ on June 28, which was co-authored by Ian Kingsbury, Ph.D., and Dr. Roy Eappen, who is a member of the Endocrine Society.

Kingsbury and Eappen were critical of a recent federal court ruling that struck down an Arkansas law banning sex-change procedures for minors, which relied on the Endocrine Society’s guidelines on sex-change procedures for minors. In the ruling, these guidelines were described as widely-accepted clinical practice guidelines for the treatment of gender dysphoria.

The pair argued that the Endocrine Society’s guidelines on sex-change procedures for minors were based on “low” or “very low” quality evidence and influenced by transgender activists, noting that concerns exist among endocrinologists about the lack of scientific support, combined with the speed at which irreversible treatments are granted to young patients.

The two faced criticism from Endocrine Society President Dr. Stephen Hammes, who released an op-ed published in the WSJ on July 4.

Dr. Hammes wrote that the pair ignore “scientific evidence and conclusions” reached by “reputable medical organizations,” such as the American Medical Association and the American Academy of Pediatrics, defending the Endocrine Society’s clinical practice guideline, which he said was developed through a rigorous and transparent process based on extensive evidence and input from its 18,000 members.

“More than 2,000 studies published since 1975 form a clear picture: Gender-affirming care improves the well-being of transgender and gender-diverse people and reduces the risk of suicide,” Dr. Hammes wrote.

Dr. Hammes also noted that federal judges in Tennessee, Kentucky, and Florida had joined the Arkansas judge in striking down similar bans on transgender procedures “based on much of the same evidence.”

However, the 21 clinicians and researchers from multiple countries contest Dr. Hammes’ claim that sex change procedures improve well-being, stating that the claim “is not supported by the best available evidence.”

The open letter expresses surprise and disagreement with the claims made by Dr. Hammes.

“As experienced professionals involved in direct care for the rapidly growing numbers of gender-diverse youth, the evaluation of medical evidence or both, we were surprised by the Endocrine Society’s claims about the state of evidence for gender-affirming care for youth,” they wrote.

“Every systematic review of evidence to date, including one published in the Journal of the Endocrine Society, has found the evidence for mental health benefits of hormonal interventions for minors to be of low or very low certainty,” they wrote. “By contrast, the risks are significant and include sterility, lifelong dependence on medication, and the anguish of regret.”

They added that it is for this reason that “more and more European countries and international professional organizations now recommend psychotherapy rather than hormones and surgeries as the first line of treatment for gender-dysphoric youth.”

“Dr. Hammes’s claim that gender transition reduces suicides is contradicted by every systematic review, including the review published by the Endocrine Society, which states, ‘We could not draw any conclusions about death by suicide.’ There is no reliable evidence to suggest that hormonal transition is an effective suicide-prevention measure,” they wrote.

The group called for medical societies to agree on recommendations based on the “best available evidence” and cautioned against both exaggerating benefits and minimizing risks.

“The politicization of transgender healthcare in the U.S. is unfortunate,” the group of experts wrote. “The way to combat it is for medical societies to align their recommendations with the best available evidence—rather than exaggerating the benefits and minimizing the risks.”