Magali Pignard: Gender dysphoria: a new evaluation reveals very low certainty evidence on endocrine treatment
Article by Magali Pignard - Published on 16 February 2025
Trad. Chat GPT/DeepL
The most rigorous assessment to date (Jan 2025) of studies into the effects of puberty blockers and cross-sex hormones in under-26s found evidence of ‘very low certainty’, meaning that ‘the actual effect is likely to be very different from the estimated effect’. |
Two systematic reviews and meta-analyses have been carried out by researchers at McMaster University (Canada), including Dr Gordon Guyatt, one of the main founders of evidence-based medicine.
These are the first evaluations to meet the highest methodological standards:
for carrying out and reporting a systematic review and a meta-analysis,
for assessing the risk of bias in each included study and the certainty of evidence for each outcome of interest.
➥ Search for studies until September 2023, involving individuals under the age of 26.
➥ Outcomes assessed: psychological (gender dysphoria, depression, global function) and physical.
Puberty blockers: general findings on gender dysphoria and conclusion
10 studies included, 311 excluded.
“Comparative observational studies (n = 3), comparing puberty blockers to no puberty blockers, provided very low certainty evidence regarding global functioning and depression outcomes.
Before-and-after studies (n = 7) provided very low certainty evidence regarding gender dysphoria, global functioning, depression, and bone mineral density.
There remains considerable uncertainty about the effects of puberty blockers in individuals with gender dysphoria (GD). Methodologically rigorous prospective studies are needed to clarify the effects of this intervention.”
Cross-sex hormones: overall results and conclusion
24 studies included, 311 excluded.
“Comparative observational studies (n = 9) primarily provided very low certainty evidence regarding gender dysphoria, global functioning, and depression. One comparative observational study (Green 2022) reported that the odds of depression might be lower (low certainty) in individuals who received cross-sex hormones compared to those who did not.
Before-and-after studies (n = 13) provided very low certainty evidence regarding gender dysphoria, global functioning, depression, and bone mineral density. Case series studies (n = 2) provided high certainty evidence indicating that the proportion of individuals experiencing cardiovascular events 7 to 109 months after receiving hormone therapy was 0.04 (high certainty).
There is considerable uncertainty regarding the effects of hormone therapy, and we cannot rule out the possibility of either benefit or harm. Methodologically rigorous prospective studies are needed to generate higher-certainty evidence.”
➥ To find out about the quality of studies evaluated by the main systematic reviews: Tableau Excel en ligne : Qualité des études
I liked the point about keeping online tools simple. While looking for a way to sketch out a Pokémon team before committing to it, I came across Pokémon Team Builder, and the straightforward layout made sense to me.
This is an interesting discussion of how evidence quality and certainty can shape the interpretation of research findings. The distinction between available evidence and the strength of conclusions drawn from it is particularly important in complex areas of healthcare, where careful evaluation of study methods, limitations, and outcomes matters. Presenting the underlying evidence clearly can help readers engage with the topic more thoughtfully. For some completely unrelated downtime afterward, Quenq Vice City offers a browser-based gaming experience.
When a game has a compact objective and readable feedback, it is much easier to stay engaged. Monkey Mart offers that kind of straightforward arcade session without a complicated setup.
Understanding the basic features of a Piso WiFi setup can help users manage wireless access more effectively. Helpful information about connectivity, configuration, and troubleshooting can make routine tasks easier. Anyone exploring piso wifi can benefit from straightforward resources that explain important settings in an accessible way.
The article makes a fair point about lowering the barrier to trying something new. TFTFans gave me a quick way to plan a 28-hex Teamfight Tactics board, which was useful when I only wanted to test an idea.