The myth of "reliable research" in pediatric gender medicine: a critical assessment of the Dutch studies and subsequent research.
Summary
Two Dutch studies formed the basis and best available evidence for the practice of medical sexual transitioning in young people. We demonstrate that these studies are methodologically flawed and should never have been used in medical settings to justify scaling up this "innovative clinical practice". Three methodological biases undermine the research: (1) subject selection ensured that only the most successful cases were included in the results; (2) the finding that "resolution of gender dysphoria" was due to reversal of the questionnaire employed; (3) concomitant psychotherapy made it impossible to separate the effects of this intervention from those of hor- mones and surgery. We discuss the significant risk of harm that the Dutch research exposed, as well as the lack of applicability of the Dutch protocol to the currently rising incidence of non-binary young people with psychiatric difficulties, who are predominantly natal females. Problems of "spin", i.e. the tendency to present weak or negative results as certain and positive, continue to plague reports from clinics actively administering hormonal and surgical interventions to young people. it's time for gender medicine to pay attention to published objective systematic reviews as well as uncertainties about outcomes and definable potential harms for these vulnerable young people