Kilotest: Violations of contrast poor issue for Society for Evidence Based Gender Medicine (SEGM) page

Basics

About the page

• URL: https://segm.org/
• Tested 2 days ago on 2026-10-07 at 22:28 by job 261007T2202-905
• Summary of results:
  • Rule engines:
    • Called: 12
    • Were able to test: 12
    • Reported any rule violations: 12
  • Violations: 3251
  • Violators: 625
  • Issues: 57
• Download the full technical report (JSON)

About the issue

• Why it matters: Content is difficult to understand
• Priority: highest
• Related WCAG standard: 1.4.3
• Reported by 7 rule engines (Accessibility Checker + Alfa + Axe + HTML CodeSniffer + Pour + SureA11y + WAVE)
• Violations: 701
• Violators: 231

Violators

Here are the HTML elements reported to violate rules belonging to the contrast poor issue.

Take me there links will open the page in a new tab and try to scroll to the element and highlight it. This does not always succeed. You can return here by closing the new tab.

• Element 0

  • Tag name: HTML
  • Text: [not applicable]
  • Start tag: <html lang="en" dir="ltr" prefix="og: https://ogp.me/ns#" class=" js">
  • XPath: /html
  • Bounding box: x = 0, y = 0, width = 1920, height = 13453
  • Reported by
  • What diagnoses were reported?

• Element 1101

  • Tag name: P
  • Text: Society for Evidence-Based Gender Medicine
  • Start tag: <p class="foot-tag">
  • XPath: /html/body/div[1]/footer[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/p[1]
  • Bounding box: x = 8, y = 13383, width = 1904, height = 16
  • Reported by WAVE
  • What diagnoses were reported?

• Element 1102

  • Tag name: P
  • Text: © 2020-2026 SEGM
  • Start tag: <p class="copyright">
  • XPath: /html/body/div[1]/footer[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/p[2]
  • Bounding box: x = 8, y = 13415, width = 1904, height = 18
  • Reported by WAVE
  • Take me there
  • What diagnoses were reported?

• Element 141

  • Tag name: SPAN
  • Text: Search
  • Start tag: <span class="text">
  • XPath: /html/body/div[1]/section[1]/div[1]/div[1]/div[2]/div[1]/div[1]/div[1]/div[1]/form[1]/div[1]/button[1]/span[2]
  • Bounding box: [not obtained]
  • Reported by SureA11y + WAVE
  • What diagnoses were reported?

• Element 155

  • Tag name: BUTTON
  • Text: Search
  • Start tag: <button type="submit" class="segm-button segm-button--primary segm-button--primary--dark-cyan segm-button--search">
  • XPath: /html/body/div[1]/section[1]/div[1]/div[1]/div[3]/div[1]/div[1]/div[1]/div[1]/div[1]/form[1]/div[1]/button[1]
  • Bounding box: x = 362, y = 773, width = 119, height = 43
  • Reported by Alfa
  • What diagnoses were reported?

• Element 159

  • Tag name: SPAN
  • Text: Search
  • Start tag: <span class="text">
  • XPath: /html/body/div[1]/section[1]/div[1]/div[1]/div[3]/div[1]/div[1]/div[1]/div[1]/div[1]/form[1]/div[1]/button[1]/span[2]
  • Bounding box: x = 407, y = 785, width = 54, height = 19
  • Reported by Accessibility Checker + Axe + Pour
  • What diagnoses were reported?

• Element 164

  • Tag name: DIV
  • Text: Subscribe
  • Start tag: <div class="additional-subscription-nav-button">
  • XPath: /html/body/div[1]/section[1]/div[1]/div[1]/div[3]/div[1]/div[2]/div[1]/div[1]
  • Bounding box: x = 8, y = 851, width = 559, height = 36
  • Reported by Alfa
  • Take me there
  • What diagnoses were reported?

• Element 165

  • Tag name: A
  • Text: Subscribe
  • Start tag: <a class="segm-button segm-button--primary segm-button--primary--orange segm-button--primary--subscribe" href="/subscribe-segms-mailing-list">
  • XPath: /html/body/div[1]/section[1]/div[1]/div[1]/div[3]/div[1]/div[2]/div[1]/div[1]/a[1]
  • Bounding box: x = 226, y = 851, width = 123, height = 36
  • Reported by Accessibility Checker + Axe + Pour + SureA11y + WAVE
  • Take me there
  • What diagnoses were reported?

• Element 168

  • Tag name: DIV
  • Text: Home
  • Start tag: <div class="menu__item menu__item--level-0">
  • XPath: /html/body/div[1]/section[1]/div[1]/div[1]/div[3]/div[1]/nav[1]/div[1]
  • Bounding box: x = 8, y = 887, width = 48, height = 21
  • Reported by Alfa
  • Take me there
  • What diagnoses were reported?

• Element 169

  • Tag name: A
  • Text: Home
  • Start tag: <a href="/" data-drupal-link-system-path="&lt;front&gt;" class="is-active" aria-current="page">
  • XPath: /html/body/div[1]/section[1]/div[1]/div[1]/div[3]/div[1]/nav[1]/div[1]/a[1]
  • Bounding box: x = 8, y = 887, width = 48, height = 20
  • Reported by Axe + Pour + WAVE
  • Take me there
  • What diagnoses were reported?

• Element 1046

  • Tag name: P
  • Text: Donate online
  • Start tag: <p style="text-align:left;">
  • XPath: /html/body/div[1]/section[11]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/p[3]
  • Bounding box: x = 8, y = 12505, width = 1904, height = 52
  • Reported by Alfa
  • Take me there
  • What diagnoses were reported?

• Element 1047

  • Tag name: A
  • Text: Donate online
  • Start tag: <a class="donate-top ext" style="display:inline-block;max-width:max-content;position:static;" href="https://donate.stripe.com/eVq5kCgySgTK4GycBq9bO04" data-extlink="" target="_blank" rel="noopener nofollow noreferrer">
  • XPath: /html/body/div[1]/section[11]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/p[3]/a[1]
  • Bounding box: x = 8, y = 12494, width = 195, height = 62
  • Reported by Accessibility Checker + Axe + HTML CodeSniffer + Pour + WAVE
  • Take me there
  • What diagnoses were reported?

• Element 1083

  • Tag name: P
  • Text: Your email will be stored securely and will never be shared with third parties. You can unsubscribe at any time using the link in our emails. See our Privacy Policy.
  • Start tag: <p>
  • XPath: /html/body/div[1]/section[12]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/form[1]/div[2]/p[1]
  • Bounding box: x = 8, y = 13225, width = 1904, height = 60
  • Reported by Alfa
  • Take me there
  • What diagnoses were reported?

• Element 1084

  • Tag name: A
  • Text: Privacy Policy
  • Start tag: <a href="/privacy-policy">
  • XPath: /html/body/div[1]/section[12]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/form[1]/div[2]/p[1]/a[1]
  • Bounding box: x = 1591, y = 13230, width = 130, height = 20
  • Reported by Accessibility Checker + Axe + Pour + WAVE
  • Take me there
  • What diagnoses were reported?

• Element 1074

  • Tag name: INPUT
  • Text: Email
  • Start tag: <input class="civicrm-enabled form-email required" data-civicrm-field-key="civicrm_1_contact_1_email_email" data-drupal-selector="edit-civicrm-1-contact-1-email-email" type="email" id="edit-civicrm-1-contact-1-email-email" name="civicrm_1_contact_1_email_email" value="" size="60" maxlength="254" placeholder="Email *" required="required" aria-required="true" style="">
  • XPath: /html/body/div[1]/section[12]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/form[1]/fieldset[1]/div[1]/div[1]/input[1]
  • Bounding box: x = 721, y = 13131, width = 356, height = 62
  • Reported by Pour
  • What diagnoses were reported?

• Element 1076

  • Tag name: INPUT
  • Text: [not applicable]
  • Start tag: <input class="webform-button--submit segm-button segm-button--newsletter segm-button--primary segm-button--primary--dark-cyan button button--primary js-form-submit form-submit" data-drupal-selector="edit-actions-submit" data-disable-refocus="true" type="submit" id="edit-actions-submit" name="op" value="Subscribe" data-once="drupal-ajax" style="">
  • XPath: /html/body/div[1]/section[12]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/form[1]/fieldset[1]/div[1]/div[2]/input[1]
  • Bounding box: x = 1077, y = 13138, width = 122, height = 48
  • Reported by Axe + Pour + WAVE
  • What diagnoses were reported?

• Element 233

  • Tag name: DIV
  • Text: Register now … Learn More
  • Start tag: <div class="conference-promo__actions conference-promo--angled__actions">
  • XPath: /html/body/div[1]/section[2]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[2]/div[1]/div[2]
  • Bounding box: x = 8, y = 1420, width = 1142, height = 52
  • Reported by Alfa
  • Take me there
  • What diagnoses were reported?

• Element 234

  • Tag name: A
  • Text: Register now
  • Start tag: <a href="https://events.humanitix.com/youth-gender-distress/tickets?utm_source=Website_homepage&amp;utm_medium=Button&amp;utm_campaign=Register_homepage_website" class="conference-promo__button conference-promo__button--primary conference-promo--angled__button conference-promo--angled__button--primary ext" target="_blank" data-extlink="" rel="noopener nofollow noreferrer">
  • XPath: /html/body/div[1]/section[2]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[2]/div[1]/div[2]/a[1]
  • Bounding box: x = 8, y = 1420, width = 165, height = 52
  • Reported by Axe + HTML CodeSniffer + Pour + SureA11y + WAVE
  • Take me there
  • What diagnoses were reported?

• Element 263

  • Tag name: DIV
  • Text: Publication date … October 4, 2026
  • Start tag: <div class="field field-publication-date node datetime field__field-publication-date field--datetime field--datetime__field-publication-date field--node__field-publication-date field--node--datetime____field-publication-date">
  • XPath: /html/body/div[1]/section[4]/div[1]/div[1]/div[2]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]
  • Bounding box: x = 130, y = 2546, width = 741, height = 65
  • Reported by Alfa
  • Take me there
  • What diagnoses were reported?

• Element 265

  • Tag name: DIV
  • Text: October 4, 2026
  • Start tag: <div>
  • XPath: /html/body/div[1]/section[4]/div[1]/div[1]/div[2]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]
  • Bounding box: x = 130, y = 2591, width = 741, height = 21
  • Reported by Axe + Pour + SureA11y + WAVE
  • Take me there
  • What diagnoses were reported?

• Element 264

  • Tag name: H4
  • Text: Publication date
  • Start tag: <h4>
  • XPath: /html/body/div[1]/section[4]/div[1]/div[1]/div[2]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/h4[1]
  • Bounding box: x = 130, y = 2546, width = 741, height = 21
  • Reported by Axe + Pour + SureA11y
  • What diagnoses were reported?

• Element 269

  • Tag name: A
  • Text: Detransition, Posttraumatic Stress Disorder, and Moral Injury
  • Start tag: <a href="/Detransition-PTSD-moral-injury" hreflang="en">
  • XPath: /html/body/div[1]/section[4]/div[1]/div[1]/div[2]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[2]/div[1]/span[1]/a[1]
  • Bounding box: x = 130, y = 2624, width = 683, height = 29
  • Reported by HTML CodeSniffer
  • Take me there
  • What diagnoses were reported?

• Element 270

  • Tag name: DIV
  • Text: The utility of PTSD and "moral injury" clinical and diagnostic concepts in detransition care
  • Start tag: <div class="views-field views-field-field-subtitle">
  • XPath: /html/body/div[1]/section[4]/div[1]/div[1]/div[2]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[3]
  • Bounding box: x = 130, y = 2658, width = 741, height = 46
  • Reported by Alfa
  • Take me there
  • What diagnoses were reported?

• Element 271

  • Tag name: DIV
  • Text: The utility of PTSD and "moral injury" clinical and diagnostic concepts in detransition care
  • Start tag: <div class="field-content news-subtitle">
  • XPath: /html/body/div[1]/section[4]/div[1]/div[1]/div[2]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[3]/div[1]
  • Bounding box: x = 130, y = 2658, width = 741, height = 46
  • Reported by Axe + Pour + SureA11y + WAVE
  • Take me there
  • What diagnoses were reported?

• Element 275

  • Tag name: SPAN
  • Text: Read more
  • Start tag: <span class="field-content">
  • XPath: /html/body/div[1]/section[4]/div[1]/div[1]/div[2]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[5]/span[1]
  • Bounding box: x = 130, y = 2804, width = 118, height = 23
  • Reported by Alfa
  • What diagnoses were reported?

• Element 276

  • Tag name: A
  • Text: Read more
  • Start tag: <a href="/Detransition-PTSD-moral-injury" hreflang="en">
  • XPath: /html/body/div[1]/section[4]/div[1]/div[1]/div[2]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[5]/span[1]/a[1]
  • Bounding box: x = 130, y = 2804, width = 118, height = 23
  • Reported by Axe + Pour + SureA11y + WAVE
  • What diagnoses were reported?

• Element 436

  • Tag name: DIV
  • Text: December 1, 2025
  • Start tag: <div>
  • XPath: /html/body/div[1]/section[4]/div[1]/div[1]/div[2]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[10]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]
  • Bounding box: x = 8410, y = 2591, width = 741, height = 21
  • Reported by Pour + SureA11y + WAVE
  • Take me there
  • What diagnoses were reported?

• Element 435

  • Tag name: H4
  • Text: Publication date
  • Start tag: <h4>
  • XPath: /html/body/div[1]/section[4]/div[1]/div[1]/div[2]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[10]/div[1]/div[1]/div[1]/div[1]/div[1]/h4[1]
  • Bounding box: x = 8410, y = 2546, width = 741, height = 21
  • Reported by Pour + SureA11y
  • What diagnoses were reported?

• Element 440

  • Tag name: A
  • Text: Notable Publications in Gender Medicine, September–October 2025
  • Start tag: <a href="/SEGM-Digest-Issue4-2025" hreflang="en">
  • XPath: /html/body/div[1]/section[4]/div[1]/div[1]/div[2]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[10]/div[1]/div[1]/div[2]/div[1]/span[1]/a[1]
  • Bounding box: x = 8410, y = 2624, width = 741, height = 29
  • Reported by HTML CodeSniffer
  • Take me there
  • What diagnoses were reported?

• Element 442

  • Tag name: DIV
  • Text: SEGM Digest, Issue 4 (September–October)
  • Start tag: <div class="field-content news-subtitle">
  • XPath: /html/body/div[1]/section[4]/div[1]/div[1]/div[2]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[10]/div[1]/div[1]/div[3]/div[1]
  • Bounding box: x = 8410, y = 2658, width = 741, height = 23
  • Reported by Pour + SureA11y + WAVE
  • Take me there
  • What diagnoses were reported?

• Element 447

  • Tag name: A
  • Text: Read more
  • Start tag: <a href="/SEGM-Digest-Issue4-2025" hreflang="en">
  • XPath: /html/body/div[1]/section[4]/div[1]/div[1]/div[2]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[10]/div[1]/div[1]/div[5]/span[1]/a[1]
  • Bounding box: x = 8410, y = 2781, width = 118, height = 23
  • Reported by Pour + SureA11y + WAVE
  • What diagnoses were reported?

• Element 451

  • Tag name: A
  • Text: More Spotlight
  • Start tag: <a class="red-more-news" href="/news">
  • XPath: /html/body/div[1]/section[4]/div[1]/div[1]/div[2]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[11]/div[1]/div[1]/a[1]
  • Bounding box: x = 9598, y = 2627, width = 204, height = 42
  • Reported by HTML CodeSniffer + Pour + SureA11y + WAVE
  • Take me there
  • What diagnoses were reported?

• Element 282

  • Tag name: DIV
  • Text: Publication date … September 29, 2026
  • Start tag: <div class="field field-publication-date node datetime field__field-publication-date field--datetime field--datetime__field-publication-date field--node__field-publication-date field--node--datetime____field-publication-date">
  • XPath: /html/body/div[1]/section[4]/div[1]/div[1]/div[2]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[2]/div[1]/div[1]/div[1]/div[1]/div[1]
  • Bounding box: x = 1050, y = 2546, width = 741, height = 65
  • Reported by Alfa
  • Take me there
  • What diagnoses were reported?

• Element 284

  • Tag name: DIV
  • Text: September 29, 2026
  • Start tag: <div>
  • XPath: /html/body/div[1]/section[4]/div[1]/div[1]/div[2]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[2]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]
  • Bounding box: x = 1050, y = 2591, width = 741, height = 21
  • Reported by Axe + Pour + SureA11y + WAVE
  • Take me there
  • What diagnoses were reported?

• Element 283

  • Tag name: H4
  • Text: Publication date
  • Start tag: <h4>
  • XPath: /html/body/div[1]/section[4]/div[1]/div[1]/div[2]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[2]/div[1]/div[1]/div[1]/div[1]/div[1]/h4[1]
  • Bounding box: x = 1050, y = 2546, width = 741, height = 21
  • Reported by Axe + Pour + SureA11y
  • What diagnoses were reported?

• Element 288

  • Tag name: A
  • Text: Ten Myths of Pediatric Gender Medicine
  • Start tag: <a href="/Key-Myths-Youth-Gender%20Medicine-PT" hreflang="en">
  • XPath: /html/body/div[1]/section[4]/div[1]/div[1]/div[2]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[2]/div[1]/div[1]/div[2]/div[1]/span[1]/a[1]
  • Bounding box: x = 1050, y = 2624, width = 446, height = 29
  • Reported by HTML CodeSniffer
  • Take me there
  • What diagnoses were reported?

• Element 289

  • Tag name: DIV
  • Text: SEGM responds to claims about puberty blockers and cross-sex hormones for the Portuguese Parliament
  • Start tag: <div class="views-field views-field-field-subtitle">
  • XPath: /html/body/div[1]/section[4]/div[1]/div[1]/div[2]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[2]/div[1]/div[1]/div[3]
  • Bounding box: x = 1050, y = 2658, width = 741, height = 46
  • Reported by Alfa
  • Take me there
  • What diagnoses were reported?

• Element 290

  • Tag name: DIV
  • Text: SEGM responds to claims about puberty blockers and cross-sex hormones for the Portuguese Parliament
  • Start tag: <div class="field-content news-subtitle">
  • XPath: /html/body/div[1]/section[4]/div[1]/div[1]/div[2]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[2]/div[1]/div[1]/div[3]/div[1]
  • Bounding box: x = 1050, y = 2658, width = 741, height = 46
  • Reported by Axe + Pour + SureA11y + WAVE
  • Take me there
  • What diagnoses were reported?

• Element 294

  • Tag name: SPAN
  • Text: Read more
  • Start tag: <span class="field-content">
  • XPath: /html/body/div[1]/section[4]/div[1]/div[1]/div[2]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[2]/div[1]/div[1]/div[5]/span[1]
  • Bounding box: x = 1050, y = 2804, width = 118, height = 23
  • Reported by Alfa
  • What diagnoses were reported?

• Element 295

  • Tag name: A
  • Text: Read more
  • Start tag: <a href="/Key-Myths-Youth-Gender%20Medicine-PT" hreflang="en">
  • XPath: /html/body/div[1]/section[4]/div[1]/div[1]/div[2]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[2]/div[1]/div[1]/div[5]/span[1]/a[1]
  • Bounding box: x = 1050, y = 2804, width = 118, height = 23
  • Reported by Axe + Pour + SureA11y + WAVE
  • What diagnoses were reported?

• Element 301

  • Tag name: DIV
  • Text: Publication date … July 30, 2026
  • Start tag: <div class="field field-publication-date node datetime field__field-publication-date field--datetime field--datetime__field-publication-date field--node__field-publication-date field--node--datetime____field-publication-date">
  • XPath: /html/body/div[1]/section[4]/div[1]/div[1]/div[2]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[3]/div[1]/div[1]/div[1]/div[1]/div[1]
  • Bounding box: x = 1970, y = 2546, width = 741, height = 65
  • Reported by Alfa
  • Take me there
  • What diagnoses were reported?

• Element 303

  • Tag name: DIV
  • Text: July 30, 2026
  • Start tag: <div>
  • XPath: /html/body/div[1]/section[4]/div[1]/div[1]/div[2]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[3]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]
  • Bounding box: x = 1970, y = 2591, width = 741, height = 21
  • Reported by Pour + SureA11y + WAVE
  • Take me there
  • What diagnoses were reported?

• Element 302

  • Tag name: H4
  • Text: Publication date
  • Start tag: <h4>
  • XPath: /html/body/div[1]/section[4]/div[1]/div[1]/div[2]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[3]/div[1]/div[1]/div[1]/div[1]/div[1]/h4[1]
  • Bounding box: x = 1970, y = 2546, width = 741, height = 21
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  • Text: SEGM reviews Mikael Landén’s new article
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  • Text: June 16, 2026
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  • Text: New analysis raises serious questions about claims that restrictive laws increased youth suicide attempts.
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  • Text: April 2, 2026
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  • Text: Assessing the Trustworthiness of the Analysis, Conclusions and Recommendations
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  • Text: February 5, 2026
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  • Text: The American Society of Plastic Surgeons Rejects Adolescent Gender Surgery and Raises Serious Concerns Regarding All Minor Gender Transitions
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  • Text: ASPS Position Statement: gender surgery for minors fails the evidence test
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  • Text: February 1, 2026
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  • Text: Swiss Report of Decline in Youth Gender Dysphoria Does Not Add Up
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  • Text: Reevaluating recent claims of a "collapse" in demand for gender transitions in youth
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  • Text: Read more
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  • Text: January 22, 2026
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  • Text: Trans is Not the New Gay
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  • Text: How psychoanalytic elitism and the rejection of science are creating a repetition of the past
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  • Text: Read more
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  • Text: January 12, 2026
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  • Text: Treatment of young people with gender incongruence requires more than consent
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  • Text: This article appeared on Aftenposten on November 17, 2025, and is translated and reproduced here with permission.
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  • Text: SEGM in Media
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  • Text: “
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  • Text: All this echoes warnings issued in some European countries. In 2024 a report commissioned by Britain’s government, known as the Cass Review, concluded that evidence for the benefits (and harms) of puberty blockers and cross-sex hormones on children and adolescents was “remarkably weak”. Under President Donald Trump, America’s federal department of health and human services issued a similar report, which agreed that the evidence of...
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  • Text: All this echoes warnings issued in some European countries. In 2024 a report commissioned by Britain’s government, known as the Cass Review, concluded that evidence for the benefits (and harms) of puberty blockers and cross-sex hormones on children and adolescents was “remarkably weak”. Under President Donald Trump, America’s federal department of health and human services issued a similar report, which agreed that the evidence of...
  • Start tag: <a href="https://www.economist.com/united-states/2026/02/06/lawsuits-over-transgender-medicine-for-minors-could-be-huge" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer">
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  • Text: Recently I attended a conference in New York, hosted by Society for Evidence Based Gender Medicine (SEGM), a US-based non-profit, where I was asked to give a presentation on ‘lessons from the largest youth gender clinic in the world’ – for that’s what GIDS was...The conference was attended by professionals from other youth gender clinics around the Western world, which – like GIDS – have also received a rapid increase in referrals. And,...
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  • Text: For two years in a row, AAP members submitted formal resolutions to the executive board asking “that the academy commit to the principles of evidence based medicine by eschewing narrative and other types of non-systematic reviews as the basis for its recommendations” and either use existing systematic reviews or commission its own.
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• Element 641

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  • Text: A resolution submitted in April with two dozen signatories also asked that an “urgent...
  • Start tag: <a href="https://www.bmj.com/content/382/bmj.p1877" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer">
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  • Text: In June, England’s National Health Service announced that it would restrict the use of puberty blockers to clinical trials because “there is not enough evidence to support their safety or clinical effectiveness as a routinely...
  • Start tag: <p>
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• Element 657

  • Tag name: A
  • Text: In June, England’s National Health Service
  • Start tag: <a href="https://www.nytimes.com/2023/08/03/health/aap-gender-affirming-care-evidence-review.html" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer">
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  • Tag name: A
  • Text: announced
  • Start tag: <a href="https://www.nytimes.com/2023/08/03/health/aap-gender-affirming-care-evidence-review.html" title="" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer">
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• Element 659

  • Tag name: A
  • Text: that it would restrict the use of puberty blockers to clinical trials because “there is not enough evidence to support their safety or clinical effectiveness as a routinely...
  • Start tag: <a href="https://www.nytimes.com/2023/08/03/health/aap-gender-affirming-care-evidence-review.html" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer">
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• Element 494

  • Tag name: P
  • Text: Inside the conference, we heard about the ways in which adolescent development can get stuck in perpetuity — descriptions which, let’s be honest, now apply to much of society at large. There’s black-and-white thinking, and a lack of tolerance for ambiguity. There’s a splitting of the world into good or bad objects, along with an inability to think through the consequences of present actions or to care about the future. There’s a fear of sexual development and reproduction; and...
  • Start tag: <p>
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• Element 495

  • Tag name: A
  • Text: Inside the conference, we heard about the ways in which adolescent development can get stuck in perpetuity — descriptions which, let’s be honest, now apply to much of society at large. There’s black-and-white thinking, and a lack of tolerance for ambiguity. There’s a splitting of the world into good or bad objects, along with an inability to think through the consequences of present actions or to care about the future. There’s a fear of sexual development and reproduction; and...
  • Start tag: <a href="https://unherd.com/2025/09/toddler-logic-is-poisoning-politics/" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer">
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  • Tag name: P
  • Text: The conference was organized by the Society for Evidence Based Gender Medicine. Their principle: “Young people with gender dysphoria deserve respect, compassion and high-quality care based on scientific evidence.” SEGM formed in 2019 because it was “in concern in the face of a rapidly growing group of vulnerable adolescents with gender dysphoria who have undergone highly medicalized treatment,” which “has never been proven to be effective or safe.” According to its...
  • Start tag: <p>
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• Element 511

  • Tag name: A
  • Text: The conference was organized by the Society for Evidence Based Gender Medicine. Their principle: “Young people with gender dysphoria deserve respect, compassion and high-quality care based on scientific evidence.” SEGM formed in 2019 because it was “in concern in the face of a rapidly growing group of vulnerable adolescents with gender dysphoria who have undergone highly medicalized treatment,” which “has never been proven to be effective or safe.” According to its...
  • Start tag: <a href="https://www.emma.de/artikel/transaktivisten-bedrohen-wissenschaftler-341999" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer">
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• Element 527

  • Tag name: A
  • Text: Dr D’Angelo told today’s conference attendees—who included current and former leaders of gender clinics as well as researchers and practitioners from around the world—that the labelling of SEGM as a “hate group” was “a deliberate and damaging misrepresentation of our work. Our focus on evidence-based care is not an act of hate—it is an act of advocacy for safe, effective healthcare for all sexual- and gender-minority individuals,” he said. “These false labels are not just an attack...
  • Start tag: <a href="https://www.genderclinicnews.com/p/evidence-over-ideology" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer">
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• Element 543

  • Tag name: A
  • Text: Letters to WHO from the Society for Evidence Based Gender Medicine (SEGM), which has itself commissioned several forthcoming relevant systematic reviews, and the Clinical Advisory Network on Sex and Gender (CAN-SG), a network of mainly UK and Irish clinicians, raised the question of whether WHO would be evaluating the benefits and harms of hormonal treatments for gender incongruence—or if instead it “has taken a policy position on this without critically appraising the evidence,” as a letter from...
  • Start tag: <a href="https://www.bmj.com/content/387/bmj.q2227" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer">
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• Element 559

  • Tag name: A
  • Text: The review by Hilary Cass, paediatrician and former president of the Royal College of Paediatrics and Child Health, was commissioned by the NHS and built on the findings of Cass’s 2022 interim report. Then, she found that the evidence underpinning the treatment intensive, “gender affirming” model of care for distressed young people was “limited” and “inconclusive.” The final report is even clearer: “The reality is that we have no good evidence on the long term outcomes of interventions to manage...
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• Element 575

  • Tag name: A
  • Text: In October 2023, SEGM held its first official conference in New York, which brought together an array of high-profile speakers, such as Mikael Landén, a psychiatrist and researcher at Sweden’s Karolinska Institute, and Sallie Baxendale, a professor of clinical neuropsychology at University College London. Journalists from Canadian public radio attended, along with then-BBC Newsnight reporter Hannah Barnes, whose bestselling book “Time to Think” chronicled the rise...
  • Start tag: <a href="https://undark.org/2024/05/20/pediatric-transgender-care-contentious-segm/" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer">
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• Element 591

  • Tag name: A
  • Text: It is especially hard for kids who are making decisions about their identities when those identities are still evolving. Many construct their lives around this new identity. To admit they have changed their minds, especially during the excruciatingly self-conscious period of adolescence, when they are deeply susceptible to peer judgment, is that much harder. The effects of medical transition —...
  • Start tag: <a href="https://www.nytimes.com/live/2024/01/30/opinion/thepoint?searchResultPosition=2#transgender-detransitioning-numbers" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer">
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• Element 607

  • Tag name: A
  • Text: On Thursday, the Society for Evidence Based Gender Medicine, or SEGM, issued its second letter criticizing the WHO’s effort, critiquing the guidelines-development process as apparently flawed from the time of its quiet inception two to three years ago... SEGM, in its new letter, asserted that those original two WHO guidelines made claims, specifically that cross-sex...
  • Start tag: <a href="https://www.nysun.com/article/beleaguered-world-health-organization-wades-into-transgender-debate-and-is-met-with-uproar-over-plans-to-develop-guidelines-on-trans-healthcare" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer">
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  • Tag name: P
  • Text: Historically, the small numbers of children presenting with gender dysphoria were primarily prepubescent males. In recent years, there has been a sharp increase in referrals of adolescents, and particularly adolescent females, to gender clinics. Many do not have a significant history of childhood gender dysphoria and a number suffer from comorbid mental health issues and neurodevelopmental conditions such as autism (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD). The reasons for these changes are understudied and remain poorly understood.
  • Start tag: <p style="line-height: 1.6em;">
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• Element 697

  • Tag name: A
  • Text: adolescent females
  • Start tag: <a href="http://link.springer.com/10.1007/s10508-018-1204-9" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer">
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• Element 698

  • Tag name: A
  • Text: comorbid
  • Start tag: <a href="https://doi.org/10.1186/s13034-015-0042-y" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer">
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• Element 699

  • Tag name: A
  • Text: mental health issues
  • Start tag: <a href="//doi.org/10.1542/peds.2017-3845" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer">
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• Element 700

  • Tag name: A
  • Text: autism (ASD)
  • Start tag: <a href="https://doi.org/10.1080/15374416.2016.1228462" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer">
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• Element 701

  • Tag name: A
  • Text: Attention-Deficit/Hyperactivity Disorder (ADHD)
  • Start tag: <a href="https://doi.org/10.1007/s10803-019-04298-1" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer">
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• Element 702

  • Tag name: P
  • Text: Childhood-onset gender dysphoria has been shown to have a high rate of natural resolution, with 61-98% of children reidentifying with their biological sex during puberty. The research into the course of gender dysphoria desistance among the cohort presenting with adolescent-onset gender dysphoria is still in its infancy, due to the novelty of this presentation. However, recent research from the UK clinic population suggests that 10-12% of youth may be detransitioning within 16 months to 5 years of initiating medical interventions, with an additional 20-22% discontinuing treatments for a range of reasons. The researchers noted that the detransition rate found in the recently-presenting population raises critical questions about the phenomenon of "overdiagnosis, overtreatment, or iatrogenic harm as found in other medical fields." U.S. data suggest that the rate of medical detransition has reached ~30%.
  • Start tag: <p style="line-height: 1.6em;">
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  • Tag name: A
  • Text: 61-98%
  • Start tag: <a href="https://pubmed.ncbi.nlm.nih.gov/26754056/" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer">
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• Element 704

  • Tag name: A
  • Text: 10
  • Start tag: <a href="https://www.mdpi.com/2227-9032/10/1/121" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer">
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• Element 705

  • Tag name: A
  • Text: 12%
  • Start tag: <a href="https://doi.org/10.1192/bjo.2021.1022" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer">
  • XPath: /html/body/div[1]/section[6]/div[1]/div[1]/div[2]/div[1]/div[2]/div[1]/p[2]/a[3]
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• Element 706

  • Tag name: A
  • Text: 20
  • Start tag: <a href="https://doi.org/10.1192/bjo.2021.1022" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer">
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• Element 707

  • Tag name: A
  • Text: 22%
  • Start tag: <a href="https://www.mdpi.com/2227-9032/10/1/121" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer">
  • XPath: /html/body/div[1]/section[6]/div[1]/div[1]/div[2]/div[1]/div[2]/div[1]/p[2]/a[5]
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• Element 708

  • Tag name: A
  • Text: overdiagnosis, overtreatment, or iatrogenic harm as found in other medical fields
  • Start tag: <a href="https://www.mdpi.com/2227-9032/10/1/121" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer">
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• Element 709

  • Tag name: A
  • Text: has reached ~30%
  • Start tag: <a href="https://academic.oup.com/jcem/article/107/9/e3937/6572526" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer">
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• Element 751

  • Tag name: BLOCKQUOTE
  • Text: SEGM in Twitter … — SEGM (@segm_ebm) __
  • Start tag: <blockquote class="twitter-tweet" data-twitter-extracted-i1791411973732840207="true">
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  • Tag name: A
  • Text: __
  • Start tag: <a href="https://twitter.com/segm_ebm/status/2106880570638926325" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer">
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  • What diagnoses were reported?

• Element 752

  • Tag name: P
  • Text: SEGM in Twitter
  • Start tag: <p lang="en" dir="ltr">
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  • What diagnoses were reported?

• Element 759

  • Tag name: BLOCKQUOTE
  • Text: SEGM in Twitter … — SEGM (@segm_ebm) __
  • Start tag: <blockquote class="twitter-tweet" data-twitter-extracted-i1791411973732840207="true">
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  • Text: SEGM in Twitter
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  • Text: SEGM in Twitter … — SEGM (@segm_ebm) __
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  • Text: __
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  • What diagnoses were reported?

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  • Text: SEGM in Twitter
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  • Text: SEGM in Twitter … — SEGM (@segm_ebm) __
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  • Text: __
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  • Text: SEGM in Twitter
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  • What diagnoses were reported?

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  • Tag name: DIV
  • Text: SEGM in Twitter … — SEGM (@segm_ebm) __
  • Start tag: <div class="slider-item-body">
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  • Text: SEGM in Twitter … — SEGM (@segm_ebm) __
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  • Text: __
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  • Text: SEGM in Twitter
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  • Tag name: BLOCKQUOTE
  • Text: SEGM in Twitter … — SEGM (@segm_ebm) __
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  • Text: __
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  • Text: SEGM in Twitter
  • Start tag: <p lang="en" dir="ltr">
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  • Text: SEGM in Twitter … — SEGM (@segm_ebm) __
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  • Text: __
  • Start tag: <a href="https://twitter.com/segm_ebm/status/2099921020798800097" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer">
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  • What diagnoses were reported?

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  • Text: SEGM in Twitter
  • Start tag: <p lang="en" dir="ltr">
  • XPath: /html/body/div[1]/section[7]/div[1]/div[1]/div[2]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/div[7]/div[1]/div[1]/div[1]/div[1]/blockquote[1]/p[1]
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  • What diagnoses were reported?

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  • Tag name: P
  • Text: Historically, medical interventions to achieve the appearance of the desired sex were reserved primarily for adults with long histories of dysphoria. Such interventions were preceded by a prolonged engagement with the patient, including thorough psychological assessments. While objective population-level data of adult gender transitioners show persistent mental health struggles and sharply elevated mortality and morbidity, subjective patient-reported outcomes suggest low regret rates. Unfortunately, "regret" studies routinely fail to get in touch with 20-60% of the transitioned patients, leaving unanswered questions about the substantial number lost to follow-up. 'Regret" studies also suffer from other significant limitations. However, there is little reason to doubt that a number of adult transitioners, having made an informed decision regarding the balance of benefits, harms, and uncertainties, live rewarding lives.
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  • Take me there
  • What diagnoses were reported?

• Element 825

  • Tag name: A
  • Text: persistent mental health struggles
  • Start tag: <a class="ext" href="http://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2020.1778correction" data-extlink="" rel="noopener nofollow noreferrer" tabindex="-1" target="_blank" title="(opens in a new window)">
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  • What diagnoses were reported?

• Element 826

  • Tag name: A
  • Text: mortality and morbidity
  • Start tag: <a class="ext" href="https://doi.org/10.1371/journal.pone.0016885" data-extlink="" rel="noopener nofollow noreferrer" tabindex="-1" target="_blank" title="(opens in a new window)">
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  • What diagnoses were reported?

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  • Tag name: A
  • Text: 20-60%
  • Start tag: <a class="ext" href="http://journals.sagepub.com/doi/10.1177/1039856218775216" data-extlink="" rel="noopener nofollow noreferrer" target="_blank" title="(opens in a new window)">
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  • Take me there
  • What diagnoses were reported?

• Element 828

  • Tag name: A
  • Text: significant
  • Start tag: <a class="ext" href="https://link.springer.com/article/10.1007/s10508-023-02623-5" data-extlink="" rel="noopener nofollow noreferrer" target="_blank" title="(opens in a new window)">
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  • What diagnoses were reported?

• Element 829

  • Tag name: A
  • Text: limitations
  • Start tag: <a href="https://segm.org/regret-detransition-rate-unknown">
  • XPath: /html/body/div[1]/section[8]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/p[1]/a[5]
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  • What diagnoses were reported?

• Element 830

  • Tag name: P
  • Text: However, around 2010's, there was a marked change in the approach to the management of gender dysphoria, particularly for gender-dysphoric youth. A number of countries in Western Europe, North America, and Australia, began to promote the "gender-affirmative" model of care for youth. Under this model of care, young people presenting with gender dysphoria or asserting a transgender identity are affirmed in their desire to undergo gender transition, and are provided with "barrier-free" hormonal and surgical interventions. While mental health professionals are often involved, their role is typically limited to preparing the young person for gender transition, regardless of any co-occurring mental health challenges or whether there was a relatively recent history of transgender identification. As such, the provision of medical intervention now happens with a much-reduced psychological assessment.
  • Start tag: <p>
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  • Take me there
  • What diagnoses were reported?

• Element 831

  • Tag name: A
  • Text: "gender-affirmative" model of care for youth
  • Start tag: <a class="ext" href="http://doi.apa.org/getdoi.cfm?doi=10.1037/a0037490" data-extlink="" rel="noopener nofollow noreferrer" tabindex="-1" target="_blank" title="(opens in a new window)">
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  • Take me there
  • What diagnoses were reported?

• Element 832

  • Tag name: A
  • Text: hormonal and surgical interventions
  • Start tag: <a class="ext" href="https://linkinghub.elsevier.com/retrieve/pii/S2352464221001292" data-extlink="" rel="noopener nofollow noreferrer" tabindex="-1" target="_blank" title="(opens in a new window)">
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  • Take me there
  • What diagnoses were reported?

• Element 833

  • Tag name: P
  • Text: In the last 36 months, a growing number of Western countries have recognized the significant concerns with the "gender-affirmative" model of care, which became visible, in part, due to the growing voices of detransitioners and regretters coming from the novel population of gender-dysphoric youth. After completing systematic reviews of evidence, which showed that the risk-benefit ratio of youth transitions ranges from uncertain to unfavorable, these countries have begun to sunset the "gender-affirmation" practice in favor of an approach that favors psychosocial interventions as the first, and usually the only line of treatment available to most minors.
  • Start tag: <p>
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  • Take me there
  • What diagnoses were reported?

• Element 834

  • Tag name: A
  • Text: systematic
  • Start tag: <a class="ext" href="https://cass.independent-review.uk/nice-evidence-reviews/" data-extlink="" rel="noopener nofollow noreferrer" target="_blank" title="(opens in a new window)">
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  • Take me there
  • What diagnoses were reported?

• Element 835

  • Tag name: A
  • Text: reviews
  • Start tag: <a class="ext" href="https://onlinelibrary.wiley.com/doi/abs/10.1111/apa.16791" data-extlink="" rel="noopener nofollow noreferrer" target="_blank" title="(opens in a new window)">
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  • Take me there
  • What diagnoses were reported?

• Element 836

  • Tag name: A
  • Text: evidence
  • Start tag: <a class="ext" href="https://palveluvalikoima.fi/documents/1237350/22895008/Valmistelumuistion+Liite+1.+Kirjallisuuskatsaus.pdf/5ad0f362-8735-35cd-3e53-3d17a010f2b6/Valmistelumuistion+Liite+1.+Kirjallisuuskatsaus.pdf?t=1592317703000" data-extlink="" rel="noopener nofollow noreferrer" target="_blank" title="(opens in a new window)">
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  • Take me there
  • What diagnoses were reported?

• Element 839

  • Tag name: LI
  • Text: Sweden has made the decision to no longer offer gender transition to minors outside of research settings, and restricted eligibility to the "classic" early childhood onset of gender dysphoria. All others are to be treated with psychosocial support and psychotherapy, with a focus on accepting and thriving in natal puberty.
  • Start tag: <li>
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  • What diagnoses were reported?

• Element 840

  • Tag name: A
  • Text: Sweden
  • Start tag: <a href="https://segm.org/segm-summary-sweden-prioritizes-therapy-curbs-hormones-for-gender-dysphoric-youth">
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  • What diagnoses were reported?

• Element 841

  • Tag name: LI
  • Text: Finland has sharply restricted eligibility for gender transition to minors with a classic, early childhood-onset of gender dysphoria and no mental health comorbidities, and stated that psychotherapy should be the first line of treatment.
  • Start tag: <li>
  • XPath: /html/body/div[1]/section[8]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/ul[1]/li[2]
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  • What diagnoses were reported?

• Element 842

  • Tag name: A
  • Text: Finland
  • Start tag: <a href="https://segm.org/Finland_deviates_from_WPATH_prioritizing_psychotherapy_no_surgery_for_minors">
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  • What diagnoses were reported?

• Element 843

  • Tag name: LI
  • Text: England banned the use of puberty blockers for gender dysphoria outside of research trials. NHS England's interim clinical policy states that “The primary intervention for children and young people who are assessed as suitable for The Service is psychosocial (including) and psychological support and intervention; the psychoeducation main objective is to alleviate distress associated with gender incongruence and promote the individual’s global functioning and wellbeing.” On March 21, 2024, the NHS also updated its policy on cross-sex hormones for youth, removing the requirement of puberty blockers as a prerequisite step for cross-sex hormone treatment, presumably to make two policies better aligned (since puberty blockers will no longer be available). The final Cass Report was published in April 2024. SEGM's analysis concluded that the report signaled the end of the era of "gender-affirmative," gender-clinic-led model of care in England, with significant worldwide implications. No new prescriptions of cross-sex hormones for minors have been issued since the publication of the final Cass Report, and the use of puberty blockers are only be allowed as part of the PATHWAYS clinical trial, which is set to start recruitment during 2026.
  • Start tag: <li>
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  • Take me there
  • What diagnoses were reported?

• Element 844

  • Tag name: A
  • Text: banned
  • Start tag: <a href="https://www.gov.uk/government/news/ban-on-puberty-blockers-to-be-made-indefinite-on-experts-advice" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer">
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  • What diagnoses were reported?

• Element 845

  • Tag name: A
  • Text: NHS England
  • Start tag: <a class="ext" href="https://www.engage.england.nhs.uk/consultation/puberty-suppressing-hormones/user_uploads/interim-policy-on-puberty-supressing-hormones-for-gender-incongruence-or-dysphoria.pdf" data-extlink="" rel="noopener nofollow noreferrer" target="_blank" title="(opens in a new window)">
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  • What diagnoses were reported?

• Element 847

  • Tag name: A
  • Text: updated
  • Start tag: <a class="ext" href="https://www.england.nhs.uk/publication/clinical-commissioning-policy-prescribing-of-gender-affirming-hormones/" data-extlink="" rel="noopener nofollow noreferrer" target="_blank" title="(opens in a new window)">
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• Element 848

  • Tag name: A
  • Text: April 2024
  • Start tag: <a class="ext" href="https://cass.independent-review.uk/home/publications/final-report/" data-extlink="" rel="noopener nofollow noreferrer" target="_blank" title="(opens in a new window)">
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• Element 849

  • Tag name: A
  • Text: analysis
  • Start tag: <a href="https://segm.org/Final-Cass-Report-2024-NHS-Response-Summary">
  • XPath: /html/body/div[1]/section[8]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/ul[1]/li[3]/a[5]
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• Element 850

  • Tag name: A
  • Text: No new prescriptions
  • Start tag: <a href="https://www.thetimes.com/uk/healthcare/article/nhs-swaps-gender-drugs-for-holistic-care-jxhm3b6vk" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer">
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• Element 851

  • Tag name: A
  • Text: PATHWAYS
  • Start tag: <a href="https://www.kcl.ac.uk/research/pathways-trial" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer">
  • XPath: /html/body/div[1]/section[8]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/ul[1]/li[3]/a[7]
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• Element 852

  • Tag name: LI
  • Text: Following the Cass Report, Wales and Scotland joined England in stopping new prescriptions of puberty blockers as a treatment for gender dysphoria in youth <18. Scotland's policy goes even further than England's. While in England, cross-sex hormones can still be prescribed "around the patient's 16th birthday," they cannot cannot be accessed in Scotland until a patient is 18.
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• Element 853

  • Tag name: A
  • Text: Wales
  • Start tag: <a class="ext" href="https://www.walesonline.co.uk/news/health/under-18s-wont-prescribed-puberty-29039035" data-extlink="" rel="noopener nofollow noreferrer" target="_blank" title="(opens in a new window)">
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• Element 854

  • Tag name: A
  • Text: Scotland
  • Start tag: <a class="ext" href="https://www.bbc.com/news/uk-scotland-68844119" data-extlink="" rel="noopener nofollow noreferrer" target="_blank" title="(opens in a new window)">
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• Element 855

  • Tag name: LI
  • Text: Denmark has restricted eligibility for puberty blockers and cross-sex hormones, currently transitioning only 6% of youth referrals whose gender dysphoria is most consistent with the classic "Dutch" presentation (early childhood onset that intensified in adolescence, but otherwise uncomplicated by mental illness). This change in practice predated a change to treatment guidelines, which will be updated later this year.
  • Start tag: <li>
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• Element 856

  • Tag name: A
  • Text: Denmark
  • Start tag: <a href="https://segm.org/Denmark-sharply-restricts-youth-gender-transitions">
  • XPath: /html/body/div[1]/section[8]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/ul[1]/li[5]/a[1]
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• Element 857

  • Tag name: LI
  • Text: Norway's Healthcare Investigation Board (NHIB/UKOM) has deemed puberty blockers, cross-sex hormones & surgery for children & young people experimental, determining that the current “gender-affirmative” guidelines are not evidence-based and must be revised. Norway's public health authority has signaled an intention to respond to UKOM's concerns with an adjustment to the current treatment guidelines.
  • Start tag: <li>
  • XPath: /html/body/div[1]/section[8]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/ul[1]/li[6]
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• Element 858

  • Tag name: A
  • Text: Norway's
  • Start tag: <a class="ext" href="https://twitter.com/segm_ebm/status/1634032333618819073?s=20" data-extlink="" rel="noopener nofollow noreferrer" target="_blank" title="(opens in a new window)">
  • XPath: /html/body/div[1]/section[8]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/ul[1]/li[6]/a[1]
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• Element 859

  • Tag name: A
  • Text: Norway's public health authority
  • Start tag: <a class="ext" href="https://twitter.com/segm_ebm/status/1673709405605429248?s=20" data-extlink="" rel="noopener nofollow noreferrer" target="_blank" title="(opens in a new window)">
  • XPath: /html/body/div[1]/section[8]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/ul[1]/li[6]/a[2]
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• Element 862

  • Tag name: LI
  • Text: In Australia, the Health Minister Mark Butler announced a national review of care and treatment guidelines for children and young people who identify as transgender. This announcement followed the decision by Queensland's Health Minister to initiate an independent review of prescribing puberty blockers and cross-sex hormones to gender-dysphoric youth, citing regulatory tightening in Finland, Norway, Denmark, Sweden, and the UK. The Queensland review was published in December 2025. The same day, the government of Queensland announced a pause in prescriptions of puberty blockers and cross-sex hormones for minors, pending the publication of the results from the UK's PATHWAYS study. Shortly after, the government of the Norther Territory announced restrictions for the prescription of puberty blockers.
  • Start tag: <li>
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• Element 863

  • Tag name: A
  • Text: Australia
  • Start tag: <a href="https://www.theguardian.com/australia-news/live/2025/jan/31/australia-news-live-antisemitism-anthony-albanese-peter-dutton-dural-caravan-frydenberg-adam-bandt-greens-public-transport-ntwnfb?CMP=share_btn_url&amp;page=with%3Ablock-679c3c988f088478fa0ca84e#block-679c3c988f088478fa0ca84e" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer">
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• Element 864

  • Tag name: A
  • Text: Queensland's Health Minister
  • Start tag: <a href="https://statements.qld.gov.au/statements/101903" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer">
  • XPath: /html/body/div[1]/section[8]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/ul[2]/li[1]/a[2]
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• Element 865

  • Tag name: A
  • Text: The Queensland review
  • Start tag: <a href="https://www.health.qld.gov.au/research-reports/reports/review-investigation/hormone-therapies-review" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer">
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• Element 866

  • Tag name: A
  • Text: announced a pause
  • Start tag: <a href="https://statements.qld.gov.au/statements/104227" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer">
  • XPath: /html/body/div[1]/section[8]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/ul[2]/li[1]/a[4]
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• Element 867

  • Tag name: A
  • Text: announced restrictions
  • Start tag: <a href="https://evrimagaci.org/gpt/northern-territory-bans-puberty-blockers-for-trans-youth-520848" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer">
  • XPath: /html/body/div[1]/section[8]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/ul[2]/li[1]/a[5]
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• Element 868

  • Tag name: LI
  • Text: The Royal Australian and New Zealand College of Psychiatrists (RANZCP) acknowledged that "evidence and professional opinion is divided as to whether an affirmative approach should be taken in relation to treatment of transgender children or whether other approaches are more appropriate." New Zealand delayed its release of evidence review and recommendations for the use of puberty blockers, citing, in part, the Cass Report and the need to consider its findings and recommendations. On November 2025, the Health Ministry announced new regulation halting prescriptions of puberty blockers.
  • Start tag: <li>
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• Element 869

  • Tag name: A
  • Text: The Royal Australian and New Zealand College of Psychiatrists (RANZCP)
  • Start tag: <a href="https://segm.org/first_mental_health_guideline_to_deviate_from_gender_affirmation">
  • XPath: /html/body/div[1]/section[8]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/ul[2]/li[2]/a[1]
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• Element 870

  • Tag name: A
  • Text: delayed
  • Start tag: <a class="ext" href="https://www.rnz.co.nz/news/national/514615/ministry-of-health-delays-review-into-use-of-puberty-blockers" data-extlink="" rel="noopener nofollow noreferrer" target="_blank" title="(opens in a new window)">
  • XPath: /html/body/div[1]/section[8]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/ul[2]/li[2]/a[2]
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• Element 871

  • Tag name: A
  • Text: new regulation
  • Start tag: <a href="https://www.health.govt.nz/regulation-legislation/puberty-blockers" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer">
  • XPath: /html/body/div[1]/section[8]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/ul[2]/li[2]/a[3]
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• Element 872

  • Tag name: LI
  • Text: Italy's National Bioethics Committee (CNB) just updated its stance on puberty blockers (PB) for gender dysphoria. The November 2024 guidance states that PBs should only be provided after mental health internvetions failed, and only in the context of proper research trials.
  • Start tag: <li>
  • XPath: /html/body/div[1]/section[8]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/ul[2]/li[3]
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• Element 873

  • Tag name: A
  • Text: Italy's
  • Start tag: <a href="https://bioetica.governo.it/media/ymhlpqt4/abstract-triptorelina.pdf" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer">
  • XPath: /html/body/div[1]/section[8]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/ul[2]/li[3]/a[1]
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• Element 874

  • Tag name: LI
  • Text: The official journal of the German Medical Association published an article on the controversies in youth gender transition, stating that "the scientific evidence that these therapies are more beneficial than harmful is not as robust as has long been proclaimed." The article discussed the deficiencies in the evidence, noted that countries that were among the first to implement the practice of youth gender transition "are rowing back," and raised questions about implications for Germany's policy. A key German-language systematic review (with an English-translated appendix) updated the NICE systematic reviews and concurred with the findings concerning very low certainty of evidence. At the same time, the Association of the Scientific Medical Societies in Germany completed a "consensus" guideline that ignores the systematic reviews of evidence and promotes youth transitions. Following public criticism of the methodology, including by 15 prominent German Chairs of child adolescent psychiatry, the German guidelines were revised with considerably more cautious rec
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• Element 875

  • Tag name: A
  • Text: The official journal of the German Medical Association
  • Start tag: <a class="ext" href="https://www.aerzteblatt.de/archiv/234841/Pubertaetsblocker-Debatte-um-Transitionstherapie" data-extlink="" rel="noopener nofollow noreferrer" target="_blank" title="(opens in a new window)">
  • XPath: /html/body/div[1]/section[8]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/ul[2]/li[4]/a[1]
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• Element 876

  • Tag name: A
  • Text: systematic review
  • Start tag: <a class="ext" href="https://econtent.hogrefe.com/doi/10.1024/1422-4917/a000972" data-extlink="" rel="noopener nofollow noreferrer" target="_blank" title="(opens in a new window)">
  • XPath: /html/body/div[1]/section[8]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/ul[2]/li[4]/a[2]
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• Element 877

  • Tag name: A
  • Text: English-translated appendix
  • Start tag: <a class="ext" href="https://econtent.hogrefe.com/doi/suppl/10.1024/1422-4917/a000972" data-extlink="" rel="noopener nofollow noreferrer" target="_blank" title="(opens in a new window)">
  • XPath: /html/body/div[1]/section[8]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/ul[2]/li[4]/a[3]
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• Element 878

  • Tag name: A
  • Text: criticism
  • Start tag: <a href="https://segm.org/German-draft-guidelines-gender-dysphoria-children-adolescents-2024">
  • XPath: /html/body/div[1]/section[8]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/ul[2]/li[4]/a[4]
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• Element 879

  • Tag name: A
  • Text: 15 prominent German Chairs of child adolescent psychiatry
  • Start tag: <a href="https://www.zi-mannheim.de/forschung/abteilungen-ags-institute/kjpp/informationen.html" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer">
  • XPath: /html/body/div[1]/section[8]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/ul[2]/li[4]/a[5]
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• Element 880

  • Tag name: LI
  • Text: France's National Academy of Medicine has signaled that work is underway to address the emerging issues with medial "gender affirmation" in minors.
  • Start tag: <li>
  • XPath: /html/body/div[1]/section[8]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/ul[2]/li[5]
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• Element 881

  • Tag name: A
  • Text: France's National Academy of Medicine
  • Start tag: <a href="https://segm.org/France-cautions-regarding-puberty-blockers-and-cross-sex-hormones-for-youth">
  • XPath: /html/body/div[1]/section[8]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/ul[2]/li[5]/a[1]
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• Element 882

  • Tag name: LI
  • Text: Belgium's Director of Cochrane Belgium has expressed public concerns that puberty blockers are experimental and that the treatment guidelines promulgated by WPATH are not evidence-based. However, it is not clear whether the Belgium health authority plans to act on these concerns.
  • Start tag: <li>
  • XPath: /html/body/div[1]/section[8]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/ul[2]/li[6]
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• Element 883

  • Tag name: A
  • Text: Belgium's Director of Cochrane Belgium
  • Start tag: <a class="ext" href="https://twitter.com/segm_ebm/status/1641950432540135424?s=20" data-extlink="" rel="noopener nofollow noreferrer" target="_blank" title="(opens in a new window)">
  • XPath: /html/body/div[1]/section[8]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/ul[2]/li[6]/a[1]
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• Element 884

  • Tag name: LI
  • Text: In the Netherlands, Amsterdam UMC, the clinic that pioneered the Dutch Protocol, has responded to the Cass Report. The response indicated that the Dutch 2018 treatment guidelines are currently undergoing revision. According to the Dutch Health Council, "the Minister for Medical Care has asked the Health Council, among other things, to map out what is scientifically known about the (long-term) consequences of puberty blockers and gender-affirming hormone treatments for physical and mental health. The Minister also asks to compare the Dutch approach with the approach in other countries and with care standards and applicable laws and regulations." It is apparent that the international debate about youth transitions has reached the Netherlands.
  • Start tag: <li>
  • XPath: /html/body/div[1]/section[8]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/ul[2]/li[7]
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• Element 885

  • Tag name: A
  • Text: In the Netherlands
  • Start tag: <a class="ext" href="https://amsterdamumc.org/nl/vandaag/een-reactie-van-amsterdam-umc-op-de-cass-review-over-transgenderzorg.htm" data-extlink="" rel="noopener nofollow noreferrer" target="_blank" title="(opens in a new window)">
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• Element 886

  • Tag name: A
  • Text: Dutch 2018 treatment guidelines
  • Start tag: <a class="ext" href="https://richtlijnendatabase.nl/gerelateerde_documenten/f/19927/Kwaliteitsstandaard%20Transgenderzorg%20-%20Somatisch.pdf" data-extlink="" rel="noopener nofollow noreferrer" target="_blank" title="(opens in a new window)">
  • XPath: /html/body/div[1]/section[8]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/ul[2]/li[7]/a[2]
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• Element 887

  • Tag name: A
  • Text: Dutch Health Council
  • Start tag: <a href="https://www.gezondheidsraad.nl/onderwerpen/zorg/alle-adviezen-over-zorg/transgenderzorg" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer">
  • XPath: /html/body/div[1]/section[8]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/ul[2]/li[7]/a[3]
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• Element 888

  • Tag name: A
  • Text: reached
  • Start tag: <a href="https://segm.org/Dutch-protocol-debate-Netherlands">
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• Element 891

  • Tag name: LI
  • Text: At the Federal level, following the Biden administration's assertions that "gender-affirming" care is safe and effective, the Trump administration issued an executive order (EO) instructing federal agencies to stop the support for the hormonal and surgical gender transitions for minors, and to rescind their reliance on WPATH. The EO ordered the HHS to independently evaluate the evidence and approaches to youth gender dysphoria treatments within 90 days. This executive order will have significant implications for the practice of youth gender medicine in the United States.
  • Start tag: <li>
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• Element 892

  • Tag name: A
  • Text: assertions
  • Start tag: <a href="https://segm.org/fact-checking-gender-affirming-care-and-young-people-HHS">
  • XPath: /html/body/div[1]/section[8]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/ul[3]/li[1]/a[1]
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• Element 893

  • Tag name: A
  • Text: executive order
  • Start tag: <a href="https://www.whitehouse.gov/presidential-actions/2025/01/protecting-children-from-chemical-and-surgical-mutilation/" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer">
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• Element 894

  • Tag name: LI
  • Text: Florida was the first state to have its public health authority disallow medical transitions for youth under 18 (while "grandfathering" existing cases). At least 24 (and as many as 26) states passed laws to ban gender reassignment of minors, which have proven contentious. One of the state lawsuits, U.S. v Skrmetti, is currently awaiting the Supreme Court decision. (SEGM's submitted an Amicus Brief informing the courts of the issues at hand, available here).
  • Start tag: <li>
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• Element 895

  • Tag name: A
  • Text: Florida
  • Start tag: <a class="ext" href="https://nypost.com/2022/11/04/florida-medical-boards-ban-gender-transition-for-minors/" data-extlink="" rel="noopener nofollow noreferrer" target="_blank" title="(opens in a new window)">
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• Element 896

  • Tag name: A
  • Text: contentious
  • Start tag: <a class="ext" href="https://19thnews.org/2022/04/trans-youth-justice-department-warning/" data-extlink="" rel="noopener nofollow noreferrer" target="_blank" title="(opens in a new window)">
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• Element 898

  • Tag name: A
  • Text: Amicus Brief
  • Start tag: <a href="https://www.supremecourt.gov/DocketPDF/23/23-477/323919/20240903143746537_23-477%20Amicus%20Brief%20SEGM.pdf" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer">
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• Element 899

  • Tag name: LI
  • Text: The Endocrine Society's (ES) President recently went on record asserting that gender transition of minors is a proven evidence-based practice. A letter from prominent clinicians involved in treatments of gender-dysphoric youth and evaluation of the outcomes sharply disagreed with such an assessment and called for the medical societies to "align their recommendations with the best available evidence—rather than exaggerating the benefits and minimizing the risks." The ES is currently in the process of updating its treatment guidelines, with no estimate for when n
  • Start tag: <li>
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• Element 900

  • Tag name: A
  • Text: proven evidence-based practice
  • Start tag: <a class="ext" href="https://www.wsj.com/articles/trans-gender-affirming-care-endocrine-society-evidence-fdb8562c?mod=article_inline" data-extlink="" rel="noopener nofollow noreferrer" target="_blank" title="(opens in a new window)">
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• Element 901

  • Tag name: A
  • Text: sharply disagreed
  • Start tag: <a class="ext" href="https://www.wsj.com/articles/trans-gender-affirming-care-transition-hormone-surgery-evidence-c1961e27" data-extlink="" rel="noopener nofollow noreferrer" target="_blank" title="(opens in a new window)">
  • XPath: /html/body/div[1]/section[8]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/ul[3]/li[3]/a[2]
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• Element 902

  • Tag name: LI
  • Text: Most recently, the American Academy of Pediatrics (AAP) finally conceded it was time to conduct an independent review of the evidence and update its guidance, but it has already presaged the review's conclusion, which is that it will support the current pro-affirmation AAP position. This contradicts findings of multiple systematic reviews of evidence that found the benefits of gender transition for minors are highly uncertain, while the risks may be significant. Specifically, if the Endocrine Society's treatment guidelines for gender-dysphoric youth are followed, a minor's future sterility is likely. Other health risks include compromised bone health, altered brain development, cardiovascular complications, and a number of other, as yet unknown, risks.
  • Start tag: <li>
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• Element 903

  • Tag name: A
  • Text: conceded
  • Start tag: <a class="ext" href="https://publications.aap.org/aapnews/news/25340/AAP-reaffirms-gender-affirming-care-policy?autologincheck=redirected" data-extlink="" rel="noopener nofollow noreferrer" target="_blank" title="(opens in a new window)">
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  • What diagnoses were reported?

• Element 912

  • Tag name: A
  • Text: complications
  • Start tag: <a class="ext" href="https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.119.005597" data-extlink="" rel="noopener nofollow noreferrer" target="_blank" title="(opens in a new window)">
  • XPath: /html/body/div[1]/section[8]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/ul[3]/li[4]/a[10]
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• Element 904

  • Tag name: A
  • Text: presaged the review's conclusion
  • Start tag: <a href="https://segm.org/AAP_policy_update_2023_SEGM_recommendations">
  • XPath: /html/body/div[1]/section[8]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/ul[3]/li[4]/a[2]
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• Element 905

  • Tag name: A
  • Text: multiple systematic reviews of evidence
  • Start tag: <a href="https://segm.org/NICE_gender_medicine_systematic_review_finds_poor_quality_evidence">
  • XPath: /html/body/div[1]/section[8]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/ul[3]/li[4]/a[3]
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• Element 906

  • Tag name: A
  • Text: Endocrine Society's
  • Start tag: <a class="ext" href="http://journals.aace.com/doi/10.4158/1934-2403-23.12.1437" data-extlink="" rel="noopener nofollow noreferrer" target="_blank" title="(opens in a new window)">
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• Element 907

  • Tag name: A
  • Text: bone
  • Start tag: <a href="https://segm.org/the_effect_of_puberty_blockers_on_the_accrual_of_bone_mass">
  • XPath: /html/body/div[1]/section[8]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/ul[3]/li[4]/a[5]
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  • What diagnoses were reported?

• Element 908

  • Tag name: A
  • Text: health
  • Start tag: <a class="ext" href="https://academic.oup.com/jcem/article-lookup/doi/10.1210/jc.2014-2439" data-extlink="" rel="noopener nofollow noreferrer" target="_blank" title="(opens in a new window)">
  • XPath: /html/body/div[1]/section[8]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/ul[3]/li[4]/a[6]
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  • What diagnoses were reported?

• Element 909

  • Tag name: A
  • Text: altered
  • Start tag: <a href="10.1016/j.psyneuen.2020.104733">
  • XPath: /html/body/div[1]/section[8]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/ul[3]/li[4]/a[7]
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  • What diagnoses were reported?

• Element 910

  • Tag name: A
  • Text: brain
  • Start tag: <a class="ext" href="http://journal.frontiersin.org/article/10.3389/fnhum.2017.00528/full" data-extlink="" rel="noopener nofollow noreferrer" target="_blank" title="(opens in a new window)">
  • XPath: /html/body/div[1]/section[8]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/ul[3]/li[4]/a[8]
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  • What diagnoses were reported?

• Element 911

  • Tag name: A
  • Text: cardiovascular
  • Start tag: <a class="ext" href="https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.118.038584" data-extlink="" rel="noopener nofollow noreferrer" target="_blank" title="(opens in a new window)">
  • XPath: /html/body/div[1]/section[8]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/ul[3]/li[4]/a[9]
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  • What diagnoses were reported?

• Element 921

  • Tag name: P
  • Text: The practice of medically transitioning minors, currently referred to as "gender-affirmative care," began to gain momentum following a single-site study in the Netherlands. Previously, gender transition was available only to mature adults, with the average age of transition frequently in the 30's. However, it was noted that the results of adult transitions were frequently disappointing, which was believed to be explained by unsatisfactory cosmetic outcomes, particularly for males, who had a "never disappearing masculine appearance." in the 1990's, the Dutch clinicians began to experiment with transitioning minors using endocrine interventions with the hope that a better cosmetic outcome would also lead to better mental health ones. The results of the innovative Dutch experiment, which has become known as "the Dutch Protocol," were documented in two publications: the 2011 study, which reported on cases who underwent puberty blockade, and the 2014 study, which reported on a subset of the cases who completed surgeries, including the removal of ovaries and testes upon reaching the age of 18.
  • Start tag: <p>
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• Element 922

  • Tag name: A
  • Text: mature adults
  • Start tag: <a href="https://dx.plos.org/10.1371/journal.pone.0016885" rel="noopener nofollow noreferrer noreferrer" tabindex="-1" target="_blank" class="ext" data-extlink="">
  • XPath: /html/body/div[1]/section[9]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/p[1]/a[1]
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• Element 923

  • Tag name: A
  • Text: never disappearing masculine appearance
  • Start tag: <a href="https://eje.bioscientifica.com/view/journals/eje/155/suppl_1/1550131.xml" rel="noopener nofollow noreferrer noreferrer" tabindex="-1" target="_blank" class="ext" data-extlink="">
  • XPath: /html/body/div[1]/section[9]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/p[1]/a[2]
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  • What diagnoses were reported?

• Element 924

  • Tag name: A
  • Text: 2011
  • Start tag: <a data-reflink="_i18" data-rid="CIT0039" href="https://doi.org/10.1111/j.1743-6109.2010.01943.x" rel="noopener nofollow noreferrer noreferrer" tabindex="-1" target="_blank" class="ext" data-extlink="">
  • XPath: /html/body/div[1]/section[9]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/p[1]/a[3]
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  • What diagnoses were reported?

• Element 925

  • Tag name: A
  • Text: 2014
  • Start tag: <a data-reflink="_i18" data-rid="CIT0038" href="https://doi.org/10.1542/peds.2013-2958" rel="noopener nofollow noreferrer noreferrer" tabindex="-1" target="_blank" class="ext" data-extlink="">
  • XPath: /html/body/div[1]/section[9]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/p[1]/a[4]
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  • What diagnoses were reported?

• Element 926

  • Tag name: P
  • Text: The youth in the Dutch study reported high levels psychological functioning at 1.5 years after surgery, the study end point. However, both of the studies suffer from a high risk of bias due to their study design and suffer from limited applicability to the populations of adolescents presenting today According to a recently-published overview of the Dutch protocol, the interventions described in the study are currently being applied in the way there were not intended. Specifically, adolescents who were not cross-gender identified prior to puberty, who have significant mental health problems, as well as those who have non-binary identities are now commonly treated using endocrine and surgical interventions described by the Dutch—yet all of these presentations were explicitly disqualified from the Dutch protocol.
  • Start tag: <p>
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• Element 927

  • Tag name: A
  • Text: populations of adolescents presenting today
  • Start tag: <a href="https://doi.org/10.1080/0092623X.2022.2121238" rel="noopener nofollow noreferrer noreferrer" tabindex="-1" target="_blank" class="ext" data-extlink="">
  • XPath: /html/body/div[1]/section[9]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/p[2]/a[1]
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• Element 928

  • Tag name: A
  • Text: recently-published
  • Start tag: <a href="https://www.tandfonline.com/doi/full/10.1080/0092623X.2022.2046221" rel="noopener nofollow noreferrer noreferrer" tabindex="-1" target="_blank" class="ext" data-extlink="">
  • XPath: /html/body/div[1]/section[9]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/p[2]/a[2]
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  • What diagnoses were reported?

• Element 929

  • Tag name: P
  • Text: The study itself suffers from significant limitations, ranging from a weak study design, only marginal improvements in psychological function, and number of under-reported adverse health events that occurred over the course of they study (including 1 case of death and 3 cases of severe morbidity). Researchers have also questions the validity of the gender dysphoria resolution reported by the Dutch, in light of their unusual handling of the gender dysphoria scale. Despite these limitations, the Dutch clinical experiment has become the basis for the practice of medical transition of minors worldwide and serves as the basis for the recommendations outlined in the 2017 Endocrine Society guidelines and has given rise to the so-called "gender affirmative" model of care for youth, which requires access to puberty blockers, hormones, and potentially surgery.
  • Start tag: <p>
  • XPath: /html/body/div[1]/section[9]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/p[3]
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  • What diagnoses were reported?

• Element 930

  • Tag name: A
  • Text: unusual handling of the gender dysphoria scale
  • Start tag: <a href="https://www.tandfonline.com/doi/full/10.1080/0092623X.2022.2046221" rel="noopener nofollow noreferrer noreferrer" tabindex="-1" target="_blank" class="ext" data-extlink="">
  • XPath: /html/body/div[1]/section[9]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/p[3]/a[1]
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  • What diagnoses were reported?

• Element 931

  • Tag name: A
  • Text: Endocrine Society guidelines
  • Start tag: <a href="https://doi.org/10.1210/jc.2017-01658" rel="noopener nofollow noreferrer noreferrer" tabindex="-1" target="_blank" class="ext" data-extlink="">
  • XPath: /html/body/div[1]/section[9]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/p[3]/a[2]
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  • What diagnoses were reported?

• Element 932

  • Tag name: A
  • Text: access to puberty blockers, hormones, and potentially surgery
  • Start tag: <a href="https://linkinghub.elsevier.com/retrieve/pii/S2352464221001292" rel="noopener nofollow noreferrer noreferrer" tabindex="-1" target="_blank" class="ext" data-extlink="">
  • XPath: /html/body/div[1]/section[9]/div[1]/div[1]/div[1]/div[1]/div[1]/div[1]/p[3]/a[3]
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• Element 1005

  • Tag name: P
  • Text: We agree with the concerns voiced by the recent publication, "Reconsidering Informed Consent for Trans-Identified Children, Adolescents, and Young Adults," that the Dutch studies have been misunderstood and misrepresented as providing evidence of the safety and efficacy of hormonal and surgical "gender-affirming" interventions for all youth. It is important that both the strengths and the weaknesses of these studies are thoroughly understood, as these two studies represent the best available evidence behind the practice of pediatric gender transition. You can read more about the strengths and limitations of the Dutch studies here.
  • Start tag: <p>
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• Element 1006

  • Tag name: A
  • Text: Reconsidering Informed Consent for Trans-Identified Children, Adolescents, and Young Adults
  • Start tag: <a href="https://www.tandfonline.com/doi/full/10.1080/0092623X.2022.2046221" rel="noopener nofollow noreferrer noreferrer" tabindex="-1" target="_blank" class="ext" data-extlink="">
  • XPath: /html/body/div[1]/section[9]/div[1]/div[3]/div[1]/div[1]/div[1]/div[1]/p[1]/a[1]
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  • What diagnoses were reported?

• Element 1007

  • Tag name: A
  • Text: here
  • Start tag: <a href="https://www.tandfonline.com/doi/full/10.1080/0092623X.2022.2046221" rel="noopener nofollow noreferrer noreferrer" tabindex="-1" target="_blank" class="ext" data-extlink="">
  • XPath: /html/body/div[1]/section[9]/div[1]/div[3]/div[1]/div[1]/div[1]/div[1]/p[1]/a[2]
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  • What diagnoses were reported?