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Doctor's Desk

We rely on medical associations for sound guidance based on the best available evidence. 

So why has American healthcare for gender-distressed youth diverged so sharply from European countries that have conducted systematic evidence reviews? 

In recent years, several systematic reviews of evidence for the use of puberty blockers and hormones for children and adolescents with gender dysphoria have been completed by European public health authorities, two of which can be read here and here. These independent systematic reviews of evidence found the practice of youth gender transition to either not be clearly beneficial, or even net-harmful. 


As noted in a British Medical Journal (BMJ) investigation, Gender dysphoria in young people is rising-and so is professional disagreement, countries including England, Sweden, and Finland have found that the risks of puberty blockers, cross sex hormones and surgeries outweigh the potential benefits, and have shifted to psychosocial support as the first line of treatment for minors.

Medicine Boxes

What's going on with AAP?

“We are making strong recommendations based on weak evidence” 

Dr. Julia Mason, MD

In August 2023, the AAP authorized a systematic review of evidence to update its current gender affirming care policy, while “reaffirming” the existing policy in the interim. 


The call for this systematic review was brought forward through the AAP Resolution process by Dr. Julia Mason, MD, starting in 2020, and has faced significant roadblocks as AAP Leadership began to change the resolution process itself.

Dr. Mason details this history in an interview.

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