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At a time when it’s become increasingly difficult for national publications to support trans people and their rights to equality without suffering backlash from lobbyists who oppose gender-affirming care, we’d like to thank The Lancet for its continued efforts in publishing scientifically robust content that affirms the need for a better understanding of transgender and gender diverse people and their physical and mental healthcare needs.

Here we share some examples of the positive work being done by the publication:

Building an understanding of transgender care  – Editorial – April 2021
‘International Transgender Day of Visibility invites us to educate ourselves and pave the way towards acceptance by communities, creating an open environment where people can live with their authentic gender identity. For this year’s campaign, we would like to emphasise the message that gender-affirming hormone therapies are a necessary medical intervention for many transgender people, and haematologists consulted on the thrombotic risk of these patients should not question their need but support the safe continuation of physical transition for people who choose that path

Measurement tools for gender identity, gender expression, and gender dysphoria in transgender and gender-diverse children and adolescents: a systematic review – Review – June 2021
‘Since the development of these tools, societal and cultural attitudes towards gender diversity have evolved substantially, and many of the tools reflect the terminology, understanding, and diagnostic frameworks that were standard at the time of their creation. Consequently, there are limitations with the implementation of many tools in contemporary clinical practice and research [..] most measures do not include items for assessing non-binary or fluid aspects of gender identity and therefore entirely miss these important concepts, which are relevant to many TGD young people

Equity in paediatric care for sexual and gender minority adolescents – Comment – May 2021
‘For health care to be affirmative, it should acknowledge and address sexual and gender minority adolescents’ identities and unique needs [..] for transgender and non-binary adolescents, affirmative care requires access to puberty blockers, hormones, and potentially surgery

We would stress however that publishing opinion-led content, that relies heavily on anecdotal observation rather than evidence, only serves to give a platform to a ‘debate’ that has the potential to cause harm to trans and gender diverse adults and children.

By way of an example, we reference The Lancet‘s recent Correspondence section, where we saw mention that puberty blockers are a “highly experimental treatment”. This is opinion-led, demonstrably false, and in complete contradiction to well established global standards of transgender affirming healthcare (Endocrine Society). puberty blockers are well evidenced and used to great effect in the treatment of gender dysphoria. As highlighted in previous articles published in the Lancet.

The authors then go on to reference and misrepresent the findings of a 2020 Judicial Review regarding the use of puberty blockers, without mentioning that the Judicial Review in question is not only currently subject to an appeal, it has also been partly nullified by a subsequent March 2021 High Court case that ruled that parents can in fact consent to the use of puberty blockers on their children’s behalf.

By doing this the authors present a view that isn’t a true reflection of the current situation, and readers will be forgiven for misunderstanding the discussion about good and effective treatments for those that live with gender dysphoria.

We have contacted The Lancet to ask that all future submissions meet the high standards for which the publication is so well regarded.

 

Photo by Mikhail Pavstyuk on Unsplash