Gender incongruence in children, adolescents, and adults: response to Dr White

We are delighted to clarify the evidence in our editorial for Dr White¹ (a full point-by-point response is available online).²

White states there is ‘no inaccurate information’ from All About Trans³ when countering our claim that charities and non-NHS groups use ‘inaccurate information, including exaggerated risks of suicide’. The blog post claims that ‘hormones can be “life saving” for young people’. It describes a volunteer saying ‘hormone blockers’ were ‘life saving and empowering for young people’. The site states ‘Attempted suicide amongst trans people in the UK is 48% ...’.⁴ This figure (not confirmed via medical records) comes from a subgroup of 27 people responding to a survey, whose average age was 38, with a third considering themselves disabled. This is unlikely to be a representative, relevant, or generalisable relevant sample.⁵

We support children being able to dress and present in the way they wish. The study White cites as supporting children in their socially preferred gender role, and showing benefit of social transition,⁶ is exactly that: it refers to social, not medical, transition. No medical treatments were used. If anything, it suggests that medical intervention in this group was not necessary and points to socially assigned gender roles being harmful.

It is vital that doctors do not foreclose discussion by distorting the little evidence base that does exist. Admitting uncertainty is uncomfortable, but is the vital step to obtaining better research data to improve the care of current and future patients.

• © British Journal of General Practice 2019