To the Editor: Writing recently in The Lancet, Byng and colleagues1 argue that our clinical guidelines on care of transgender children that appeared in the MJA2 use imprecise language, do not consider long term effects, and lack robust evidence. Several points the authors raise are valid and indeed align with what we and others have written about the state of evidence and need for high quality research in the field.3,4 However, it is important to provide additional clarification.
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- 1. Byng R, Bewley S, Clifford D, McCartney M. Gender‐questioning children deserve better science. Lancet 2018; 392: 2435.
- 2. Telfer MM, Tollit MA, Pace CC, Pang KC. Australian standards of care and treatment guidelines for transgender and gender diverse children and adolescents. Med J Aust 2018; 209: 132–136. https://www.mja.com.au/journal/2018/209/3/australian-standards-care-and-treatment-guidelines-transgender-and-gender .
- 3. Chew D, Anderson J, Williams K, et al. Hormonal treatment in young people with gender dysphoria: a systematic review. Pediatrics 2018; 141: e20173742.
- 4. Schuster MA, Reisner SL, Onorato SE. Beyond bathrooms–meeting the health needs of transgender people. N Engl J Med 2016; 375: 101–103.
- 5. Byng R, Bewley S, Clifford D, McCartney M. Redesigning gender identity services: an opportunity to generate evidence. BMJ 2018; 363: k4490.
- 6. Coleman E, Bockting W, Botzer M, et al. Standards of care for the health of transsexual, transgender, and gender nonconforming people, version 7. Int J Transgend 2012; 13: 165–232.
- 7. Reardon S. Largest ever study of transgender teenagers set to kick off. Nature 2016; 531: 560.
- 8. James SE, Herman JL, Rankin S, et al. The report of the 2015 US Transgender Survey. Washington, DC: National Center for Transgender Equality, 2016.
- 9. Rafferty J. Policy statement: American Academy of Pediatrics. Ensuring comprehensive care and support for transgender and gender‐diverse children and adolescents. Pediatrics 2018; 142: e20182162.
No relevant disclosures.