The World Health Organization Announces Transgender Guideline Plans | SEGM

On December 18, 2023, the World Professional Organization (WHO) announced the final composition of the  Guideline Development Group (GDG), tasked with developing guidelines related to transgender health in 2024, and sought public comment. The guidelines will focus on 5 areas: provision of gender-affirming care, medical training, gender-affirmative health policies, “provision of health care for trans and gender diverse people who suffered interpersonal violence based in their needs”, as well as “legal recognition of self-determined gender identity.” The group is scheduled to meet at the WHO headquarters in Geneva on February 19-21, 2024 to evaluate and interpret the evidence, formulate guideline recommendations, and suggest implementation strategies. Since adolescents and young adults are the largest and fastest-growing group of transgender-identified individuals, it is likely that the WHO guidelines will apply to this vulnerable group as a target population.

There are several concerns related to this WHO announcement. Specifically, they include a biased guideline panel composition, an inappropriately handled public comment period, and the rushed guideline development process overall. Further, the language of the announcement does not appear to be neutral. It states the goal of “increasing access and utilization” of, presumably, gender-affirmative interventions by “trans and gender diverse people,” and declares the goal of legal recognition of “self-determined gender identity.” This suggests that the decision to promote gender transition in the respective societal arenas (medical, policy, legal) has already been made before the group has even met to review and interpret the evidence—a step that must both precede and inform the guideline recommendations. All these concerns put this WHO guideline at risk of producing biased and untrustworthy recommendations.

Countries with strong public health authorities who have demonstrated a commitment to the principles of evidence-based medicine in the area of youth gender medicine (e.g., England, Sweden, Finland) are likely to ignore biased WHO guidelines. However, countries with fewer resources, or countries where public health authorities are just starting to note the international debates, will bear the brunt of contending with a WHO-endorsed guideline that may have the appearance of an evidence-based guideline, but which may be promoting potentially non-beneficial or even harmful interventions for gender-dysphoric youth. For this reason, individuals and organizations concerned with the health and well-being of gender-dysphoric youth should pay close attention to the WHO announcement, and the significant concerns it raises. We elaborate on each of these concerns below. The deadline for public comment is January 8, 2024.

Source: The World Health Organization Announces Transgender Guideline Plans | SEGM

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