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International clinical practice guidelines for gender minority/trans people: systematic review and quality assessment
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  • Published on:
    WPATH Standards of Care: A new edition using outdated methods weakens the trustworthiness of content
    • Sara Dahlen, PhD Student King's College London
    • Other Contributors:
      • Catherine Meads, Professor of Health, Faculty of Health, Education, Medicine and Social Care
      • Susan Bewley, Emeritus Professor of Obstetrics and Women’s Health

    The World Professional Association for Transgender Health’s (WPATH) new Standards of Care version 8 (SoCv8) have been published[1]. Like earlier versions, SoCv8 will be used to justify insurance coverage and medical interventions for gender minority/trans people.

    The Global Applicability section of SOCv8 refers to our systematic review (SR) of international clinical practice guidelines (CPGs) for gender minority/trans people [2]. WPATH recognized the existence of a “wide range of valuable health care resources”[1](pS16), but appears to make oblique criticism about our SR[2] missing resources, especially seven references “that explicitly draw on expertise from regions outside North America and Europe”[1](pS16). We examined these:
    • Two could not have been included as they were published after our study - one password protected educational module[3], another single country guideline[4].
    • Three studies appear in our excluded full studies table (W3) with reasons[5,6,7].
    • An earlier version of one single-country guideline[8] also appears in W3[9].
    • The 2011 WHO guideline[10] and 2016 update[11] of the consolidated WHO guidelines[12] that underpin an implementation document[13] were already included. This implementation document[13] was not identified by key opinion leaders we contacted. Given it aligns with WHO guidelines (reproducing its recommendations, Introduction Table 1 pxix), it too would not meet the SR inclusion criteria.


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    Conflict of Interest:
    None declared.