Endocrine Society Position on Gender Dysphoria Treatments Not Supported by Available Evidence

A recently-published rebuttal to the Endocrine Society's Position on transgender interventions

In December of 2020, the Endocrine Society, in partnership with the Pediatric Endocrine Society, released a Position Statement regarding transgender health. That position statement asserts that there is a durable biological underpinning to transgender identification and that hormonal and surgical interventions for those suffering from gender dysphoria are safe and effective. The statement additionally claims that such interventions are "standard of care." 

A recently published peer-reviewed letter to the editor of the Journal of Clinical Endocrinology and Metabolism (JCEM), an official journal of the Endocrine Society, argues that these positions are unsupported by current medical evidence. Rather than resting on a durable biological underpinning, gender identity appears to arise in response to a complex interplay of biological, environmental, and cultural factors, and is subject to change over the course of an individual's lifetime. Further, hormonal and surgical interventions are associated with significant physical health risks, and the claims of effectiveness are not supported by the available quality systematic reviews of evidence.

Finally, the current treatment approach promoted by WPATH and the Endocrine Society can only be described as "practice guidelines" and does not rise to the level of "standard of care." Unlike standards of care, which are authoritative, unbiased consensus positions designed to produce optimal outcomes, practice guidelines are suggestions or recommendations to improve care that, depending on their sponsor, may be biased.

The letter argues that the lack of durability of gender identity in young people presenting with gender dysphoria should give pause to administering potentially harmful and often irreversible medical interventions during formative years.