---
title: "Systematic reviews and adolescent transgender health: evidence, gaps, and policy implications"
id: "pubmed-42660154"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42660154"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42660154/"
doi: "10.1016/S0140-6736(26)00788-9"
published_at: "2026-08-29T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Systematic reviews and adolescent transgender health: evidence, gaps, and policy implications
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42660154
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42660154/)
- **DOI:** [10.1016/S0140-6736(26)00788-9](https://doi.org/10.1016%2FS0140-6736(26)00788-9)
- **Published At:** 2026-08-29T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- The article is a Viewpoint in Lancet examining how **systematic reviews** have been used in literature and policy concerning medical care for transgender adolescents (puberty start to age 18). - Since 2017, 13 reviews (seven since 2023) have summarized studies of **puberty suppression** and **gender-affirming hormone therapy** on psychosocial, cognitive, and physical outcomes in transgender, gender diverse, and non-binary adolescents. - Systematic reviews are regarded as high-quality evidence in evidence-based medicine; thus their conclusions significantly affect health-care guidance, government policy, and public debate. - The authors review conclusions from these systematic reviews about efficacy and safety of interventions and highlight concerns about misuse of review findings to shape treatment options and care pathways. - The Viewpoint stresses that clinical guideline development should integrate all three pillars of evidence-based medicine: empirical evidence, clinical expertise, and patient values, and that experts in the field should evaluate these facets. - The article documents author affiliations with the Amsterdam University Medical Center and notes funding and other declarations of interest for both authors. - MeSH indexing covers topics including Adolescent, Evidence-Based Medicine, Gender-Affirming Care, Puberty Suppression, Transgender Persons, Health Policy, and Politics, reflecting the clinical and policy focus of the piece. - The authors caution that selective or inappropriate use of systematic reviews can influence care pathways and broader societal debates, implying the need for careful appraisal and balanced guideline processes. - Specific methodological details of the included systematic reviews, numeric outcomes, and granular study-level results are not reported in the abstract and therefore are not provided in this Viewpoint summary.
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Electronic address: alc.devries@amsterdamumc.nl.") Affiliations Expand ### Affiliations * 1 Department of Medical Psychology, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands; Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands. * 2 Department of Child and Adolescent Psychiatry, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands; Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands. Electronic address: alc.devries@amsterdamumc.nl. * PMID: **42660154** * DOI: [ 10.1016/S0140-6736(26)00788-9 ](https://doi.org/10.1016/s0140-6736\(26\)00788-9) Item in Clipboard Review # Systematic reviews and the needs of the adolescent transgender health care field David Matthew Doyle et al. Lancet. 2026. Show details Display options Display options Format Abstract PubMed PMID Lancet Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Lancet%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Lancet%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42660154/) . 2026 Aug 29;408(10557):861-866. doi: 10.1016/S0140-6736(26)00788-9. ### Authors [David Matthew Doyle](https://pubmed.ncbi.nlm.nih.gov/?term=Doyle+DM&cauthor_id=42660154)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42660154/#short-view-affiliation-1 "Department of Medical Psychology, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands; Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands."), [Annelou L C de Vries](https://pubmed.ncbi.nlm.nih.gov/?term=de+Vries+ALC&cauthor_id=42660154)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42660154/#short-view-affiliation-2 "Department of Child and Adolescent Psychiatry, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands; Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands. Electronic address: alc.devries@amsterdamumc.nl.") ### Affiliations * 1 Department of Medical Psychology, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands; Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands. * 2 Department of Child and Adolescent Psychiatry, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands; Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands. Electronic address: alc.devries@amsterdamumc.nl. * PMID: **42660154** * DOI: [ 10.1016/S0140-6736(26)00788-9 ](https://doi.org/10.1016/s0140-6736\(26\)00788-9) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract Gender-affirming medical treatment for adolescents (defined as the start of puberty to age 18 years) has become an increasingly contested area of medicine in recent years. 13 reviews have been conducted since 2017 (with seven since 2023) to summarise studies on the potential effects of pubertal suppression and gender-affirming hormone therapy on psychosocial, cognitive, and physical outcomes in adolescents who are transgender, gender diverse, or non-binary. As systematic reviews are seen as the highest quality of sources of empirical knowledge according to the principles of evidence-based medicine, these reviews have far-reaching influence on government and health-care policies and practice, and prompt broader societal debates. In this Viewpoint, we review the conclusions of these systematic reviews regarding the efficacy and safety of pubertal suppression and gender-affirming hormone therapy for adolescents, and examine how these reviews are being misused to influence treatment options and care pathways. We affirm that the development of clinical guidelines should be underpinned by all three facets of evidence-based medicine (ie, empirical evidence, clinical expertise, and patient values), as evaluated by experts in the field. Copyright © 2026 Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement Declaration of interests DMD reports funding from the European Commission via the European Research Council (ERC-StG 101042028), Marie Skłodowska-Curie Actions (HORIZON-MSCA-DN 101226906), and the Dutch Research Council (406.XS.24.01.070) supporting this work; support for invited keynotes and travel from the EU COST Action Sex and Gender in Vascular Liver Diseases and the European Professional Association for Transgender Health; fees received for grant evaluation for the Polish National Centre for Research and Development; participation on the Trans*GenderJourney External Scientific Advisory Board; and fulfilled an unpaid leadership role in the European Public Health Association as a member of the steering committee of the sexual and gender minority health special interest group, all outside of this Viewpoint. ALCdV reports funding from the Dutch Research Council via the Talentprogramme Vici Netherlands Organisation for Health Research and Development (09150172110101); support for invited keynotes and travel from the Department of Psychiatry at Utrecht University Medical Center, Benecke Medical Education Services, Takeda Nederland, Slovenská lekárska spoločnosť, the World Professional Association for Transgender Health, Klinik für Kinder- und Jugendpsychiatrie, -psychosomatik und-psychotherapie, Henry Benjamin Resource Centre, Society for Psychotherapy Group, Naisen, and Swedish Professional Association for Transgender Health; received payment for expert testimony from Hempsons; and fulfilled unpaid leadership or fiduciary roles as President of the European Professional Association for Transgender Health (EPATH) and EPATH liaison board member of the World Professional Association for Transgender Health, all outside of this Viewpoint. ## Publication types * Review Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Review%22%5Bpt%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Review) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42660154/) ## MeSH terms * Adolescent Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Adolescent%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Adolescent) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42660154/) * Evidence-Based Medicine Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Evidence-Based+Medicine%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Evidence-Based+Medicine) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42660154/) * Female Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Female%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Female) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42660154/) * Gender-Affirming Care* Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Gender-Affirming+Care%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Gender-Affirming+Care) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42660154/) * Health Policy Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Health+Policy%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Health+Policy) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42660154/) * Humans Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Humans%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Humans) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42660154/) * Male Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Male%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Male) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42660154/) * Politics Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Politics%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Politics) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42660154/) * Puberty Suppression Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Puberty+Suppression%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Puberty+Suppression) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42660154/) * Systematic Reviews as Topic* Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Systematic+Reviews+as+Topic%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Systematic+Reviews+as+Topic) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42660154/) * Transgender Persons* / psychology Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Transgender+Persons%2Fpsychology%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Transgender+Persons) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42660154/) [x] Cite Copy Download .nbib .nbib Format: AMA APA MLA NLM **Send To** * [Clipboard](https://pubmed.ncbi.nlm.nih.gov/42660154/) * [Email](https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F42660154%2F%23open-email-panel) * [Save](https://pubmed.ncbi.nlm.nih.gov/42660154/) * [My Bibliography](https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F42660154%2F%23open-bibliography-panel) * [Collections](https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F42660154%2F%23open-collections-panel) * [Citation Manager](https://pubmed.ncbi.nlm.nih.gov/42660154/) [x] NCBI Literature Resources [MeSH](https://www.ncbi.nlm.nih.gov/mesh/) [PMC](https://www.ncbi.nlm.nih.gov/pmc/) [Bookshelf](https://www.ncbi.nlm.nih.gov/books) [Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). 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