Gender medicine for children and young people is built on shaky foundations. Here is how we strengthen services

Medicine is a science of uncertainty and an art of probability–William OslerWilliam Osler’s much quoted aphorism is well known to every medical student. Living with medicine’s many uncertainties would be intolerable for doctors and for patients without some coping mechanisms. In Osler’s time, doctors relied on a mix of knowledge, custom, and paternalism to hide uncertainties from patients, and provide treatments they had learnt from their mentors. Nowadays we have the three pillars of evidence based medicine to lean on: the integration of best available research evidence with clinical expertise, and patient values and preferences.My independent review into gender identity services for children and young people is published today.1 When conducting the review, I found that in gender medicine those pillars are built on shaky foundations.I took on this review in full knowledge of the controversial nature of the subject, the polarisation and toxicity of the debate, and the weakness…
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