US paediatric leaders back gender affirming approach while also ordering evidence review

The American Academy of Paediatrics (AAP) reaffirmed its policy supporting the gender affirming model of care while at the same time announcing that it would commission a systematic review of the evidence and “develop an expanded set of guidance” on medical treatment in minors.1The announcement marks a shift for the AAP, which last year defended its 2018 policy statement 2 to The BMJ as being based on a “rigorous evidence review.”The policy recommends “developmentally appropriate healthcare” including medical and surgical intervention.But some specialists have criticised the academy for promoting treatments whose outcomes lack the certainty afforded by a systematic review of the evidence.3Gordon Guyatt, distinguished professor in the department of health research methods, evidence, and impact at McMaster University and one of the founders of evidence based medicine, explained to The BMJ that with few exceptions, strong recommendations should not be based on low quality evidence. And “trustworthy guidelines” follow…
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