McDeavitt, Cohn & Kulatunga-Moruzi
Pediatric Gender Affirming Care is Not Evidence-based is a review article by Kathleen McDeavitt, J. Cohn, and Chan Kulatunga-Moruzi. It was published on May 10, 2025, in the scientific journal Current Sexual Health Reports (volume 17) and is freely available to read as open access.
The main article on this subject is The Dutch Protocol.
The authors discuss what research says about the outcomes of puberty blockers and gender-affirming hormones in minors with gender dysphoria. They examine studies from the past fifteen to twenty years.
Key points
The article addresses three types of outcomes: bone health, metabolic effects, and mental health. According to the authors, individual studies do not show a consistent picture of improved mental health. They argue that research in this area has substantial quality problems, meaning that the evidence as a whole is considered weak and uncertain. They recommend adapting clinical guidelines so that they reflect the limited strength of the evidence.
Structure of the article
The paper is a review article, not new research involving patients. The authors summarize the findings of recent systematic reviews and draw practical conclusions from them. The reference list contains 149 citations. These include WPATH’s 2022 Standards of Care, the Endocrine Society’s 2017 guideline, and the 2024 final report of the Cass Review. The article was published under a Creative Commons license (CC BY 4.0) and may therefore be freely distributed.
Place in the debate
The title expresses a position rather than offering a neutral summary. The Society for Evidence-Based Gender Medicine discussed the article in the first episode of the SEGM Digest and called it an excellent review. The organization itself takes a critical position. In May 2026, McDeavitt and Cohn also published an analysis of three decades of research into the Dutch Protocol. The article is consistent with earlier assessments in this archive, such as the British NICE review from 2020, which rated the evidence for puberty blockers as being of very low certainty. By contrast, the Dutch Health Council reached a different conclusion on June 30, 2026: according to the council, hormone treatments achieve their physical goals and research also shows that they improve mental health. Readers would do well to consider both conclusions side by side.
Why it is included in this archive
It is a recent, freely accessible summary of the critical position in the debate about the evidence base. Other perspectives can be found under science and debate.