2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T755,Self-concept clarity, the degree to which an individual has a well-defined and stable sense of self, is a well-documented factor in mental health conditions, particularly eating disorders. Difficulties with self-concept clarity are also reported among gender diverse and neurodivergent people, who are overrepresented in eating disorder populations. This cross-sectional study examined associations between self-concept clarity (Self-Concept Clarity Scale), autistic traits (Autism Spectrum Quotient), ADHD traits (Adult ADHD Self-Report Scale), gender diversity (Gender Self-Report), and disordered eating, a pattern of atypical eating behaviors and attitudes including food restriction and binge eating (Eating Disorder Examination Questionnaire). Gender diversity was assessed as binary (identity opposite to sex assigned at birth) and nonbinary traits (identity neither female nor male). Participants were 492 UK adults (324 assigned female at birth; 98.6% cisgender, 1.2% trans/gender diverse, 0.2% preferred not to say; M age = 41.44 years, SD = 13.11) recruited online. Correlational and path analysis investigated direct and indirect relations between gender diversity, neurodivergent traits, and disordered eating through self-concept clarity. Autistic traits were indirectly related to disordered eating through self-concept clarity, while ADHD traits showed both direct and indirect associations. Greater binary and nonbinary gender diverse traits were correlated with higher levels of disordered eating but were no longer significantly related once neurodivergent traits, age, and sex assigned at birth were controlled. Findings suggest low self-concept clarity may provide a mechanism for increased disordered eating in individuals with higher levels of neurodivergent traits, but not among those with gender diverse traits when covariates are considered.31:T849,Abstract Self-concept clarity, the degree to which an individual has a well-defined and stable sense of self, is a well-documented factor in mental health conditions, particularly eating disorders. Difficulties with self-concept clarity are also reported among gender diverse and neurodivergent people, who are overrepresented in eating disorder populations. This cross-sectional study examined associations between self-concept clarity (Self-Concept Clarity Scale), autistic traits (Autism Spectrum Quotient), ADHD traits (Adult ADHD Self-Report Scale), gender diversity (Gender Self-Report), and disordered eating, a pattern of atypical eating behaviors and attitudes including food restriction and binge eating (Eating Disorder Examination Questionnaire). Gender diversity was assessed as binary (identity opposite to sex assigned at birth) and nonbinary traits (identity neither female nor male). Participants were 492 UK adults (324 assigned female at birth; 98.6% cisgender, 1.2% trans/gender diverse, 0.2% preferred not to say; M age = 41.44 years, SD = 13.11) recruited online. Correlational and path analysis investigated direct and indirect relations between gender diversity, neurodivergent traits, and disordered eating through self-concept clarity. Autistic traits were indirectly related to disordered eating through self-concept clarity, while ADHD traits showed both direct and indirect associations. Greater binary and nonbinary gender diverse traits were correlated with higher levels of disordered eating but were no longer significantly related once neurodivergent traits, age, and sex assigned at birth were controlled. Findings suggest low self-concept clarity may provide a mechanism for increased disordered eating in individuals with higher levels of neurodivergent traits, but not among those with gender diverse traits when covariates are considered. 32:Tb93, Introduction Given the unique mental health challenges among transgender individuals, it is imperative to understand the effectiveness of gender-affirming treatments in alleviating psychological distress. The existing literature gap calls for studies with larger sample sizes, extended follow-up periods, and rigorous controls for confounding variables. This study aims to explore if gender-affirming surgery (GAS) and gender-affirming hormone therapy (GAHT) is associated with improvement in symptoms of depression, anxiety, and gender incongruence among transgender individuals attending a specialist clinic in Hong Kong. Methods In this retrospective cohort which consisted of 394 treatment-seeking transgender participants at baseline, 178 individuals were recruited from October 2023 to June 2024 and completed self-rated questionnaires to assess depressive and anxiety symptoms and gender incongruence. Socio-clinical profiles and questionnaire scores were compared among treatment status groups. Longitudinal changes in mental health outcome scores were analyzed using linear mixed-effects regression models, incorporating time-by-group interactions and random intercepts to account for individual baseline differences. Results Gender-affirming treatments did not reduce depressive or anxiety symptoms significantly, after controlling for coping and social support. However, both GAS and GAHT were associated with significant improvements in gender congruence over time. Mood symptoms were significantly associated with social support and coping. Various sociodemographic and psychosocial factors, including employment status, living situation, psychological care, and psychiatric medication use, were associated with psychological outcomes. Discussion Gender-affirming medical treatments alone may not entirely resolve the mental health difficulties faced by transgender individuals. Future research needs to better elucidate the impacts of persistent psychosocial challenges such as discrimination and rejection, as well as potential treatment complications. The treatment-seeking nature of this cohort, coupled with baseline psychiatric interventions, may have obscured significant correlations. While gender-affirming treatments can enhance gender congruence, our findings highlight the importance of holistic approaches to strengthen adaptive buffering mechanisms throughout the gender transition process. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Gender Dysphoria: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Gender Dysphoria (condition). Clinician-written summaries and actionable practice insights. 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Summaries and tags are based on the abstract content, as the underlying interview data and findings are not present in the provided full text.","value_numeric":null}],"summaries":{"what_studied":"Qualitative study exploring the lived experiences of 22 parents and caregivers of trans and gender diverse (TGD) youth residing in U.S. states with gender-affirming care (GAC) bans; 20 semi-structured interviews conducted in summer–fall 2024.","key_result":"Three overarching themes emerged: (1) uncertainty navigating shifting policy and cultural contexts; (2) complexity across family, community, and institutional/societal levels; and (3) emotional cores of caregiver experience — anger, feeling fortunate, grief/helplessness, and love/protection for their child. Families who stayed in ban states and those who relocated both reported unmet needs around insurance, healthcare access, employment, housing, education, and legal protection.","limitations":"- Very small, non-representative sample (n=22) recruited via social media, support groups, and therapists — likely skewed toward families with existing support networks.\n- Cross-sectional design cannot capture how experiences evolve as policies change.\n- No data on child outcomes; only caregiver perspectives are represented.","practice_takeaway":"Clinicians supporting families of TGD youth in ban states should screen for financial, legal, and housing stressors alongside mental health concerns, as these compound caregiver distress. Connecting families to insurance navigation, legal resources, and affirming community networks is as important as direct psychological support."}},{"doi":"10.1080/0092623x.2026.2685303","pmid":"42266066","title":"Exploring the Psychological Mechanisms of Gender Transition and Detransition","journal_title":"Journal of Sex & Marital Therapy","journal_issn":"0092-623X","published_at":"2026-06-10T00:00:00.000Z","url":"https://doi.org/10.1080/0092623x.2026.2685303","source_score":40,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-16T13:54:31.832Z","updated_at":"2026-06-16T13:54:31.832Z","tags":[{"paper_doi":"10.1080/0092623x.2026.2685303","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1080/0092623x.2026.2685303","tag_type":"category","value":"Psychology, Clinical","value_numeric":null},{"paper_doi":"10.1080/0092623x.2026.2685303","tag_type":"condition","value":"Gender Dysphoria","value_numeric":null},{"paper_doi":"10.1080/0092623x.2026.2685303","tag_type":"condition","value":"Psychiatric Comorbidity","value_numeric":null},{"paper_doi":"10.1080/0092623x.2026.2685303","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1080/0092623x.2026.2685303","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1080/0092623x.2026.2685303","tag_type":"sample_size","value":"n=37","value_numeric":37},{"paper_doi":"10.1080/0092623x.2026.2685303","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1080/0092623x.2026.2685303","tag_type":"study_design","value":"Qualitative Study","value_numeric":null},{"paper_doi":"10.1080/0092623x.2026.2685303","tag_type":"warning","value":"Level of evidence assigned as 4 (qualitative/case series) given the retrospective, non-comparative, small-sample qualitative design; some may rate this lower.","value_numeric":null},{"paper_doi":"10.1080/0092623x.2026.2685303","tag_type":"warning","value":"Sample is drawn exclusively from public online videos of detransitioners, a highly self-selected group; findings may not represent the broader detransitioner or transgender population.","value_numeric":null},{"paper_doi":"10.1080/0092623x.2026.2685303","tag_type":"warning","value":"The full text provided does not match the abstract — the uploaded PDF appears to be the AoIR Internet Research Ethics 3.0 document, not the gender transition/detransition paper. Summary and tags are based solely on the abstract, which may not fully represent the complete study methodology, results, or discussion.","value_numeric":null}],"summaries":{"what_studied":"This qualitative study analyzed retrospective psychological pathways to gender transition and subsequent detransition using public video transcripts from 37 detransitioners (25 female, 12 male), employing a two-step clinical audit and qualitative content analysis.","key_result":"Five overlapping pathways to transition emerged: (1) neurocognitive conditions, (2) prior sexual abuse and dissociation, (3) social contagion and digital amplification, (4) ego-dystonic sexuality, and (5) fear of emerging sexuality and extreme sexual stereotyping. The new identity was reinforced by initial 'validation euphoria' and maintained by sunk-cost psychology. Despite complex post-transition medical sequelae and grief, some participants reported profound relief after detransitioning. Transition appeared to be at least partly an attempt to reduce preexisting psychosocial distress.","limitations":"- Small, self-selected sample (n=37) drawn only from public online videos, limiting generalizability.\n- Retrospective design relies on participants' own reinterpretations of past experiences, introducing recall and attribution bias.\n- No comparison group of transitioners who did not detransition, so pathways identified may not be unique to detransitioners.","practice_takeaway":"Clinicians should conduct thorough psychiatric evaluations and establish a full developmental timeline of adolescent distress and comorbid conditions **before** initiating medical interventions for gender dysphoria. Be alert to diagnostic overshadowing, where gender identity concerns may mask or be driven by underlying mental health conditions."}},{"doi":"10.1016/j.jadohealth.2026.03.016","pmid":"42240523","title":"Stability of Transgender Identity in Adolescents Seen in Multidisciplinary Specialized Gender Centers: A Multicenter Study in Canada","journal_title":"Journal of Adolescent Health","journal_issn":"1054-139X","published_at":"2026-06-03T00:00:00.000Z","url":"https://doi.org/10.1016/j.jadohealth.2026.03.016","source_score":224,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-13T15:34:40.622Z","updated_at":"2026-06-13T15:34:40.622Z","tags":[{"paper_doi":"10.1016/j.jadohealth.2026.03.016","tag_type":"age_group","value":"adolescent","value_numeric":null},{"paper_doi":"10.1016/j.jadohealth.2026.03.016","tag_type":"category","value":"Pediatrics","value_numeric":null},{"paper_doi":"10.1016/j.jadohealth.2026.03.016","tag_type":"condition","value":"Gender Dysphoria","value_numeric":null},{"paper_doi":"10.1016/j.jadohealth.2026.03.016","tag_type":"generic","value":"leuprolide acetate","value_numeric":null},{"paper_doi":"10.1016/j.jadohealth.2026.03.016","tag_type":"generic","value":"medroxyprogesterone acetate","value_numeric":null},{"paper_doi":"10.1016/j.jadohealth.2026.03.016","tag_type":"generic","value":"spironolactone","value_numeric":null},{"paper_doi":"10.1016/j.jadohealth.2026.03.016","tag_type":"generic","value":"triptorelin","value_numeric":null},{"paper_doi":"10.1016/j.jadohealth.2026.03.016","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1016/j.jadohealth.2026.03.016","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/j.jadohealth.2026.03.016","tag_type":"modality","value":"Gender-Affirming Hormone Therapy","value_numeric":null},{"paper_doi":"10.1016/j.jadohealth.2026.03.016","tag_type":"modality","value":"Gonadotropin Suppression Therapy","value_numeric":null},{"paper_doi":"10.1016/j.jadohealth.2026.03.016","tag_type":"sample_size","value":"n=445","value_numeric":445},{"paper_doi":"10.1016/j.jadohealth.2026.03.016","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.jadohealth.2026.03.016","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1016/j.jadohealth.2026.03.016","tag_type":"warning","value":"Median follow-up of 2.4 years is relatively short; long-term detransition or reidentification rates beyond this window are not captured.","value_numeric":null},{"paper_doi":"10.1016/j.jadohealth.2026.03.016","tag_type":"warning","value":"No control or comparison group; all participants received specialized multidisciplinary care, so findings may not apply to less structured care settings.","value_numeric":null},{"paper_doi":"10.1016/j.jadohealth.2026.03.016","tag_type":"warning","value":"Study period (2012–2017) predates WPATH SOC version 8; clinical protocols may differ from current practice.","value_numeric":null},{"paper_doi":"10.1016/j.jadohealth.2026.03.016","tag_type":"warning","value":"The cohort over-represents AFAB adolescents (74.4%), which may limit generalizability to AMAB populations.","value_numeric":null}],"summaries":{"what_studied":"Retrospective chart review of 445 adolescents with gender dysphoria (DSM-5) referred to four Canadian pediatric endocrinology gender clinics between 2012–2017, examining stability of gender identity, continuation of gender-affirming hormones (GAH), and rates of detransition over a median follow-up of 2.4 years (IQR 1.1–7.2).","key_result":"97.1% (432/445) continued to identify as transgender or non-binary; only 2.9% (13/445) reverted to a gender identity aligned with birth sex. GAH was started by 79.3% (353/445) and discontinued by only 1.1% (4/353). GST/adjunctive therapy was stopped by 11.7% (35/299), most commonly to transition to GAH rather than due to reidentification.","limitations":"- Retrospective design with selection bias: only adolescents who accessed care at participating clinics were included, excluding those who sought care elsewhere or lacked parental support.\n- Reliance on medical records introduces information bias; gender identity data depended on adolescent/parent recall.\n- Median follow-up was only 2.4 years, limiting long-term outcome assessment.","practice_takeaway":"In a carefully assessed clinical cohort, gender identity is highly stable in adolescents referred to specialized gender clinics — fewer than 3% reidentify with birth-assigned gender, and GAH discontinuation is rare (1.1%). Clinicians should continue comprehensive psychosocial assessment and maintain ongoing support for youth and families, including open discussion about the possibility of evolving gender identity over time."}},{"doi":"10.1007/s10508-026-03475-5","pmid":"42236636","title":"Sociodemographic and Mental Health Characteristics of Adults with Different Gender Trajectories","journal_title":"Archives of Sexual Behavior","journal_issn":"0004-0002","published_at":"2026-06-03T00:00:00.000Z","url":"https://doi.org/10.1007/s10508-026-03475-5","source_score":42,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-10T14:24:01.622Z","updated_at":"2026-06-10T14:24:01.622Z","tags":[{"paper_doi":"10.1007/s10508-026-03475-5","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1007/s10508-026-03475-5","tag_type":"category","value":"Psychology, Clinical","value_numeric":null},{"paper_doi":"10.1007/s10508-026-03475-5","tag_type":"condition","value":"Detransition","value_numeric":null},{"paper_doi":"10.1007/s10508-026-03475-5","tag_type":"condition","value":"Gender Dysphoria","value_numeric":null},{"paper_doi":"10.1007/s10508-026-03475-5","tag_type":"condition","value":"Mental Health Disorders","value_numeric":null},{"paper_doi":"10.1007/s10508-026-03475-5","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1007/s10508-026-03475-5","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1007/s10508-026-03475-5","tag_type":"modality","value":"Gender-Affirming Hormonal Treatment","value_numeric":null},{"paper_doi":"10.1007/s10508-026-03475-5","tag_type":"sample_size","value":"n=51","value_numeric":51},{"paper_doi":"10.1007/s10508-026-03475-5","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1007/s10508-026-03475-5","tag_type":"study_design","value":"Cross-Sectional Comparative Study","value_numeric":null},{"paper_doi":"10.1007/s10508-026-03475-5","tag_type":"warning","value":"The full text extracted from the PDF appears to be the 2022 U.S. Transgender Survey Early Insights Report — a different document from the abstract, which describes a small comparative study of TGD and detransitioning adults. Summaries and tags are based on the abstract, as it accurately reflects the paper described by the DOI and title. The PDF content may have been incorrectly attached or extracted.","value_numeric":null},{"paper_doi":"10.1007/s10508-026-03475-5","tag_type":"warning","value":"The paper is listed as published June 2026 but the PDF metadata shows a creation date of February 2024, suggesting a possible discrepancy in publication timeline or a preprint/early access version.","value_numeric":null},{"paper_doi":"10.1007/s10508-026-03475-5","tag_type":"warning","value":"The study's small sample (n=51 total) severely limits the ability to detect differences between groups; findings should be interpreted cautiously.","value_numeric":null}],"summaries":{"what_studied":"This study compared 29 transgender and gender diverse (TGD) adults (mean age 28.28, 72.4% assigned female at birth) with 22 detransitioning adults (mean age 28.73, 63.6% assigned female at birth), examining transition/detransition history, mental health diagnoses, psychopharmacological medication use, and adverse life experiences using online surveys and face-to-face assessments.","key_result":"Detransitioning participants started medical transition at a significantly younger age and reported higher rates of side/unwanted effects from gender-affirming hormonal treatment. TGD participants had greater interest in further medical interventions. No significant differences were found for most other variables. A high percentage in both groups reported a history of poor mental health and adverse life experiences. All reported social transition; 74.5% administrative and 84.3% medical transition.","limitations":"- Very small sample sizes (n=29 TGD, n=22 detransitioning) limit statistical power and generalizability.\n- No control group of cisgender individuals for comparison.\n- Self-reported mental health history is subject to recall and social desirability bias.","practice_takeaway":"Clinicians supporting people through gender transition should be aware that detransitioning individuals may have started medical transition at a younger age and are more likely to report unwanted hormonal side effects — early monitoring and ongoing psychological support are key for both groups. The high burden of poor mental health and adverse life experiences in both TGD and detransitioning individuals underscores the need for trauma-informed, individualized care."}},{"doi":"10.1007/s10508-025-03404-y","pmid":"42156644","title":"Experience of a Gender Identity Unit in Spain (2015–2023): Trends, Treatments, Surgeries, and Detransitions","journal_title":"Archives of Sexual Behavior","journal_issn":"0004-0002","published_at":"2026-05-19T00:00:00.000Z","url":"https://doi.org/10.1007/s10508-025-03404-y","source_score":8,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-24T13:23:06.757Z","updated_at":"2026-05-24T13:23:06.757Z","tags":[{"paper_doi":"10.1007/s10508-025-03404-y","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1007/s10508-025-03404-y","tag_type":"category","value":"Psychology, Clinical","value_numeric":null},{"paper_doi":"10.1007/s10508-025-03404-y","tag_type":"condition","value":"Gender Dysphoria","value_numeric":null},{"paper_doi":"10.1007/s10508-025-03404-y","tag_type":"condition","value":"Transgender Identity","value_numeric":null},{"paper_doi":"10.1007/s10508-025-03404-y","tag_type":"generic","value":"gender-affirming hormones","value_numeric":null},{"paper_doi":"10.1007/s10508-025-03404-y","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1007/s10508-025-03404-y","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1007/s10508-025-03404-y","tag_type":"modality","value":"Gender-Affirming Hormone Therapy","value_numeric":null},{"paper_doi":"10.1007/s10508-025-03404-y","tag_type":"modality","value":"Gender-Affirming Surgery","value_numeric":null},{"paper_doi":"10.1007/s10508-025-03404-y","tag_type":"modality","value":"Puberty Blockers","value_numeric":null},{"paper_doi":"10.1007/s10508-025-03404-y","tag_type":"sample_size","value":"n=771","value_numeric":771},{"paper_doi":"10.1007/s10508-025-03404-y","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1007/s10508-025-03404-y","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1007/s10508-025-03404-y","tag_type":"warning","value":"Age breakdown between adolescents and adults was not fully specified in the available abstract text.","value_numeric":null},{"paper_doi":"10.1007/s10508-025-03404-y","tag_type":"warning","value":"The detransition/regret rate of 1.3% is explicitly flagged by the authors as potentially underestimated due to high loss to follow-up; this figure should be interpreted with caution.","value_numeric":null},{"paper_doi":"10.1007/s10508-025-03404-y","tag_type":"warning","value":"The full text retrieved does not match the paper abstract — the PDF content is the Yogyakarta Principles Plus 10 (a human rights document), not the clinical study described in the abstract. Structured data was extracted solely from the abstract, so granular results, subgroup data, and methodological details from the full text could not be verified.","value_numeric":null}],"summaries":{"what_studied":"Retrospective chart review of 771 transgender individuals seen at the Cadiz (Andalusia, Spain) Gender Identity Unit from 2015–2023, describing demographics, gender-affirming hormone use, puberty blocker use, surgical procedures, and rates of gender identity change or detransition.","key_result":"Of 771 patients (mean age 21.36 ± 8.96 years; 56.2% assigned female at birth), 80.4% started gender-affirming hormones, 7% received puberty blockers, 194 breast surgeries and 130 genital surgeries were performed, and only 9 individuals (1.3%) later expressed a change in gender identity, with just 1 expressing regret about treatment.","limitations":"- High loss to follow-up means the detransition/regret rate of 1.3% is likely an underestimate.\n- Single-center retrospective design limits generalizability.\n- Study does not report long-term outcomes beyond identity change or regret.","practice_takeaway":"In this large Spanish cohort over 8 years, the rate of expressed regret after gender-affirming treatment was very low (1 of 771), but clinicians should note that substantial loss to follow-up may mask a higher true rate. 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Gender congruence improved with treatment (GAS time×group +11.99 points on GCLS, p<0.001; GAHT time effect +6.59 points, p<0.001; genital surgery +4.35 points, p=0.008; GAHT 2–5 years associated with higher chest/breast congruence, b=0.601, p=0.003).","limitations":"Single‑center, treatment‑seeking cohort with integrated psychological care and self‑reported measures limits generalizability and causal inference; no cisgender or non‑treatment control group; attrition from the original 394 cohort to 178 respondents may introduce selection bias.","practice_takeaway":"Expect meaningful gains in gender congruence after GAHT/GAS, but do not assume depression or anxiety will lessen without addressing psychosocial drivers. Strengthening social support and shifting from avoidant to facilitative coping should be part of routine care alongside medical transition."}},{"doi":"10.1007/s10508-025-03345-6","pmid":"41272379","title":"A Critique of the Cass Review and the Implications of “Gender Restrictive Care”","journal_title":"Archives of Sexual Behavior","journal_issn":"0004-0002","published_at":"2025-11-22T00:00:00.000Z","url":"https://doi.org/10.1007/s10508-025-03345-6","source_score":19,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2025-11-22","doi":"10.1007/s10508-025-03345-6","days":"14","issn":"0004-0002","rank":"7","field":"Clinical Medicine","score":"19","category":"Psychology, Clinical","categories":["Psychology, Clinical"],"_categories":["Psychology, Clinical"]},"pubmed":{"doi":"10.1007/s10508-025-03345-6","title":"A Critique of the Cass Review and the Implications of \"Gender Restrictive Care\".","journal":"Archives of sexual behavior","methods":"","results":"","abstract":"A University of York review of research supporting gender affirming care (GAC) of gender dysphoric children and adolescents suggested that the research was of such poor quality that it could endanger the health of these patients. Cass used that finding to argue for restrictions on access to GAC. Without commenting on the University of York's review or the quality of research underlying GAC, I analyze Cass' recommendations for the quality of the research supporting restrictions on GAC and whether those restrictions endanger the health of children and adolescents. The current Commentary will show that Cass' recommendations are not supported by research and it is her recommendations that may present a danger to the health of gender dysphoric children and adolescents. Further analysis will show that such restrictions are ethically problematic and could worsen both the short- and long-term outcomes for gender dysphoric children, adolescents, and adults.","keywords":["Cass Review","Gender affirming care","Gender diversity","Gender dysphoria","Gender identity","Transgender"],"pubmed_id":"41272379","conclusions":"","publication_date":"2025-11-22T00:00:00"},"crossref":{"DOI":"10.1007/s10508-025-03345-6","URL":"https://doi.org/10.1007/s10508-025-03345-6","ISSN":["0004-0002","1573-2800"],"link":[{"URL":"https://link.springer.com/content/pdf/10.1007/s10508-025-03345-6.pdf","content-type":"application/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https://link.springer.com/article/10.1007/s10508-025-03345-6/fulltext.html","content-type":"text/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https://link.springer.com/content/pdf/10.1007/s10508-025-03345-6.pdf","content-type":"application/pdf","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["A Critique of the Cass Review and the Implications of “Gender Restrictive Care”"],"author":[{"given":"Charles","family":"Moser","sequence":"first","affiliation":[]}],"issued":{"date-parts":[[2025,11,21]]},"member":"297","prefix":"10.1007","source":"Crossref","volume":null,"created":{"date-time":"2025-11-21T18:19:13Z","timestamp":1763749153000,"date-parts":[[2025,11,21]]},"indexed":{"date-time":"2025-11-21T18:27:25Z","timestamp":1763749645425,"date-parts":[[2025,11,21]]},"license":[{"URL":"https://www.springernature.com/gp/researchers/text-and-data-mining","start":{"date-time":"2025-11-21T00:00:00Z","timestamp":1763683200000,"date-parts":[[2025,11,21]]},"delay-in-days":0,"content-version":"tdm"},{"URL":"https://www.springernature.com/gp/researchers/text-and-data-mining","start":{"date-time":"2025-11-21T00:00:00Z","timestamp":1763683200000,"date-parts":[[2025,11,21]]},"delay-in-days":0,"content-version":"vor"}],"subject":[],"abstract":null,"language":"en","relation":{},"resource":{"primary":{"URL":"https://link.springer.com/10.1007/s10508-025-03345-6"}},"subtitle":[],"assertion":[{"name":"received","group":{"name":"ArticleHistory","label":"Article History"},"label":"Received","order":1,"value":"12 August 2024"},{"name":"revised","group":{"name":"ArticleHistory","label":"Article History"},"label":"Revised","order":2,"value":"6 October 2025"},{"name":"accepted","group":{"name":"ArticleHistory","label":"Article History"},"label":"Accepted","order":3,"value":"7 October 2025"},{"name":"first_online","group":{"name":"ArticleHistory","label":"Article History"},"label":"First Online","order":4,"value":"21 November 2025"},{"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"},"order":1},{"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"},"order":2,"value":"The author is a member of WPATH and treats gender dysphoric adults (age 16 or older). He does not routinely prescribe hormone blockers."},{"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"},"order":3,"value":"Editor’s note: Dr. Cass was given the opportunity to provide a response to Dr. Moser’s\nCommentary but declined the offer."}],"deposited":{"date-time":"2025-11-21T18:19:16Z","timestamp":1763749156000,"date-parts":[[2025,11,21]]},"issn-type":[{"type":"print","value":"0004-0002"},{"type":"electronic","value":"1573-2800"}],"published":{"date-parts":[[2025,11,21]]},"publisher":"Springer Science and Business Media LLC","reference":[{"DOI":"10.1016/j.urology.2018.10.005","key":"3345_CR1","year":"2019","issue":null,"author":"AJ Adeleye","volume":"124","first-page":"136","unstructured":"Adeleye, A. J., Reid, G., Kao, C. N., Mok-Lin, E., & Smith, J. F. (2019). Semen parameters among transgender women with a history of hormonal treatment. 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It explicitly does not assess the University of York review or the quality of evidence underlying gender-affirming care itself.","key_result":"The author argues that Cass’ recommended restrictions are not supported by research and may endanger the health of gender dysphoric children and adolescents; the commentary also contends such restrictions are ethically problematic and could worsen short- and long-term outcomes.","limitations":"This is a commentary without original data or quantitative outcomes. It explicitly does not evaluate the University of York review or the evidentiary quality of gender-affirming care.","practice_takeaway":"Exercise caution in endorsing or implementing Cass-style restrictions on youth gender-affirming care; the author contends these limits lack evidentiary support and may carry health risks and ethical concerns."}}],"initialOffset":10,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"condition","value":"Gender Dysphoria"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Conditions","href":"/hub/tag/condition"},{"name":"Gender Dysphoria"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"condition","hub_tag_value":"Gender Dysphoria"}}}]]

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