The Digester

NHS England released 10 narrowly focused evidence reviews that included 17 of 547 screened studies and announced a pause on new hormone prescriptions for people under 18, prompting criticism that the reviews excluded major research and used methodology that fragmented available evidence.

NHS England published 10 evidence reviews that screened 547 full-text reports and included 17 studies, a 97 percent exclusion rate.
The reviews were split by precise drug combinations and by binary versus non-binary status, creating ten narrowly defined questions that critics say fragmented the evidence base.
High-profile studies cited in recent years, including Chen et al 2023, Tordoff et al 2022, and key Dutch Protocol research, were excluded under the reviews criteria.
Reviewers used the GRADE framework to rate surviving observational studies as very low certainty, a classification experts say reflects study design rather than proof that treatments do not work.
NHS England announced a pause on new hormone prescriptions for under-18s and indicated a separate review of adult gender-affirming hormone therapy is planned

NHS England reviews excluded 97% of trans studies before pausing youth hormone prescriptions

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