SynthesisBMJ open2021
International clinical practice guidelines for gender minority/trans people: systematic review and quality assessment.
Synthesis in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 3 syntheses or guidelines pooled it, 28 citations in OpenAlex.
- Transmasculine pregnancy-Occurrence, associations, and outcomes: A quantitative systematic review.Acta obstetricia et gynecologica Scandinavica · 2026Pooled it
- Systematic Review, Quality Assessment, and Synthesis of Guidelines for Emergency Department Care of Transgender and Gender-diverse People: Recommendations for Immediate Action to Improve Care.The western journal of emergency medicine · 2024Pooled it
- A systematic review of psychosocial functioning changes after gender-affirming hormone therapy among transgender people.Nature human behaviour · 2023Pooled it
- Quality of the World Professional Association for Transgender Health Guideline Standards of Care 8: An Appraisal Using the AGREE II Instrument.Archives of sexual behavior · 2026Article
- Getting to the bottom of it: Comparative medical and psychological risk for gonadectomy among individuals with and without presurgical psychological assessment.International journal of transgender health · 2026Article
- Impact of Prostate Cancer Treatment on Quality of Life of LGBTQ+ Patients: A Systematic Review.The world journal of men's health · 2025Review
- Towards Best-Practice Healthcare for Transgender Patients: Quality Improvement in United Kingdom General Practice.Healthcare (Basel, Switzerland) · 2025Article
- Gender Reassignment and the Role of the Laboratory in Monitoring Gender-Affirming Hormone Therapy.Journal of clinical medicine · 2024Review
- Article
- 'Don't think that we die from AIDS': Invisibilised uncertainty and global transgender health.Sociology of health & illness · 2023Article
- Care of Transgender Patients: A General Practice Quality Improvement Approach.Healthcare (Basel, Switzerland) · 2022Article
- Standards of Care for the Health of Transgender and Gender Diverse People, Version 8.International journal of transgender health · 2022Article
- Reflections on the Clinician's Role with Individuals Who Self-identify as Transgender.Archives of sexual behavior · 2021Article
- Authors' reply.BJPsych bulletin · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo identify and critically appraise published clinical practice guidelines (CPGs) regarding healthcare of gender minority/trans people.
designSystematic review and quality appraisal using AGREE II (Appraisal of Guidelines for Research and Evaluation tool), including stakeholder domain prioritisation.
settingSix databases and six CPG websites were searched, and international key opinion leaders approached.
participantsCPGs relating to adults and/or children who are gender minority/trans with no exclusions due to comorbidities, except differences in sex development.
interventionAny health-related intervention connected to the care of gender minority/trans people.
main outcome measuresNumber and quality of international CPGs addressing the health of gender minority/trans people, information on estimated changes in mortality or quality of life (QoL), consistency of recommended interventions across CPGs, and appraisal of key messages for patients.
resultsTwelve international CPGs address gender minority/trans people's healthcare as complete (n=5), partial (n=4) or marginal (n=3) focus of guidance. The quality scores have a wide range and heterogeneity whichever AGREE II domain is prioritised. Five higher-quality CPGs focus on HIV and other blood-borne infections (overall assessment scores 69%-94%). Six lower-quality CPGs concern transition-specific interventions (overall assessment scores 11%-56%). None deal with primary care, mental health or longer-term medical issues. Sparse information on estimated changes in mortality and QoL is conflicting. Consistency between CPGs could not be examined due to unclear recommendations within the World Professional Association for Transgender Health Standards of Care Version 7 and a lack of overlap between other CPGs. None provide key messages for patients.
conclusionsA paucity of high-quality guidance for gender minority/trans people exists, largely limited to HIV and transition, but not wider aspects of healthcare, mortality or QoL. Reference to AGREE II, use of systematic reviews, independent external review, stakeholder participation and patient facing material might improve future CPG quality. PROSPERO REGISTRATION NUMBER: CRD42019154361.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.