First Randomized Clinical Trial Confirms Benefits of Gender-Affirming Care

This study is the first of its kind. Conducting randomized controlled trials for gender-affirming care, similar to many conventional medical treatments, is unethical — a fact that the researchers in this study acknowledge. Withholding medication that has years of clinical backing and a plethora of studies would likely face rejection from most institutional review boards. The challenge isn’t unique to gender-affirming care.

In order to get around the ethical problems of withholding care, the researchers studied only adults, and opted for a shorter follow-up period. The researchers point out that by doing this, the control group would not be disadvantaged for very long, and that such a wait period would be deemed acceptable for transgender people who want to contribute to such important research. This means that such a trial could be conducted ethically.

The improvement in depression and suicidality underscores the substantial benefits of gender-affirming care. The reduction scores align with the much longer observational studies, which typically report a 40-73% decrease in suicidality. While this study alone doesn’t confirm long-term advantages, when viewed alongside the extensive clinical experiences of physicians and numerous other studies indicating long-term benefits of such care, it establishes the importance of this care.

Recently, anti-trans activists have pointed to the absence of RCTs as grounds to prohibit the care, neglecting to mention that the evidence for gender-affirming care aligns with that of most other medical treatments with similar absences. With the release of this study, this argument is no longer tenable.

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