Systematic reviews carried out on the impact of the treatment of puberty blockers or cross-sex hormone for minors show that medical transition has no evidence base

The UK NICE evidence reviews (2020), examining both puberty blockers and cross-sex hormones for minors with gender dysphoria, found no reliable evidence of significant improvement in gender dysphoria, mental health, body image, or quality of life outcomes.

Zepf et al.’s Beyond NICE systematic review (2024), which evaluated newer studies published after the NICE reviews, similarly concluded that the evidence base remains methodologically weak and insufficient to support reliable conclusions regarding benefits or long-term outcomes.

The HHS evidence review (2025), Miroshnychenko et al.’s systematic review and meta-analysis (2025), the NICE reviews (2020), and Beyond Nice (2024) systematic review have consistently identified low-quality evidence, methodological weaknesses, limited long-term follow-up, and substantial uncertainty regarding the effects of puberty blockers and cross-sex hormones in minors with gender dysphoria.

^{Miroshnychenko, A., Roldan, Y., Ibrahim, S., Kulatunga-Moruzi, C., Montante, S., Couban, R., Guyatt, G., & Brignardello-Petersen, R. (2025). Puberty blockers for gender dysphoria in youth: A systematic review and meta-analysis. Archives of Disease in Childhood, 110(6), 429-436. https://doi.org/10.1136/archdischild-2024-327909}

^{National Institute for Health and Care Excellence (NICE). (2020). Evidence review: Gonadotrophin releasing hormone analogues for children and adolescents with gender dysphoria. NHS England and NHS Improvement.}

^{Available at: NICE Evidence Review PDF}

^{National Institute for Health and Care Excellence (NICE). (2020). Evidence review: Gender-affirming hormones for children and adolescents with gender dysphoria. NHS England and NHS Improvement.}

^{PDF: NICE Evidence Review – Gender-affirming hormones for children and adolescents with gender dysphoria}

^{U.S. Department of Health and Human Services, Office of Population Affairs. (2025). Treatment for pediatric gender dysphoria: Review of evidence and best practices. Washington, DC: U.S. Department of Health and Human Services.}

^{URL: HHS Gender Dysphoria Report
PDF: Full Report PDF
Executive Summary: Executive Summary PDF}

^{Zepf, F.D. et al. (2024). Beyond NICE: Aktualisierte systematische Übersicht zur Evidenzlage der Pubertätsblockade und Hormongabe bei Minderjährigen mit Geschlechtsdysphorie. Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie, 1-21. DOI: 10.1024/1422-4917/a000972
PDF: Full paper PDF}