Better Health Care Guidance Needed for
Trans People

Priscilla Lynch 

May 11, 2021

There is a global paucity of high-quality guidance for gender minority/trans people, with existing guidance largely limited to HIV and transition, new research by UK researchers has found.

Researchers from the King’s College London and Anglia Ruskin University (ARU) searched world literature for all international clinical practice guidelines on the healthcare needs of gender minority and trans people and approached key international opinion leaders in the area.

Their results, published in  BMJ Open , showed that higher quality guidelines tended to focus mainly on HIV and most others were on transition-related interventions. There were noticeable gaps in the topics of guidelines, with none addressing primary care or more general health needs of gender minority and trans people. There was little information on mortality and quality of life, and there was no patient-facing material.

While sex hormones in trans people can affect susceptibility to some conditions, including various cancers, the study authors found little research on how much these hormones affect rates and treatment regimens. There was also no advice on how these hormones affect rates, hospitalisations and mortalities because of COVID-19.

The researchers concluded that gaps can be filled by better research, resulting in improved health care guidance for gender minority/trans people.

Catherine Meads, Professor of Health at ARU and senior author of the paper, said: "We were pleased to find high quality guidelines on HIV from the World Health Organisation (WHO), but disappointed there was little else on the long term physical and mental health of trans people."

"There are clear gaps in clinical practice guidance related to gender minority and trans people, and as such clinicians should proceed with caution and explain any uncertainties to patients, who should also be engaged in the process of updating practice guidelines. More needs to be done to ensure that patient-facing material relevant to trans people is made available."


Dahlen S, Connolly D, Arif I, Junejo MH, Bewley S, Meads C. International clinical practice guidelines for gender minority/trans people: systematic review and quality assessment. BMJ Open. 2021;11(4):e048943. doi: 10.1136/bmjopen-2021-048943. PMID: 33926984

This article originally appeared on Univadis, part of the Medscape Professional Network


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