Regarding the evidence supporting the 2017 @TheEndoSociety Gender Dysphoria guidelines (affirmation based):

1: "Nearly all of the recommendations made were based upon "low" or "very low" quality evidence." >>

2. "By definition, these designations mean that there is a high likelihood that the attainment of new data will necessitate changes to the guidelines provided." >>

3. "The only data that reached the level of "moderate" quality were related to adverse medical outcomes." >>

4. "The limitations of the published studies in the growing field of transgender medicine are many. They include a general lack of randomized controlled trial design, small sample sizes, high potential for recruitment bias, >>

questions regarding the precision of measured parameters, non-generalizable population groups, relatively short follow-up, high numbers of patients lost to follow-up, and frequent reliance upon "expert opinion" alone." >>

5. "While such deficiencies are not unique to this field of investigation, the strength of the recommendations made on the basis of this type of evidence is, in many respects, disproportionate." >>

6. "In other areas of medicine, much greater caution is generally applied to advancing a single treatment approach [affirmation] over other potential interventions." //
https://journals.sagepub.com/doi/abs/10.1177/0024363919873762?journalCode=lqra