Personalized Nature of Transgender Medicine as a Barrier to Developing Evidence-Based Clinical Practice Guidelines on Gender Incongruence

The document discussed the challenges in developing evidence-based clinical practice guidelines for gender incongruence due to the personalized nature of transgender medicine. While gender transition procedures like hormone-replacement therapy (HRT) and surgeries were effective in alleviating gender dysphoria, their mechanisms were not fully understood. The biomedical model suggested that perception of one's sex characteristics and societal reactions contributed to gender dysphoria. High-quality studies needed to consider intermediate outcomes, such as feminization/masculinization and perceived gender. Developing a scale for these outcomes was complex due to the unequal contribution of sex characteristics and the influence of social factors. Additionally, understanding the biological factors affecting HRT's effectiveness in feminization and masculinization remained a challenge.