[International criticism of the Dutch Protocol; time to change Dutch pediatric gender care and its guideline].

Abstract

The thorough Cass review into care for adolescents with gender dysphoria concludes that the evidence is insufficient to justify routine treatment with puberty blockers and cross-sex hormones. The review recommends a thorough exploration of the gender problems, and holistic care involving psychosocial interventions to reduce distress and improve global functioning, prioritizing non-medical interventions. Dutch pediatric gender clinics emphasize that such holistic approach is the standard in the Netherlands. However, current Dutch guidelines do not recommend this. Concerningly, the current guideline revision intends to build on the consensus-based and otherwise problematic Standard of Care 8 from the World Professional Association for Transgender Health. This paper argues for evidence-based (interim) guidelines that describe and recommend holistic gender care along the lines of the Cass report. Hormones should be the last resort for minors with gender dysphoria.