The importance of child voice in trans health research: a critical review of research on social transition and well-being in trans children

Horton, Cal

doi:10.1080/26895269.2023.2295381

Cited by 4 publications

(1 citation statement)

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“…Additionally, there is no mention of reflexivity or positionality (where the researcher stands in relationship to those they are interviewing), which has consequences for the data interpretation and is an important indicator of rigour in qualitative research of healthcare. 51 The lack of consideration for how rigorous qualitative studies are designed, combined with the aforementioned exclusion of qualitative research from the systematic reviews, and the use of single (and sometimes misrepresented; see below) quotes from participants to support much broader conclusions demonstrates a misunderstanding of qualitative evidence in the Cass Report and the valuable insights about GAC that have been generated through qualitative research (see Horton, 2023 52 ).…”

Section: The Primary Researchmentioning

confidence: 99%

Critically Appraising the Cass Report: Methodological Flaws and Unsupported Claims

Noone,

Southgate,

Ashman

et al. 2024

Preprint

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The Cass Report aimed to provide recommendations for how services for gender diverse children and young people should be delivered in England. Our critical appraisal reveals significant methodological and conceptual flaws within the report and the research commissioned to inform the report, which included seven systematic reviews and both quantitative and qualitative primary research. Using the ROBIS tool, we identified a high risk of bias in each of the systematic reviews driven by unexplained protocol deviations, ambiguous eligibility criteria, inadequate study identification, and the failure to integrate consideration of these limitations into the conclusions derived from the evidence syntheses. We also identified potential sources of bias and unsubstantiated claims in the primary research that suggest a double standard in the quality of evidence produced for the Cass Report compared to quality appraisal in the systematic reviews. We discuss these issues in relation to how evidence regarding gender affirming care is framed, the wider political context, and the future for gender affirming care. To uphold evidence-based medicine, future gender-affirming care research must generate robust observational data, involve transgender communities, and prioritise patient-centred outcomes, ensuring validity, generalisability, and cultural relevance. The Cass Report’s recommendations, given its methodological flaws and misrepresentation of evidence, warrant critical scrutiny to ensure ethical and effective support for gender-diverse youth.

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Section: The Primary Researchmentioning

confidence: 99%