NHS Review Deliberately Excludes Studies That Prove That Hormone Treatments for Trans Youth Work
NHS England is violating fundamental scientific principles in its support for stopping gender affirming treatment of young people. They have excluded 97% of all trans studies to say care doesn't work. Transphobes have taken over the system.
As part of a public consultation on making masculinizing and feminizing hormones (MAF) “non-routine” for those under 18, NHS England published an Equality and Health Inequalities Impact Assessment (EHIA) dated 9 March 2026, arguing there is “very limited evidence” on safety and outcomes for young people and proposing that new prescriptions should not be routinely available through youth services.
But here's the problem: The underpinning clinical evidence reviews were designed in a way that virtually guaranteed “no evidence” conclusions.
Erin in the Morning docments that the review criteria excluded most of the real-world treatment pathway used internationally, particularly studies where puberty blockers were initiated first and hormones added later (often with an overlap period), a pattern associated with the so-called Dutch protocol.
This exclusion removed much of the most relevant adolescent literature from consideration and then treated the resulting scarcity as proof the evidence base is weak.
Alejandra Caraballo summarized the tactic over at Bluesky:
The NHS reviews reportedly screened 547 full-text papers but included only 17 (about a 96.9% exclusion rate), and split “hormones for trans adolescents” into ten fragmented reviews by regimen and by binary vs non-binary categories, leading, she says, to zero included studies in the non-binary sub-reviews because the literature rarely disaggregates outcomes that way.
She also shows that large prospective studies were excluded because cohorts weren’t separated into the highly specific subgroupings demanded by the review design.
NHS England has created an “absence of evidence” created by overly narrow inclusion rules to justify restricting care. The fact is that most experts in the field, and trans youth and their families, know that such support does help.
Pink News reports that, within the same EHIA process, NHS England also confirmed it is separately reviewing evidence on HRT for trans adults. You can bet they will fix the numbers again in order to stop trans people from getting the help they need.
