The moral panic over Safe Schools — replete with alarmist claims that children were given lessons on chest-binding and penis-tucking — may have subsided but providing gender-affirming treatment for transgender youth remains a hot topic.

In a letter published in the Lancet in December, primary care researcher Professor Richard Byng and his GP colleagues took aim at the Australian treatment guidelines for trans and gender-diverse children and adolescents, which had been released six months earlier.

Professor Byng, from the University of Plymouth, UK, acknowledged the distress of gender dysphoria but accused the guideline authors of deploying “imprecise language” such as ‘sex assigned at birth’, and of overplaying empirical evidence.

The evidence of medium-term benefits for both hormonal treatment and puberty blockers was predicated on weak follow-up studies, he wrote, adding that the guidelines failed to consider long-term effects of the hormones or the issue of de-transition.