In a special issue of the European Journal of Developmental Psychology, two articles have appeared evaluating the influential “Dutch protocol” developed over 20 years ago at the Center for Expertise on Gender Dysphoria of the Amsterdam University Medical Center. This program calls for puberty blockers at the outset of pubescence, hormonal therapy at around age 14, and eventually surgery after the age of 16. The Dutch researchers who developed the protocol write a retrospective of their previous work, expressing even greater confidence in its reliability and questioning the negative side effects posited by some critics.
However, two American clinicians have composed a response to that narrative review, criticizing the Dutch clinic’s retrospective study design, loss of patients to long-term follow-up, selection bias, failure to account for confounding factors, lack of a control group for comparison, switching measurement scales, and minimizing risks based on tiny samples. They also note that one of the 70 patients who formed the basis of the Dutch study died due to complications from gender surgery, but that was not listed as a negative outcome.
