> and it rules out a lot of studies for not being double blind

Sorry but you're repeating disinformation that has already been refuted by the lead author, and is obviously incorrect if you read the Review itself.

http://archive.today/ea0Vi

> Dr Hilary Cass, 66, told The Times last week that one activist had begun posting falsehoods about her landmark review of the treatment of trans children before it was even published.

> She was referring to Alejandra Caraballo, an American attorney, transgender woman and instructor at Harvard Law School’s Cyberlaw Clinic.

> On April 9 — the day before the Cass review was published — Caraballo claimed it had “disregarded nearly all studies” because they were not double-blind controlled ones.

> Double-blind studies see patients randomly given either medicine or a placebo, with neither the patient or doctor knowing which.

> In a post on Twitter/X, Caraballo accused Cass and the review team of holding trans healthcare to an “impossible standard”. This was because, she said, transgender patients could not take hormones “blind”, as the effects of any hormones would fairly quickly become obvious.

> Her tweets were contradicted by the publication of the Cass review hours later.

> During a systematic review, researchers looking at studies on transgender healthcare found no blind control ones — so used another system altogether to determine study quality. Cass told The Times last week how difficult it would be to use blind control studies in relation to trans patients, for the same reasons identified by Caraballo.

> As for Caraballo’s claim that the review team “disregarded nearly all studies”, Cass pointed out that 60 out of 103 studies reviewed were used for the conclusions. They were studies deemed to be of moderate and high quality on the effects of puberty blockers and hormone treatment.

> Despite this, Caraballo’s post has been viewed 871,000 times and has not been deleted.

This is unfortunately quite a typical tactic of activists like Caraballo. They will deliberately lie to further their aims, relying on people who are unaware that their lies are lies to spread this disinformation.