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There are unsettled debates, and trend with systematic reviews is to move away from the gender affirmation model.

There are several competing models in the treatment of gender healthcare, there is no consensus on a "standard of care" for child or adolescent gender dysphoria, there are unsettled debates, there are irreversible damages to a condition that usually resolves itself in 80-98% of all cases, and LGB organisations report young people who would normally grow to be LGB (Lesbian, Bisexual and Gay) are indoctrinated or bullied into transitioning to the appearance of the opposites sex; a form of conversion therapy by gender identity.

The other distinct cohort are girls. Before 2012, gender dysphoria in the past was almost exclusively boys (roughly .01%).  But girls[ are now the majority of children who are transitioning, and this is more to do with gender ideation, a fixation on a gender identity, through social influence and contagion. There are more than 95 gender identities thus far.

 In research they are commonly referred to though as having ROGD[iv], rapid onset gender dysphoria.

Many professionals in the field do not agree with the Gender affirmation model, and in Australia, two detransitioners are suing psychologists who followed this model, with a result of irreparable harm caused to their bodies, which includes sterility.

There are competing guidelines, reports and rebuttals from NAPP, RANZCP, SEGM, UK, Sweden, France, for example;

Compilation of literature and studies that highlight unsettled debates in the Gender healthcare field.

SEGM has been creating a collection of literature that emphasizes their position of concern regarding the increase in hormonal and surgical interventions meant for gender dysphoric youth that are labelled as "gender-affirmative." It is important to note that this is not an exhaustive list of every study related to paediatric gender medicine, but rather a selection aimed at bringing attention to ongoing and unresolved debates in the field...

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