Editorial: Towards Context-Responsive, Evidence-Informed Care for Transgender and Gender Diverse Young People

Care for transgender and gender diverse (TGD) young people is among the most contested and scrutinized areas of modern medicine,¹ partly related to differences in sociocultural conventions across regions, heterogeneity within TGD populations, and inconsistent research definitions.² Evidence of appropriate care is difficult to derive from randomized controlled trials, and rigorously designed observational studies remain crucial.³ The same data are often interpreted in support of or opposition to specific gender-related care practices (eg, puberty blocker use in adolescents diagnosed with gender dysphoria),^{4 , 5} as such interpretations are frequently swayed by ideological and political forces. In many Western regions, current debates also concern the external validity of applying accumulated evidence to shifting populations amid significant secular trends-notably the marked increase in TGD-identifying youth. Importantly, comprehensive understanding of gender-related care needs and service approaches extends beyond medical considerations to encompass psychological, sociocontextual, and legal aspects. This means that appropriate gender-related care must also tackle the unique social realities of each region and jurisdiction. Despite ongoing efforts to harmonize evidence and practice globally, most contributors to the World Professional Association for Transgender Health Standards of Care Version 8 are from North America and Western Europe.⁴ To address disparities worldwide, evidence syntheses and tailored knowledge mobilization in underrepresented regions, especially regions undergoing rapid societal transformation, are essential for developing and delivering care that genuinely responds to local needs.