Response: “The Signal and the Noise”—a response to Clayton et al. (2021)

Abstract

The purpose of this response is to clarify points about the steps we took in a systematic review of the literature and to reaffirm our findings.

Gender-Affirming Treatment of Gender Dysphoria in Youth: A Perfect Storm Environment for the Placebo Effect—The Implications for Research and Clinical Practice

“…However, there is no robust empirical evidence that puberty blockers reduce suicidality or suicide rates (Biggs, 2020 ; Clayton et al, 2021 ). The authors of the paper, that was the basis for The Lancet’s claim, subsequently clarified that they were not making any causal claims that puberty blockers decreased suicidality (Rew et al, 2021 ). Another paper, claiming to have found that barriers to gender-affirming care was associated with suicidality, had to withdraw this claim in a significant correction to their article (Zwickl et al, 2021 ).…”