Gordon Guyatt, a prominent physician and member of the Canadian Medical Hall of Fame, has found himself in a contentious position regarding his research on gender-affirming care. His studies on puberty blockers and hormone therapy have drawn criticism from both supporters and opponents of transgender rights.

Guyatt, who is known for coining the term "evidence-based medicine," published two systematic reviews earlier this year. These reviews assessed the scientific evidence surrounding puberty blockers and hormone therapy for individuals with gender dysphoria. He concluded that there is insufficient evidence to determine whether these treatments are beneficial or harmful.

In one study, Guyatt stated, "The best available evidence reporting the effects of puberty blockers in individuals with (gender dysphoria) was mostly very low certainty and therefore we cannot exclude the possibility of benefit or harm." Similarly, the review on hormone therapy indicated that the evidence "does not exclude the possibility of benefit or harm."

Despite his findings, Guyatt has faced backlash. Critics have accused him of capitulating to trans ideology, while trans activists confronted him and his colleagues during a workshop at McMaster University. "Everybody’s been kind of frightened," Guyatt said in an interview. Some of his colleagues even declined to sign a letter he wrote to clarify the context of his studies.

Guyatt expressed concern over how his work has been misinterpreted, stating that it has been used to justify denying care to individuals seeking gender-affirming treatments. He acknowledged his naivety, saying, "I have spent my career thinking that if I do good science and put it out there, that that was my job."

In response to the controversy, Guyatt and four colleagues requested that the university publish a letter emphasizing the importance of respecting patient autonomy, despite the low certainty of evidence regarding the treatments. They wrote, "It is unconscionable to forbid clinicians from delivering gender-affirming care. The high respect for autonomy becomes particularly important when the certainty of the evidence is low or very low."

Guyatt stressed the need for careful evaluation when considering the potential benefits and harms of these treatments, especially for children and adolescents. He stated, "It seems to me that this is something where one must be very cautious and there should be professional teams evaluating, as we do in other situations."

The ongoing debate surrounding gender-affirming care continues to evoke strong emotions and differing opinions, highlighting the complexities of medical decision-making in this area.