How we choose our evidence
There is a lot of information about trans and gender diverse young people online. Some of it is helpful and accurate. Some of it is misleading, outdated, or based on very limited evidence.
At Transforming Families, we want parents and carers to be able to trust the information they find here. That means being careful about the research we use, being clear when there are things we don’t know, and not choosing studies simply because they tell us what we want to hear.
Our aim is to take the best available research and turn it into clear, practical information about the things that matter to families.
How do we decide what research to use?
Not every study gives us the same quality of information.
Where possible, we start with high-quality systematic reviews, which bring together the available research on a particular question and help us understand the evidence as a whole.
This is useful because a single study can sometimes produce an unusual result. If many well-conducted studies find something similar, we can generally be more confident that the finding is reliable.
When a good recent review is not available, we may use individual studies instead. We look at things such as:
- How the study was carried out
- How many people took part
- Whether the people in the study are relevant to the question we are answering
- Whether the researchers used appropriate ways of measuring what they wanted to study
- Whether other research has found something similar
We generally use research that has been peer-reviewed, meaning it has been reviewed by other researchers before publication.
We rarely use a single case report, opinion articles, or commentaries as evidence for a broad claim about trans and gender diverse people. These sources can sometimes raise useful questions, but they generally can’t tell us how common something is or whether the same finding applies to other people.
What about randomised controlled trials?
People sometimes hear that a randomised controlled trial (RCT) is the “gold standard” of research.
RCTs are very useful for answering some questions, but they’re not always suitable, practical, or ethical. For example, it can be difficult to conduct a truly ‘blind’ trial of gender-affirming hormones because participants are likely to notice the physical effects of treatment.
Understanding people’s experiences
Not every important question can be answered with numbers.
If we want to understand what it is like to be a trans or gender diverse young person, or what it is like to parent or care for one, we often use qualitative research. This usually involves researchers talking with people in-depth about their experiences and perspectives.
Qualitative research can help us understand things that surveys and statistics may miss. For example, it can show us how families experience healthcare, what kinds of support they find helpful, and what barriers they encounter.
We also involve people with lived experience in reviewing and developing Transforming Families, including trans and gender diverse people and parents and carers. Their role is not to replace the research, but to make sure that the information is presented in a way that is respectful, relevant, and useful in practice.
Parents and carers can help us identify which research findings are the most useful to families.
Combining research and lived experience helps us to make the website both evidence-based and practically useful.
What if the research doesn’t agree?
Sometimes studies reach different conclusions. Sometimes there are several possible explanations for the same finding. And sometimes the most accurate answer is simply: We don’t know yet.
When that happens, we do our best to say so.
If researchers have suggested several possible explanations, we describe them and explain which have stronger evidence behind them. If studies disagree, we try to explain that instead of choosing only the studies that give the simplest or most convenient answer.
However, being balanced does not mean treating every claim as equally reliable. For example, a finding that has been repeated across several large, well-conducted studies carries more weight than an opinion article or a report describing what happened to one person.
We apply the same standards whether a finding is reassuring, concerning, or inconvenient.
Turning research into useful information
Our job is not simply to repeat what research papers say.
Academic research can be difficult to find, expensive to access, and challenging to understand if research is not part of your everyday work.
We look across the available evidence and ask: What does this actually mean for parents and carers?
We then try to explain the answer in clear language, while keeping the important detail and uncertainty in the research.
Our aim is to help families understand what is known, what is less certain, and what may be useful when making decisions with their child.
How current is the information?
Transforming Families does not currently have funding for continuous monitoring of every new study that is published. This means that newer research may sometimes become available after a page was last reviewed.
Where resources allow, information on the website will be reviewed and updated as new evidence becomes available.