As we know, the
systematic evidence review conducted by the University of York for the Cass review found that the 'expert consensus' is largely artificial, not resulting from independent evaluations reaching the same conclusion, but from all organisations drawing on poor quality and non-evidenced based recommendations from the same sources and cross-referencing each other.
"Two international guidelines (World Professional Association for Transgender Health and Endocrine Society) formed the basis for most other guidance, influencing their development and recommendations."
"These two guidelines are themselves linked through cosponsorship and like other guidelines lack a robust and transparent approach to their development. Although it is not uncommon to adopt an expert consensus-based approach when evidence is limited, it is less common for guideline developers to draw so heavily on other guidelines.
11 This relationship may explain why there has until recently been an apparent consensus on key areas of practice for which evidence remains lacking.
54"
So while we can acknowledge that many US organisations make claims of consensus, there is not an evidenced-based consensus.