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The BMJ and transgender people

The BMJ is a peer-reviewed publication of the British Medical Association. Since 2022, the publication has made a number of controversial editorial decisions around coverage of trans healthcare, written primarily by lay writers Jennifer Block and Jane Feinmann.

The BMJ also publishes The Journal of Medical Ethics (JME) and Archives of Disease in Childhood (ADC), which have each published a number of articles on gender-affirming care for minors. In 2024, research commissioned for the Cass Review was published in ADC.

Background

The Provincial Medical and Surgical Journal was founded in 1840. In 1857 the PMSJ merged with the Associated Medical Journal (formerly the London Medical Journal), becoming the British Medical Journal.

In 1980, the journal split into British Medical Journal (Clinical research edition) and British Medical Journal (Practice observed edition). In 1988, the title was officially shortened to BMJ, then changed to The BMJ in 2014.

The BMJ is published by BMJ Publishing Group Ltd, which in turn is wholly owned by the British Medical Association (BMA). The BMJ is editorially independent from the BMA.

Anti-trans coverage

In 2022, Kamran Abbasi was named editor-in-chief. Abbasi quickly began commissioning articles questioning the evidence for gender-affirming care for minors. In introducing a controversial investigation by Jennifer Block, Abassi wrote:

“Cass’s final report will be delivered this year, but her interim report’s effect has been to question the evidence behind interventions, other than psychological support, being offered to young people seeking gender transition. Similar shifts are evident in other countries, such as Sweden.

The US, however, has moved in the opposite direction. An investigation by The BMJ finds that more and more young people are being offered medical and surgical intervention for gender transition, sometimes bypassing any psychological support (doi:10.1136/bmj.p382).5 Much of this clinical practice is supported by guidance from medical societies and associations, but closer inspection of that guidance finds that the strength of clinical recommendations is not in line with the strength of the evidence. The risk of overtreatment of gender dysphoria is real.”

The 2023 report by Jennifer Block was deeply slanted toward the views of conservative clinicians and anti-transgender activists. An accompanying video featured conservative therapists Laura Edwards-Leeper and Erica Anderson, and gender-affirming endocrinologist Joshua Safer.

In 2025, Block revealed that Abassi and The BMJ had commissioned more work, but the British Medical Association killed it following negative response to Block’s 2023 article and video.

Journal of Medical Ethics

The Journal of Medical Ethics was founded in 1975 and is published by the BMJ. Editors-in-chief are Brian D. Earp, Lucy Frith, and Arianne Shahvisi. The journal has published anti-trans authors, including Roberto D’Angelo .

Archives of Disease in Childhood

Archives of Disease in Childhood was founded in 1926. ADC began publishing research on gender-affirming care for minors in ~2015. In 2024 ADC published the Gender Identity Service Series, a collection of reports commissioned for the Cass Review.

Selected BMJ publications

Feinmann J (March 12, 2025). Puberty blockers: Former Tavistock clinicians say they wouldn’t refer patients to NHS trial. BMJ, r504. https://doi.org/10.1136/bmj.r504

Feinmann J (January 31, 2025). Puberty blockers: GPs should not be forced to be “specialist gender service,” says report. BMJ, r214. https://doi.org/10.1136/bmj.r214

Block J (October 2024). Dispute arises over World Professional Association for Transgender Health’s involvement in WHO’s trans health guideline. BMJ, q2227. https://doi.org/10.1136/bmj.q2227

Feinmann J (August 12, 2024). Adult gender services to be scrutinised after clinicians raise concerns. BMJ, q1788. https://doi.org/10.1136/bmj.q1788

Feinmann J (August 8, 2024). Nearly 900 doctors sign letter urging BMA to abandon inquiry into Cass review. BMJ, q1772. https://doi.org/10.1136/bmj.q1772

Feinmann J (August 2, 2024). Puberty blockers: BMA calls for lifting of ban on prescribing to children. BMJ, q1722. https://doi.org/10.1136/bmj.q1722

Feinmann J (July 24, 2024). Puberty blockers: No evidence that a ban has led to “surge” in suicides, finds review. BMJ, q1638. https://doi.org/10.1136/bmj.q1638

Block J (May 2024). Gender medicine in the US: how the Cass review failed to land. BMJ, q1141. https://doi.org/10.1136/bmj.q1141

Feinmann J (March 25, 2024). Transgender care: doctors are advised to return to “ordinary best practice.” BMJ, q742. https://doi.org/10.1136/bmj.q742

Block J (August 2023). US paediatric leaders back gender affirming approach while also ordering evidence review. BMJ, p1877. https://doi.org/10.1136/bmj.p1877

Abbasi K (March 9, 2023). Caring for young people with gender dysphoria. BMJ, p553. https://doi.org/10.1136/bmj.p553

Block, Jennifer (March 6, 2023). Raft of US state laws restrict access to treatments for gender dysphoria. BMJ 2023; 380 https://doi.org/10.1136/bmj.p533

Launer J (March 1, 2023). John Launer: Gender identity, polemics, and empathy. BMJ, p477. https://doi.org/10.1136/bmj.p477

Block, Jennifer (February 23, 2023). Gender dysphoria in young people is rising—and so is professional disagreement. BMJ 2023; 380 https://doi.org/10.1136/bmj.p382

  • Rapid responses https://www.bmj.com/content/380/bmj.p382/rapid-responses
  • “her article contains several misleading statements and, crucially, fails to include the perspective of individuals from the trans and gender diverse (TGD) community”
  • Zoe Kristensen and David B Menkes [Department of Psychological Medicine, University of Auckland, New Zealand] (06 March 2023). Professional responses to gender dysphoria: reality checks needed. https://www.bmj.com/content/380/bmj.p382/rr-3

Dyer C (March 10, 2022). Services for children with gender dysphoria need fundamental reform, says interim review. BMJ, o589. https://doi.org/10.1136/bmj.o589

Selected JME publications

Giordano S (June 15, 2025). Keep calm but do not carry on: ethical issues with the recommendations made by the Cass Review (2024) Journal of Medical Ethics Published Online First: 15 June 2025. https://doi.org/10.1136/jme-2024-110613

D’Angelo R (2023). Supporting autonomy in young people with gender dysphoria: psychotherapy is not conversion therapy. Journal of Medical Ethics, 51(1), 3–9. https://doi.org/10.1136/jme-2023-109282

Warton C, McDougall RJ (2022). Fertility preservation for transgender children and young people in paediatric healthcare: a systematic review of ethical considerations. Journal of Medical Ethics 2022;48:1076-1082. https://doi.org/10.1136/medethics-2021-107702

Lemma A, Savulescu J (2021). To be, or not to be? The role of the unconscious in transgender transitioning: identity, autonomy and well-being. Journal of Medical Ethics, 49(1), 65–72. https://doi.org/10.1136/medethics-2021-107397

Norcliffe-Brown D, Brannan S, Davies M, English V, Mussell R, Sheather JC (2021). Ethics briefing. Journal of Medical Ethics, 47(6), 441–442. https://doi.org/10.1136/medethics-2021-107507

Frith L (2021). The concise argument – choice, choices and the choice agenda. Journal of Medical Ethics, 48(1), 1–2. https://doi.org/10.1136/medethics-2021-108052

Boyd K (2021). Triage, consent and trusting black boxes. Journal of Medical Ethics, 47(5), 289–290. https://doi.org/10.1136/medethics-2021-107453

Giordano S, Garland F, Holm S (2021). Gender dysphoria in adolescents: can adolescents or parents give valid consent to puberty blockers? Journal of Medical Ethics, medethics-2020-106999. https://doi.org/10.1136/medethics-2020-106999

Baron T, Dierckxsens G (2021). Two dilemmas for medical ethics in the treatment of gender dysphoria in youth. Journal of Medical Ethics, 48(9), 603–607. https://doi.org/10.1136/medethics-2021-107260

McMillan J, Gavaghan C (2021). Mature minors and gender dysphoria: a matter for clinicians not courts. Journal of Medical Ethics, 47(11), 717–718. https://doi.org/10.1136/medethics-2021-107924

Beattie C (2021). High court should not restrict access to puberty blockers for minors. Journal of Medical Ethics, 48(1), 71–76. https://doi.org/10.1136/medethics-2020-107055

Notini L, Earp BD, Gillam L, McDougall RJ, Savulescu J, Telfer M, Pang KC (2020). Forever young? The ethics of ongoing puberty suppression for non-binary adults. Journal of Medical Ethics, 46(11), 743–752. https://doi.org/10.1136/medethics-2019-106012

Saad TC, Rodger D, Blackshaw BP (2019). Responding to objections to gatekeeping for hormone replacement therapy. Journal of Medical Ethics, 45(12), 828–829. https://doi.org/10.1136/medethics-2019-105813

Saad TC, Blackshaw BP, Rodger D. (2019). Hormone replacement therapy: informed consent without assessment? Journal of Medical Ethics, 45(12), 824–825. https://doi.org/10.1136/medethics-2019-105611

Ashley F (2019). Gatekeeping hormone replacement therapy for transgender patients is dehumanising. Journal of Medical Ethics, 45(7), 480–482. https://doi.org/10.1136/medethics-2018-105293

Selected ADC publications

Clayton A (2025). Gender-affirming hormone treatment for young people with gender dysphoria: where do we go from here? Archives of Disease in Childhood, 110(6), 415–416. https://doi.org/10.1136/archdischild-2025-328478

Jarvis SW, Fraser LK, Langton T, Hewitt CE, Doran T (2025). Epidemiology of gender dysphoria and gender incongruence in children and young people attending primary care practices in England: retrospective cohort study. Archives of Disease in Childhood, 110(8), 612–621. https://doi.org/10.1136/archdischild-2024-327992

Miroshnychenko, A., Ibrahim, S., Roldan, Y., Kulatunga-Moruzi C, Montante, S., Couban, R., Guyatt G, Brignardello-Petersen R (2025). Gender affirming hormone therapy for individuals with gender dysphoria aged <26 years: a systematic review and meta-analysis. Archives of Disease in Childhood, 110(6), 437–445. https://doi.org/10.1136/archdischild-2024-327921

Miroshnychenko A, Roldan Y, Ibrahim S, Kulatunga-Moruzi C, Montante S, Couban R, Guyatt G, Brignardello-Petersen R (2025). Puberty blockers for gender dysphoria in youth: A systematic review and meta-analysis. Archives of Disease in Childhood, 110(6), 429–436.

Editors (2024). Gender Identity Service Series. https://adc.bmj.com/pages/gender-identity-service-series

  • Kingdon, C. C. (2024). Holistic approach to gender questioning children and young people. Archives of Disease in Childhood, archdischild-2024-327100. https://doi.org/10.1136/archdischild-2024-327100
  • Taylor, J., Hall, R., Langton, T., Fraser, L., & Hewitt, C. E. (2024). Characteristics of children and adolescents referred to specialist gender services: a systematic review. Archives of Disease in Childhood, archdischild-2023-326681. https://doi.org/10.1136/archdischild-2023-326681
  • Hall, R., Taylor, J., Hewitt, C. E., Heathcote, C., Jarvis, S. W., Langton, T., & Fraser, L. (2024). Impact of social transition in relation to gender for children and adolescents: a systematic review. Archives of Disease in Childhood, archdischild-2023-326112. https://doi.org/10.1136/archdischild-2023-326112
  • Heathcote, C., Taylor, J., Hall, R., Jarvis, S. W., Langton, T., Hewitt, C. E., & Fraser, L. (2024). Psychosocial support interventions for children and adolescents experiencing gender dysphoria or incongruence: a systematic review. Archives of Disease in Childhood, archdischild-2023-326347. https://doi.org/10.1136/archdischild-2023-326347
  • Taylor, J., Mitchell, A., Hall, R., Heathcote, C., Langton, T., Fraser, L., & Hewitt, C. E. (2024). Interventions to suppress puberty in adolescents experiencing gender dysphoria or incongruence: a systematic review. Archives of Disease in Childhood, archdischild-2023-326669. https://doi.org/10.1136/archdischild-2023-326669
  • Taylor, J., Mitchell, A., Hall, R., Langton, T., Fraser, L., & Hewitt, C. E. (2024). Masculinising and feminising hormone interventions for adolescents experiencing gender dysphoria or incongruence: a systematic review. Archives of Disease in Childhood, archdischild-2023-326670. https://doi.org/10.1136/archdischild-2023-326670
  • Taylor, J., Hall, R., Langton, T., Fraser, L., & Hewitt, C. E. (2024). Care pathways of children and adolescents referred to specialist gender services: a systematic review. Archives of Disease in Childhood, archdischild-2023-326760. https://doi.org/10.1136/archdischild-2023-326760
  • Taylor, J., Hall, R., Heathcote, C., Hewitt, C. E., Langton, T., & Fraser, L. (2024). Clinical guidelines for children and adolescents experiencing gender dysphoria or incongruence: a systematic review of guideline quality (part 1). Archives of Disease in Childhood, archdischild-2023-326499. https://doi.org/10.1136/archdischild-2023-326499
  • Taylor, J., Hall, R., Heathcote, C., Hewitt, C. E., Langton, T., & Fraser, L. (2024). Clinical guidelines for children and adolescents experiencing gender dysphoria or incongruence: a systematic review of recommendations (part 2). Archives of Disease in Childhood, archdischild-2023-326500. https://doi.org/10.1136/archdischild-2023-326500
  • Hall, R., Taylor, J., Heathcote, C., Langton, T., Hewitt, C. E., & Fraser, L. (2024). Gender services for children and adolescents across the EU-15+ countries: an online survey. Archives of Disease in Childhood, archdischild-2023-326348. https://doi.org/10.1136/archdischild-2023-326348

McCallion, S., Smith, S., Kyle, H., McQuarrie, J., Wilkinson, G., & Kyriakou, A. (2020). G431(P) Gender dysphoria – a description of the changes in prevalence, demographics and the clinical care provided by a paediatric endocrinology department. In BSPED (p. A155.2-A155). Royal College of Paediatrics and Child Health, Abstracts of the RCPCH Conference–Online, 25 September 2020–13 November 2020. BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health. https://doi.org/10.1136/archdischild-2020-rcpch.372

Butler G, De Graaf N, Wren B, Carmichael P (2018). Assessment and support of children and adolescents with gender dysphoria. Archives of Disease in Childhood, archdischild-2018-314992. https://doi.org/10.1136/archdischild-2018-314992

[uncredited] (2016). Does changing gender make children happier? Archives of Disease in Childhood, 101(5), 460–460. https://doi.org/10.1136/archdischild-2016-310846

Gunn, H., Goedhart, C., Butler, G., Khadr, S., Carmichael, P., & Viner, R. (2015). G470 Early medical treatment of gender dysphoria: baseline characteristics of a uk cohort beginning early intervention. Archives of Disease in Childhood, 100(Suppl 3), A198.1-A198. https://doi.org/10.1136/archdischild-2015-308599.424

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