RESUMO
This commentary is a critique of a recent systematic review of the evidence for the use of puberty blockers for youth with gender dysphoria (GD) by Rew et al. (2021). In our view, the review suffers from several methodological oversights including the omission of relevant studies and suboptimal analysis of the quality of the included studies. This has resulted in an incomplete and incorrect assessment of the evidence base for the use of puberty blockers. We find that Rew et al.'s conclusions and clinician recommendations are problematic, especially when discussing suicidality. A key message of the review's abstract appears to be that puberty blockers administered in childhood reduce adult suicidality. However, the study used for the basis of this conclusion (Turban et al., 2020) did not make a causal claim between puberty blockers and decreased adult suicidality. Rather, it reported a negative association between using puberty blockers and lifetime suicidal ideation. The study design did not allow for determination of causation. Our commentary concludes by demonstrating how the GD medical literature, as it moves from one publication to the next, can overstate the evidence underpinning clinical practice recommendations for youth with GD.
Assuntos
Disforia de Gênero , Pessoas Transgênero , Adolescente , Adulto , Disforia de Gênero/tratamento farmacológico , Identidade de Gênero , Humanos , Puberdade , Comportamento SexualRESUMO
The posterolateral corner (PLC) of the knee is a complex area, previously poorly understood by radiologists. Numerous structures make up the PLC, whose evaluation is difficult because of the variable presence of the individual components, their intimate and commonly overlapping insertions, and their oblique course on traditional imaging planes. The clinical relevance of PLC injuries, especially the infrequently repaired "minor" components, adds to the confusion. Our purpose is to review the anatomy, imaging, clinical evaluation, and treatment options for PLC injuries.