Eden Openly Editorial

Guidance Appraisals

Graded appraisals of the guidance and policy documents that shape transgender healthcare, education and rights. Each appraisal takes a specific document, extracts the claims it rests on, and grades each one for the certainty the evidence actually warrants — the same method Eden Openly applies to a treatment or a screening test.

What is a Guidance Appraisal?

A Guidance Appraisal grades the claims a guidance or policy document makes against the evidence those claims rest on. It holds two questions apart: whether a claim is well supported by the evidence, and whether the policy is sound — which are not the same question. It grades the first, symmetrically: marking a claim up where the evidence supports it and down where it does not, and naming where a claim is a legal or policy choice that evidence cannot grade at all.

• The claims of a specific document, extracted and graded one by one.
• The evidence question and the policy question kept apart.
• Full references and provenance for every source.
• An appraisal of how well the claims are supported — not a position for or against the policy.

Graded, not opinion

A Guidance Appraisal is not an opinion piece. It is an evidence appraisal held to a deposit standard, with a version history and a permanent identifier, so that its grades can be checked, cited and revised as the evidence changes.

Editorial Principles

• Evidence before opinion.
• Grade the claims that cut against us at full strength.
• Distinguish evidence from inference, and both from legal or policy choices.
• Document uncertainty rather than conceal it.
• Update appraisals when significant new evidence emerges.

Published Guidance Appraisals

• GA-001 · Version 2.0 · DOI 10.5281/zenodo.22285831
  Grading the Guidance: An Evidence Appraisal of KCSIE 2026 on Children Questioning Their Gender — with its resources for schools.

The Verdict Series: appraising the guidelines

From October 2026, guidance appraisals of guidelines, standards of care, position statements, evidence reviews and court rulings on gender-affirming care are made in one series, by one registered method, in an order fixed in advance. Every statement in a document is recorded and given a verdict, GOOD, BAD or INDIFFERENT, with its reason, its page and the grounds for it; the claims that carry the most weight have their sources read in full; and every appraisal is checked by a human verifier, who is not shown our findings, before it is released.

→ The programme, the method and the full list of 85 documents

The registered method

The method is fixed in two documents, registered together, publicly, on the Open Science Framework on 7 October 2026. The registered texts govern every appraisal in the series.

• Method · Version 0.6
  EO Guideline Appraisal Protocol (GAP) — exactly how each document is appraised: the stages, the forms, the tests for strong recommendations made on weak evidence, and the release checks.
• Method · Version 0.6
  EO Verdict Series — Standard and Register — what the series is, what enters it, the order of work, what each verdict means, and the register of documents to be appraised.
• Record
  Review log — every independent review of the drafts of the method, and how each finding was resolved. Versions 0.4 and 0.5 of both documents are registered alongside, as superseded records.

→ Registration 10.17605/OSF.IO/SY4GP (all seven files, each identified by its SHA-256) · Project 10.17605/OSF.IO/4PGWN

In progress

• GA-003 · In progress · Checking the sources
  WPATH Standards of Care, version 8 (2022) — the series’ development object. Its appraisal began before the method was fixed and continues under a disclosed transition provision, so it is development material, not a validation of the method.
• GA-004 · Being set up
  American Academy of Pediatrics policy statement (Rafferty 2018; reaffirmed 2023) — frozen and fingerprinted before anyone opened it.
• GA-005 · Being set up
  Endocrine Society clinical practice guideline (Hembree 2017, with 2018 corrigendum) — frozen and fingerprinted, with earlier reading of it declared in full.

No findings from the series have been published. Each appraisal registers its own frozen records before the work that could reveal its results begins.

Appraised under a separate method

• GA-002 · In preparation
  Appraising the Cass Review — a registered meta-appraisal of the Cass Review and the York reviews it commissioned. It uses its own registered method, which places each conclusion in a category rather than grading certainty. No findings published.

Related publication types

• Evidence Reviews — comprehensive syntheses of clinical evidence.
• Evidence Notes — concise evidence summaries.
• Evidence Maps — where the evidence on a question comes from.
• Editorial Briefings — timely analysis of current issues.