Eden Openly Editorial

Updates

One place to see everything new across Eden Openly — new articles, new Evidence Reviews and Notes, Clinical Reviews and briefings, and the corrections and deposits that follow them. When something is corrected, it is logged here in the open. Nothing is changed silently.

How to read this page. Entries from July 2026 onward are dated to the day, newest first. The corpus launched in a single run through June 2026; those items are grouped under June 2026 rather than dated individually. Each Evidence Review (ER), Evidence Note (EN), Evidence Map (EM) and Clinical Review (CR) carries its permanent identifier.

October 2026

• 30 October 2026 · Updated · Clinical Guide · Draft for review
  Caring for trans and gender-diverse patients
  The guide is updated to draft 0.17, with print sheets 0.7, and adds eleven decision cards: flowcharts and quick tables for which drug to hold; clot, heart attack or stroke; surgery and anaesthesia; reading a blood result; high haematocrit; running out of hormones; testing the organs present; pelvic pain or bleeding; after genital or chest surgery; headache or seizure; and contraception. The cards can be viewed on the page or downloaded as a PDF. This draft also tightens several safety points, including when not to bridge a drug, imaging for a sudden severe headache, and same-day review for pain with a positive pregnancy test. It is still under specialist review and not for clinical use.
• 26 October 2026 · New · Clinical Guide · Draft for review
  Caring for trans and gender-diverse patients
  A quick guide for clinicians who aren’t specialists in trans care: two companion print sheets, In clinic and In the ED / on the ward, with the full referenced text behind them. Every clinical claim is cited; wording that is our own is marked as Eden Openly advice. Published as draft 0.15 while specialist clinical review is under way, and not yet for clinical use. Clauses still awaiting a named specialist’s sign-off are marked. We are asking clinicians for feedback before version 1.0, which will be deposited with a DOI.
• 26 October 2026 · New · Site page
  Clinical Guides
  A new home under Publications for short, referenced guides written for clinicians at the point of care: print sheets for the clinic or the ward, with a full web version in which every clinical claim is cited.
• 26 October 2026 · Updated · Advocacy
  The Welsh Gender Service pause: an analysis of the published record
  Section 2, “Who decided, and when”, is rewritten from the report, the private-session minutes and the Chair’s Action of 24 August. The executive recommended and the sub-committee endorsed, but the final endorsement was given by Chair’s Action the same day, after a private session of about an hour; the pause of booked surgery was added in discussion, not recommended in the paper; and no impact assessment came first. The section was checked against the documents by a reader who had not written it. The first version is kept, unchanged, at the end of the section. No grade changes. The running record carries a note of this and of the risk register added on 24 October.
• 25 October 2026 · Updated · Site page
  Our research: figures and published list brought up to date
  The page now counts 18 works deposited with a DOI, where it counted 14 evidence reviews: the count now includes the guidance appraisal GA-001, Evidence Notes EN-025 and EN-026, and Evidence Map EM-001, all three of which are added to the published list. It also counts 23 register entries for our own errors, not 19, and shows the current versions of ER-005 (3.0), ER-018 (1.1) and ER-023 (1.1). The home page takes its figures from this page and now matches it. Logged in the page’s revision history.
• 25 October 2026 · Corrected · Site pages
  Today’s entries were dated 26 October
  Six entries on this page, and entries on Our research, Publications, Evidence Maps, the evidence map page and How we use AI, were dated 26 October 2026. The work was done on 25 October 2026 (UTC), and every date is now corrected to match. No content changed.
• 25 October 2026 · New version · Research in progress
  EM-001 · Korean patients deserve Korean evidence, version 1.1
  All 30 records sent to full text were checked blind by an independent human reviewer working without AI; 25 of 30 agreed with the AI decision. On the author’s rulings, two studies were added (outcomes after reversal of genital surgery; changes in sex drive after stopping hormones) and two stayed excluded. The map now has 190 studies and 19,819 participants; Europe and North America 88.7% and Korea 0.35% are unchanged, and named questionnaires are 46 of 190 (24%). One correction: a record decided on its abstract had been labelled as decided on full text. A participant-counting rule is now written down, and one count changed (13 to 14). The report has a correction record of twenty entries and a new data file for the full-text check; the data and code on GitHub are updated. Version DOI 10.5281/zenodo.23648451. Report PDF SHA-256 4b4cb701a20a38868b5c470996ccb298d615a8dec2a6d18bb0c44d9be2c1799d. The evidence map page, Evidence Maps, Our research and How we use AI are updated to match.
• 25 October 2026 · Updated · NHS hospital accommodation
  A reported NHS England impact assessment of the hospital accommodation guidance
  The Guardian reported on 18 October that NHS England has prepared an internal impact assessment of its revised hospital accommodation guidance, identifying possible adverse impacts for trans patients as well as benefits. NHS England has not published it, and we have not seen it. It bears on two of our requests, and if our second letter is unanswered by 16 November, our Freedom of Information request will ask for it by name. Noted on What we’re asking NHS England.
• 25 October 2026 · Corrected · Site page
  How we use AI: evidence maps
  The page said, without qualification, that the author checks every claim against its source. Our first evidence map, EM-001, which cites this page as its AI statement, used AI-assisted screening and coding checked by the author only on a random sample of 80 records. The page now has a section on evidence maps and sets a new rule: every full-text decision in a map is checked by the author before deposit. EM-001’s 30 full-text decisions are being checked now, and the result will be published in its next version.
• 25 October 2026 · Corrected · Site page
  Our research: what AI does and does not do
  The page said AI never screens studies or extracts data “in our reviews”. That holds for our Evidence Reviews, but our first Evidence Map (EM-001) used AI-assisted screening and extraction, labelled on every decision and checked by the author on a blind sample of 80 records. The page now says which applies to which. Logged in the page’s revision history.
• 25 October 2026 · New · Publication type
  Evidence Maps: a new publication series
  Evidence Maps show where the evidence on a question comes from (which countries, populations, designs and measures) by counting and classifying studies, without grading their findings. The landing page sets out what a map is, what it is not, and how it is checked, and lists EM-001. Evidence Maps is in the main menu under Research.
• 25 October 2026 · Updated · Research in progress
  EM-001 · Korean patients deserve Korean evidence: the report can now be downloaded from the page
  The evidence map page and Our research now link straight to the report PDF. The link goes to the file held in the Zenodo deposit, not a separate copy, so what you download is the file whose SHA-256 is recorded (f6a78624202b947e2b23cb060dd6abfebd427346c23ba00e644adf97d8c08d4b). No figure changed.
• 25 October 2026 · Deposited · Research in progress
  EM-001 · Korean patients deserve Korean evidence: an evidence map of sexual health after gender-affirming care, version 1.0
  The first in a new Evidence Map series, deposited on Zenodo: an 11-page report with its method, the Korean evidence study by study, declarations and a correction record of fourteen entries, together with the data behind every figure (all 959 screening decisions, the 188 included studies, the 13 records that could not be obtained and the 80-record blinded author check). The data, the screening prompts and the scripts that reproduce every figure are on GitHub. Version DOI 10.5281/zenodo.23646560; all versions 10.5281/zenodo.23646559. Report PDF SHA-256 f6a78624202b947e2b23cb060dd6abfebd427346c23ba00e644adf97d8c08d4b. Linked from the evidence map page and Our research.
• 25 October 2026 · Updated · Research in progress
  Measuring sexual orientation and gender identity in Korean national surveys
  Drafting is under way, with the Korean edition prepared alongside; a full draft is due in December 2026. Section 5 now names the six quality dimensions of Korean official statistics and the Ministry of Data and Statistics.
• 25 October 2026 · Corrected · Research in progress
  Korean patients deserve Korean evidence: corrections after an independent check
  An independent check of every figure found errors, now corrected on the page and the poster. 45 of 186 studies (24%) used a published sexual-function questionnaire, not 46 (25%): our coding rule read “SEAR” inside the word “researcher”. Two studies were recoded by country, so Europe and North America is 88.7%, not 88.6%. The Korean KITE cohort had 84 people after vaginoplasty, not 75, and asked one question on sexual confidence, which we had not reported. KITE was found outside our PubMed search, so it is reported beside the map rather than counted in it; counted in, Korea would be 4.3% of participants rather than 0.35%. The page’s change log lists every correction.
• 24 October 2026 · New · Research in progress
  Korean patients deserve Korean evidence: an evidence map of sexual health after gender-affirming care
  An evidence map prepared for the Korean Association for Sexual Health (대한성학회) autumn conference on 21 November. Of 186 studies reporting sexual outcomes after gender-affirming hormones or genital surgery (19,778 participants), Europe and North America contributed 88.7% of participants and Korea 0.35%: three case series from one centre, with outcomes collected by interview. Only 24% of all studies used a published sexual-function questionnaire. The page gives the full PubMed search, the Korean database searches, the screening method and every included study. It also records an error in our own first search, which missed older Korean papers indexed in PubMed, and how it was corrected. Figures are provisional while 13 records remain unobtainable. Added to Our research.
• 24 October 2026 · Updated · Advocacy
  The Welsh Gender Service pause: an analysis of the published record
  A twenty-eighth document is added: the Committee’s risk register for the sub-committee meeting of 30 October, which records two new Welsh Gender Service risks, opened on 1 September and rated 16 against a target of 8. It lists the impact assessments among its controls in place, frames the quality and safety risk as a condition rather than a finding, and lists referral benchmarking against NHS England services as a control, with no result published. No grade changes. The document count is updated on every Welsh Gender Service page.
• 24 October 2026 · Updated · Single patient record
  The single patient record: in the House of Lords
  Weekly amendments update. As at the running list of 23 October 2026, further single patient record amendments have been tabled: Baroness Barker would exclude sexual and reproductive health information from the record without the patient’s consent and protect anonymous sexual-health services; Lord McColl of Dulwich would admit regulated non-NHS providers subject to role-based access and audit; and Lord Markham would require a data-minimisation review. Our House of Lords and assurances pages are updated. Recorded as tabled, not carried.
• 23 October 2026 · New · Advocacy
  The Welsh Gender Service pause: what the decision record shows
  Our view after the papers of 24 August were published, tested against the conditions we set on 6 October. One is met: the decision record. The others are not: absolute numbers, case-level evidence, the review framework, and a procedure-by-procedure proportionality review. The record shows a decision taken quickly, on a signal, without prior impact assessment, and widened in discussion to include booked surgery. It still does not show that pausing all three procedures was proportionate. Six asks, and what we are not saying. Added to the navigation on every Welsh Gender Service page.
• 23 October 2026 · Update and correction · NHS Wales
  The decision record is published
  The Committee published the papers of the sub-committee’s private session of 24 August: the report, the draft minutes and a Chair’s Action. It released its escalation letter of 25 August to us the day before, and answered our four letters of 5 and 6 October. The papers show the route of the decision and the options considered, and they confirm that no impact assessment preceded it. The analysis adds six documents (D22 to D27), marks one finding superseded and updates five others. The running record, correspondence page, commitments page and four other pages carry dated notes. The minutes commitment is scored as met two days late. Corrected: two pages said the impact assessments were created on 16 September. That is the date on the published files; the Committee says the first versions were created on 26 August. Two pages said the scope had never been justified in public; the minutes now give part of the reasoning, though still none procedure by procedure.
• 22 October 2026 · Update · Declared interests
  New declared interest: general membership of KALM
  The author has become a general member (일반회원) of the Korean Association for LGBTQ Medicine (한국성소수자의료연구회, KALM), an association of clinicians working in LGBTQ+ health in Korea. It is entered in the register of declared interests as interest (i), dated 22 October 2026, and the register’s Memberships section now refers to it. General membership carries no fee, voting rights or office. KALM has published Korean-language material on WPATH’s Standards of Care, Version 8, which Eden Openly appraises, so we have declared it. No other interest has changed. Papers published from today will carry the updated competing-interests statement.
• 21 October 2026 · Updated · NHS hospital accommodation
  NHS England aligns its statistics page and methodology with the new guidance
  After ET-078 was resolved, we noted that the mixed-sex accommodation statistics page and its breach rate methodology still described the collection as counting “unjustified mixing”. NHS England has now reworded both to match version 1.6 of its collection guidance, and issued a note to provider information departments on 21 October. We checked both changes. Recorded on What we’re asking NHS England and in the Evidence Transmission Register, where ET-078 stays resolved. Our other four requests are still awaiting a response.
• 21 October 2026 · Updated · Single patient record
  The single patient record: in the House of Lords
  Committee amendments continue to be tabled. As at the running list of 20 October 2026, Lord Patel (crossbench) has tabled the confidentiality amendment he signalled at Second Reading — requiring the regulations to provide that processing complies with the obligation of confidence owed to the patient — and Baroness Hollins has tabled a new clause protecting confidential psychological therapy records. Our House of Lords and assurances pages now note these. Recorded as tabled, not carried.
• 20 October 2026 · Updated · NHS hospital accommodation
  NHS England fixes the reporting-guidance link (ET-078 resolved)
  Three days after our report, NHS England replaced the October 2019 collection guidance on its mixed-sex accommodation statistics page with version 1.6 (October 2026), which reflects the new hospital accommodation guidance, removes the ‘unjustified’ and ‘justified’ terminology and applies from October 2026 data. ET-078 is resolved. Dated update notes were added to EN-026 (its original text unchanged), the clinician guide (version 1.1), What we’re asking NHS England and the advocacy page. Our other four requests are still awaiting a response.
• 20 October 2026 · Correction · Editorial
  Three sets of notes carried the wrong date
  We work in Korea, nine hours ahead of the United Kingdom, and three sets of notes on our Welsh Gender Service pages were dated by the Korean clock rather than the UK one. The third check of our coverage was dated 11 October and was made on 10 October. The note that the Senedd equality committee had published our response was dated 17 October and was made on 16 October. The notes on the first freedom of information answer were dated 20 October and were made on 19 October. Each is now re-dated, and the affected entries on this page are moved to the right day. Nothing else in them changed. We date everything by UK time because every commitment we track was given in it, and we have tightened how we check the date before writing one.
• 20 October 2026 · Update · NHS Wales
  A formal escalation letter was issued on 26 August
  The response to our request CTMUHB_584_26 says the Committee took the decision. The service was told verbally on 24 August, and a formal escalation letter was issued on 26 August. Five of our pages had said no escalation letter had been mentioned, which was true of the published record. Each now carries a dated note, and the analysis adds both freedom of information responses as D20 and D21. The response also says three clinicians, psychologists and psychiatrists, have been appointed to the review; that patients have been written to; and that the senior leadership team has met twice a week since June, so those meetings predate the concerns. The PDF is on our correspondence page.
• 19 October 2026 · Update · NHS Wales
  The first answer to our freedom of information requests
  The response to CTMUHB_569_26 says the report and minutes of the 24 August sub-committee meeting will be published on 23 October, two days after the date the Committee Secretary gave, and dates the concerns behind the pause to checks in July and August. It gives no procedure-by-procedure reason for the scope, no number of complaints, and no answer on any earlier equality assessment, the escalation letter or the Executive Lead. Recorded on our correspondence page, commitments page and running record.
• 19 October 2026 · Updated · Research in progress
  Measuring sexual orientation and gender identity in Korean national surveys
  The planned brief now covers sexual orientation as well as gender identity, as the 2022 Korean work it builds on and the National Human Rights Commission’s recommendation do. Gender identity remains the main focus. Retitled from “Measuring gender identity in Korean national surveys”; the page address is unchanged.
• 19 October 2026 · Updated · NHS hospital accommodation
  What we’re asking NHS England
  NHS England’s Elective Analysis team has replied to our report that the mixed-sex accommodation statistics page still offers the 2019 reporting guidance: the page “will be updated to reflect this change”. It had not changed when checked on 19 October 2026. The reply did not say whether updated collection guidance has already been issued; we have asked. Recorded in the correspondence register, in the Evidence Transmission Register (ET-078, now Acknowledged) and in the revision history of EN-026, whose text is unchanged. Our other four requests are still awaiting a response.
• 18 October 2026 · New · Research in progress
  Measuring gender identity in Korean national surveys
  A planned bilingual implementation brief on what it would take to introduce a gender-identity measure into Korean official health statistics, building on Korean work from 2022 and answering the reasons the government gave in 2022 for declining the National Human Rights Commission’s recommendation. Scoping has begun; publication is planned for February 2027 at the latest. Korean survey methodologists, statisticians and researchers are invited to take part. Added to Our research.
• 18 October 2026 · New · Patient card · companion to EN-026
  Admitted to hospital in England? A card for trans patients
  A one-page A4 card for patients to take into hospital and show to the nurse in charge. It quotes NHS England’s guidance (PRN02528i) on single rooms, the clinical exception, records and escalation, lists where the rule does not apply, and names the source of each passage for staff. Linked from the patient guide. Version 1.0; SHA-256 a2187ec310cca3d725dc731f72a6d744de2a436f8642fc84ab9699dec6fe2c05.
• 18 October 2026 · Corrected · Patient guide · companion to EN-026
  Trans patients and NHS England’s new hospital accommodation guidance: what it means if you are admitted
  Corrected [children’s units exception]: the guide said the rule does not apply in children’s wards and units unless a child or parent makes a reasonable request for a single-sex environment. The guidance also requires that it “would be clinically and operationally appropriate to do so”; the row now gives both conditions. Found by an independent check of text prepared for social media. Version 1.1; nothing else changed.
• 17 October 2026 · Deposited · Evidence Note · EN-026
  How NHS England’s revised hospital accommodation guidance uses its sources
  Version 1.0 deposited to Zenodo with its claim register, quotation check and source manifest. Version DOI 10.5281/zenodo.23433543; concept DOI 10.5281/zenodo.23433542. SHA-256 of the deposited files: EN-026-v1_0.pdf 3722bebb5aa719f596f0e3c8bdfc95a9e25176497bdfbbacfe07ac98cd81fb65; EN-026-v1_0-claim-register.pdf 142f838b2095649ca3fd0b4ff493d0d2b873875c362a08889add492775760fbd; EN-026-v1_0-quote-check.csv 4593a1d097e0203b5ef31c277c4ed96f73c5fcc0ab5a875e6b174ade79cfa5b6; EN-026-v1_0-source-manifest.pdf a259ed42010cfd57db69b29eeb1e5658fc757042d06c186c25ee1b66da210560. The deposited PDF replaces the interim PDF posted earlier the same day (SHA-256 44b049b29f8ec261650da797cd1b42201313faca76a624d4fd9b60a2031d063d); it adds a cover, abstract, integrity note and completed declarations, and changes no finding. Two corrections were made at deposit: the quotation-check file published earlier gave offset line numbers (Correction 31), and the deposited PDF’s Data availability statement wrongly says the source manuscript and build script are deposited with it (Correction 32), corrected on the web page and to be carried into the PDF at its next version.
• 17 October 2026 · Updated · Advocacy
  Letters sent to NHS England on hospital accommodation
  Two letters were sent to NHS England on 17 October 2026 and delivered within seconds. The first reports to the team responsible for the mixed-sex accommodation statistics that the reporting guidance linked from the revised guidance is still the 2019 version; it is recorded in the Evidence Transmission Register as ET-078. The second sets out our four other requests: the proportionality assessment, the evidence and engagement behind the guidance, procedures for the hardest cases, and how trans patients’ own safety is to be assessed. Both are awaiting a response. If there is no reply by 16 November 2026, the two requests for information will be resubmitted under the Freedom of Information Act 2000.
• 17 October 2026 · New · Advocacy
  What we’re asking NHS England
  Five requests to NHS England about its revised hospital accommodation guidance, each resting on a finding in Evidence Note EN-026: publish the proportionality assessment; publish the evidence and engagement behind the guidance; correct or explain the reporting-guidance link; give staff a procedure for the hardest cases; and say how trans patients’ own safety is to be assessed. We are not asking NHS England to reverse the policy. The page sets out what would answer each request and keeps a register of every letter and reply. No letter has yet been sent.
• 17 October 2026 · New · Advocacy
  NHS hospital accommodation and trans patients
  A new advocacy page on NHS England’s revised hospital accommodation guidance, under which trans patients are placed by biological sex. It sets out what has changed, our position in short, and where to find Evidence Note EN-026, the guides for patients and for clinicians, and every PDF and audit file. We have not written to NHS England; if we raise the reporting-guidance point, the correspondence will be recorded on the page and in the Evidence Transmission Register.
• 17 October 2026 · New Evidence Note · EN-026
  How NHS England’s revised hospital accommodation guidance uses its sources
  On 15 October 2026 NHS England replaced its 2019 guidance on same-sex hospital accommodation: trans patients should now be placed by biological sex, with a clinical exception and a single-room offer. This standalone note examines how the guidance uses its legal sources and its predecessor, what it cites for its factual propositions, and what it leaves unspecified. The rule combines the law with NHS England’s own policy choice. The guidance paraphrases the EHRC code without the statutory conditions and proportionality requirements, cites no empirical evidence, and does not reproduce the 2019 procedures for trans and non-binary patients; the reporting guidance it links to is still the October 2019 version. The note also records where the guidance is careful and accurate, and it does not judge whether the policy is right. Published with its claim register, quotation check and source manifest. SHA-256 of the PDF of record: 44b049b29f8ec261650da797cd1b42201313faca76a624d4fd9b60a2031d063d.
• 17 October 2026 · New resources · EN-026
  Hospital accommodation: guides for trans patients and for clinicians
  Two companion guides to EN-026, each with a printable A4 PDF. The patient guide explains where the new guidance applies, what staff are told to do, what you can ask for if you are admitted, and what the guidance leaves open. The clinician guide sets out the placement decision, the exceptions, recording and reporting, and the points left to local decision. Neither is legal advice, and neither takes a position on whether the policy is right.
• 17 October 2026 · Updated · Single patient record
  The single patient record: in the House of Lords
  Lords amendments are being tabled for Committee. Our House of Lords and assurances pages now note the amendments to the single patient record clause as at the running list of 16 October 2026 — among them a group in the name of Lord Clement-Jones (a patient right to opt out, access logging and an annual independent audit, and removal of the confidentiality set-aside) and a readiness-assessment amendment from Lord Kamall and Earl Howe. Recorded as tabled, not carried; the narrower National Data Guardian alternative on confidentiality had not been tabled as at that list.
• 16 October 2026 · Update · Senedd
  Our response to the Senedd’s equality committee is published
  The Senedd’s Equality, Human Rights and Social Justice Committee has published our response to its priorities consultation as POSS48, attributed to Eden Openly. It proposes that the committee examine how the public sector equality duty is discharged when a public body restricts or withdraws access to a service. Both of our Senedd submissions on the Welsh Gender Service pause are now on the public record; the other is SSP112. Recorded on our correspondence page.
• 15 October 2026 · Updated · Evidence Transmission Register
  ET-073 to ET-077 acknowledged
  QueerAF replied in full on 15 October to the points we reported on 12 October about two articles examined in Evidence Note EN-025. It declined a separate request of ours for the FOI responses behind its clinic figures, to protect sources, and we have withdrawn that request. It offered to review the note and tell us of any inaccuracies from its perspective. The five reported points are not yet addressed and remain open.
• 15 October 2026 · New · Single patient record
  The single patient record: the assurances given
  A new page tracking each ministerial assurance about the single patient record — on who may access it, what is logged, and how sensitive information is handled — against what the Bill actually requires. It records the Government’s Second Reading assurance that access will be restricted to authorised users with an audit trail, given at the despatch box and not on the face of the Bill, and the common-law duty of confidentiality left for the Minister to answer to Lord Patel. Updated as the Bill moves through the Lords.
• 15 October 2026 · Updated · Single patient record
  The single patient record: in the House of Lords
  Updated against the corrected Hansard of the 13 October Second Reading: the debate note now records the Government’s despatch-box assurance on access and audit, Lord Patel’s intended amendment on the common-law duty of confidentiality and the Minister’s undertaking to respond to him, and Lord Kamall’s front-bench questions on access and sensitive information. The hub page was moved to past tense now that Second Reading has taken place.
• 14 October 2026 · Corrected · Editorial
  How certainty is marked: Deposit Standard and How We Evaluate Evidence
  Correction and update. The two pages described our certainty marks in different ways, and neither matched the scheme our reviews use. Both now set out the same scheme: separate axes, with any axis that does not apply left out; marks of ROBUST, MODERATE or LIMITED, and MAJOR, MODEST or MINOR for clinical importance; and, where the evidence cannot answer, a mark that says why. The scheme now includes an Association axis and the NONE IDENTIFIED mark. The provenance records on our references are now listed in full on both pages, and How We Evaluate Evidence no longer contradicts itself on sources we could not obtain. Each page’s revision history records what changed.
• 14 October 2026 · Corrected · Editorial
  Deposit Standard
  Correction (factual error). Two passages still described our reviews as pseudonymous and said we “cannot publish a name”. Eden is the author’s legal first name; only her surname is not published. Both passages are corrected, matching the correction made to the page’s opening section on 10 October, and the page’s version history records the change as version 1.2.
• 14 October 2026 · Updated · Evidence Review · ER-018
  Venous Thromboembolism, Myocardial Infarction and Ischaemic Stroke in Feminising Hormone Therapy
  Version 1.1 deposited (doi:10.5281/zenodo.23355798, under concept doi:10.5281/zenodo.21417059). A documented update search and independent external review brought in syntheses and cohorts published within v1.0’s own window — among them the expanded Kaiser STRONG funder report, the 2024 cardiovascular meta-analysis, the randomised route trials and the paired ENIGI coagulation cohorts. The venous estimate is now given as roughly 1.7–2.0, with each cohort’s exposure definition stated; the ischaemic-stroke finding is no longer presented as uniformly reassuring — it is discordant between analyses, higher in the expanded Kaiser initiation cohort, and less reassuring in the pooled estimate. The full correction and update record (items 18–33) is in the review’s revision history. A standalone claim-to-reference map for the graded-body claims is deposited with this version as a supplementary file; it was built with AI assistance and verified by the author.
• 14 October 2026 · Updated · Evidence Note · EN-018
  Venous Thromboembolism, Myocardial Infarction and Ischaemic Stroke in Feminising Hormone Therapy
  The plain-language companion was updated to match ER-018 v1.1: heart attack and stroke are now separated — heart attacks are not raised (if anything lower), while stroke is less settled, with a higher signal in a large US initiation cohort and in the pooled estimate — and the clot-size range and injectable detail were refined.
• 14 October 2026 · Update · Clinical articles
  Competing interests on clinical articles now link to the register
  On ten clinical articles, the competing-interests section now names the author’s commercial interest in skincare and a planned aesthetic hospital in one line and links to the register of declared interests, where every interest is listed in full with the date it began. The interests themselves are unchanged. Evidence Reviews, Evidence Notes and Clinical Reviews keep the full statement, so that each page matches its deposited version. The ten are the four hair-removal articles and What Laser Hair Removal Actually Does to the Follicle, Oestrogen and Your Skincare Routine, Sunscreen on HRT, AHAs vs Retinoids, The Ceramide Barrier and How Oestrogen Changes Your Skin at the Cellular Level.
• 14 October 2026 · Corrected · Clinical article · Hair Removal 3/4
  Pre-Vaginoplasty Hair Removal: Laser vs Electrolysis
  Every claim was checked against the full text of its source, and the article was corrected in several places. The session counts from the one detailed laser–electrolysis comparison came from a subgroup of 19 and 10 patients, not all 52, and the total time to finish was similar with either method; two smaller surveys that found no difference in session numbers are now reported. The article said stones were a phalloplasty problem while listing them as a vaginoplasty complication; it now separates concretions in the neovagina from stones in a neo-urethra. Removing follicles during surgery is now presented as a recognised alternative or complement to clearance beforehand, and an unsourced figure (17% of follicles dormant) was removed. The 2006 study’s untreated group was 60 patients, not small, and two unsourced explanations of its null result were removed. The summary on whether removal prevents complications now matches the body. A source note saying the WPATH Standards of Care have no wording on preoperative hair removal was wrong. Wording about surgical practice was revised. The article’s revision history lists every change.
• 14 October 2026 · Corrected · Clinical article · Hair Removal 4/4
  Pre-Phalloplasty Hair Removal: Donor Sites and the Neo-Urethra
  Corrected after a full-text check of every source. The article presented the thigh as the usual source of the urethra in anterolateral thigh phalloplasty; in many centres the urethra is built from a separate flap, hairless genital tissue, grafts or prelaminated tissue, and the article now explains which skin may need clearing in each case. A surgeon’s view on forearm hair and the aesthetic case for keeping shaft hair could not be verified and were removed, as was an unsupported claim that thigh skin is hairier than the forearm. The depilation study is now described accurately: it used laser, intense pulsed light or electro-optical synergy, and found no difference in urethral hair between treated and untreated men. Hair inside a neo-urethra can be treated in more ways than the article said. The article’s revision history lists every change.
• 14 October 2026 · Corrected · Clinical article · Hair Removal 1/4
  Laser vs Electrolysis for Facial Hair Removal
  Corrected after a full-text check of every source. The article put paradoxical hair growth after laser at up to about 10%; the facial study it cited reported 16.2%. It said electrolysis is recognised in device regulation as permanent removal; that wording comes from FDA consumer information, and the regulation does not use it. A small split-body study was said to favour the Nd:YAG laser for effectiveness; it found similar hair reduction. The isotretinoin label was misquoted. The dark-skin laser series is now described with its patient-estimated figures and its internal inconsistencies, and the time per hair for electrolysis was corrected. The article’s revision history lists every change.
• 14 October 2026 · Corrected · Clinical article · Hair Removal 2/4
  Body Hair Removal: Laser vs Electrolysis
  Corrected after a full-text check of every source. The time course of hormone effects on body hair was wrong: guidelines put the onset at 6–12 months and the maximum beyond three years, not one to three years. The size of the effect was overstated; the Endocrine Society describes it as usually mild. Unsourced claims about which body sites respond most and about hair colour were removed, and the advice to wait for hormones before paying for removal is now labelled as our view. An unidentifiable source was replaced. The article’s revision history lists every change.
• 14 October 2026 · Corrected · Page
  Hair Removal in Gender-Affirming Care: series page
  The descriptions of the four articles were updated to match their corrections, including removing an overstatement of how much hormones reduce body hair. Stale “forthcoming” labels and promises of separate surgical-technique explainers were also removed from the articles.
• 13 October 2026 · New · Page
  How we handle data
  How Eden Openly handles data, both published data and any partner’s data we are asked to work with: governance first, identifiable data staying with the data holder, de-identification before analysis, an analysis plan written before the analysis, every step traceable, aggregate outputs only, and fair credit. Evidence Note EN-025 is set out as a worked example. The page also states what we have not yet done: our work to date has used published and aggregate data only. Also available in 한국어, 日本語, 繁體中文 and ภาษาไทย (machine translations; English prevails).
• 13 October 2026 · Deposited · Evidence Review · ER-005
  Feminising Hormone Therapy
  Version 3.0 deposited to Zenodo and now live on the page. Version DOI 10.5281/zenodo.23326467; concept DOI 10.5281/zenodo.22868536; version 2.2 remains available at 10.5281/zenodo.22868537. Every citation was checked against its source again, and a claim-to-reference map of all 577 citation pairs is deposited with the review, so that anyone can check what each citation rests on. The checks corrected the review in several places. It said the evidence on recovery of sperm production after stopping rests mainly on one series of nine people; a systematic review it cites concludes that production is restored in most people studied, though it may take a long time. It attributed a signal of added clot risk with progestogens mainly to medroxyprogesterone acetate, where that estimate rested on one or two events. It described its one comparison of clots by route in trans women as a comparison of venous thromboembolism, where it counted clots of all kinds. Several statements were not supported by the sources cited for them and were corrected or removed. It is renumbered 3.0 because certainty ratings change. It now carries our standard statement of competing interests and funding in full, including our commercial skincare interest and the overlap with our appraisal of the Cass Review, and a correction record of one hundred and fifty-eight entries. SHA-256 of the deposited PDF: 8433ff0d7b89d270b744f4a9da10d33b84ffa93765b590aa874bf1fc4c4730fe; of the claim-to-reference map PDF: 7b8e59703490392afe5f630f67c76baa2c774da8aab4b7dc6bf5bc128065dba8.
• 13 October 2026 · Corrected · Evidence Note · EN-005
  Feminising Hormone Therapy
  The note now matches version 3.0 of its companion review. It had said the progestogen clot signal comes mainly from medroxyprogesterone acetate, described the one comparison of clots by route without saying it counted clots of all kinds, and gave cyproterone’s lowest-dose advice more softly than the regulators do; each is corrected, with the earlier corrections of this revision set out in the note’s revision history. The note now carries our standard statement of competing interests and funding in full.
• 13 October 2026 · Updated · Evidence Transmission Register
  Five entries added: two news articles
  ET-073 to ET-077 record the discrepancies reported to QueerAF on 12 October 2026 in two articles examined in Evidence Note EN-025: four statements wrong as written, and one comparison that cannot show a difference in suicide rates. On 13 October the QueerAF journalist who co-wrote both articles replied that a fuller reply would follow, as EN-025 records. The register defines an acknowledgement as a substantive reply, so all five stand at Reported until that reply arrives.
• 13 October 2026 · New Evidence Note · EN-025
  Five numbers, five ways of counting: what the trans suicide figures circulating in the UK actually measure
  Content note: this note discusses suicide, including the deaths of children. At least five figures presented as counts of suicides among trans people are circulating in the UK. They use different rules for who is included and how deaths are found, cover different periods and areas, and none comes with a suitable denominator for the trans group it covers. So none of them can, on its own, estimate a suicide rate among trans people, show whether that rate is rising, or show how it compares with the rate in another population. This does not show that the risk is not higher. Five statements in circulation do not match their sources. The note is a standalone Evidence Note, without a companion review; its data processing record and a companion repository set out how every figure was checked. Suicide is preventable: Samaritans are there day or night on 116 123.
• 13 October 2026 · Deposited · Evidence Note · EN-025
  Five numbers, five ways of counting
  Version 1.0 deposited to Zenodo with its data processing record. Version DOI 10.5281/zenodo.23327489; concept DOI 10.5281/zenodo.23327488. SHA-256 of the deposited files: EN-025-v1_0.pdf e0124d8d70c19add10e70994d888b523d55caaacfb2d856f167b18656e7613ec; EN-025-v1_0-data-processing-record.pdf e435cb2e13b04f53d0354ad4d6111f3322bb191d300c49ced29eb708bf3ec142. The source register, the claims checked and the verification script are on GitHub.
• 12 October 2026 · Update · NHS Wales
  Llais answers on the terms of reference
  Llais answered our letter of 5 October. It was invited to comment on the terms of reference before they were finalised, which we had not known, and which is to the Committee’s credit. Llais later confirmed it was sent the terms of reference on 22 September and commented on 23 September. It was told people’s experiences of the pause will be considered as part of the wider review, and it reported a third wording of the condition for ending the pause. The correspondence page summarises the reply. Notes are added on our reading of the terms of reference, on Where the record stands, on the commitments page and on the running record, and our counts of letters to Llais and its full answers are updated on the correspondence page and our position page.
• 11 October 2026 · Correction · Clinical
  Stopping Is Not Neutral, corrected
  Re-reading every source behind the first piece in our Anatomy of Good Care series, while preparing our evidence to the UN, found that it stated its evidence more firmly than the sources do. It said guidance “recommends” bone-density testing after gonadectomy, where it says such testing should be considered; it left out the same guidance’s view that stopping around 50 after gonadectomy is reasonable, and a review’s finding that fracture risk does not seem to rise soon after menopausal hormone therapy stops; it cited a cohort for an improvement in anxiety the cohort did not find; and it rested one sentence on a paper we had not read. Each change is set out in the page’s version history (now v1.1) and recorded in our Evidence Transmission Register as ET-068. The piece’s argument stands; it now stands on the evidence as the sources state it.
• 11 October 2026 · New · United Nations
  What we told the UN about hormone therapy in detention
  We have submitted written evidence to the UN Independent Expert on sexual orientation and gender identity, for the Independent Expert’s report to the Human Rights Council on LGBT persons deprived of liberty. Our central point: in custody, an established hormone regimen should be changed or stopped only at the person’s request or for an individual clinical reason, and uncertainty about the effects of interruption does not make a non-clinical interruption neutral. The page sets out the evidence at its true strength, including where it is thin, and the seven measures we asked for. The full submission is four pages with 23 references.
• 11 October 2026 · New · Guidance Appraisals
  Appraising WPATH Standards of Care 8: where it stands, and the plan
  Our appraisal of WPATH SOC-8 (GA-003) now has its own page. On 10 October we fixed which of SOC-8’s statements and claims will have their sources read in full, which sources those are, and which systematic reviews a search found on the same questions, and registered that list on the Open Science Framework before opening any source we had not already read. The registration is embargoed until the appraisal is released, when its identifier and fingerprints are published. The sources are now being retrieved: 1,783 distinct works in all, covering 2,097 claims behind 205 of SOC-8’s statements and recommendations. The page sets out the plan the appraisal follows under the registered method, and how SOC-8, read before the method existed, entered it. No findings have been published. Appraising the guidelines and Guidance Appraisals now link to it.
• 11 October 2026 · Correction · Conversion Practices Bill
  Our Conversion Practices Bill pages and The Threshold, brought into line
  A further check found our pages on the Bill out of step with each other and, in places, with the evidence. Done carefully enough, it is not a crime (now v1.3) corrects its account of Germany’s law, which exempts parents unless they grossly breach their duty of care; of Malta’s, which says “repress” rather than “suppress”; of clause 2(1), which refers to “usual day-to-day activities”; and of where Galop’s methodology appears. It now sets out our recommendation on likely harm and our proposals on advertising, removal abroad and review, matches our asks page on single conversations and on consent, and no longer says careful conversion practice is “not a crime at all”. The overview now says careful practice “can” sit under the Bill’s threshold and records the asks page’s return; the Joint Committee page records that its description of our evidence was rewritten today. Part 2 of The Threshold corrects our own correction of 10 October: the Bill may not cover conduct intended only to make someone hide who they are. Parts 1 and 3, the series landing page and the briefing hub no longer say how often conversion practice takes particular forms beyond what the evidence supports, and Part 1 no longer cites a family figure that came from a general question in Galop’s survey. Each change is noted on its page, and recorded in our Evidence Transmission Register as ET-067. A second review later the same day found two overstatements introduced by these corrections: Parts 1 and 3 now give Galop’s own finding, that about four in five cases involved multiple attempts over time, and Part 1 says healthcare professionals “may” carry out some practices, as the 2021 research does. Status lines now give the Committee’s position as at 11 October. On 12 October Part 2 was corrected again: it now states that clause 1(3) also excludes conduct with a conversion objective in health care unless it falls far below expected standards.
• 11 October 2026 · Update · Conversion Practices Bill
  What we are asking Parliament to change, republished
  Our summary of the changes we are asking for is republished, rewritten around four principal recommendations after further review: an offence for children and adults lacking capacity with a systematic-or-intrusive threshold; a defined safe harbour for health care in place of the gross-negligence exclusion; suppression named and defined; and an offence of likely harm alongside caused harm. The companion piece is updated to match, and its version history records the changes.
• 10 October 2026 · Correction · NHS Wales
  A further check of our Welsh Gender Service pages
  A third check of our coverage against the primary documents and against itself found smaller points, each now marked where it occurs. The analysis’s table of pending replies now states our statutory deadlines subject to the question about requests signed with a first name only, as our other pages already did, and it now says “every scored standard” where it said “every standard”. The meeting of ministers with the Committee on 4 September is now sourced to ITV Wales, which reported that the Health Minister, the Social Justice Minister and the Deputy First Minister attended; we had left out the Social Justice Minister. Our piece The pause may be right now notes the Welsh specific equality duty, which says more about assessment than section 149 alone, and notes beside the Committee Secretary’s remark that the Chief Commissioner said “We took the decision”. The running record notes that one Welsh Government release describes quarterly oversight meetings and another says officials meet the Committee monthly. Smaller notes are added on the impact assessments piece, the meeting piece’s list of changes, our correspondence page, and five older entries on this page. (This entry and its notes were first dated 11 October, by the clock in Korea where we work; in the United Kingdom it was still 10 October. Corrected 20 October 2026.)
• 10 October 2026 · New · Conversion Practices Bill
  The Conversion Practices Bill: our position and our evidence
  A new section on the draft Conversion Practices Bill, now before a Joint Committee of both Houses. It collects a companion piece, Done carefully enough, it is not a crime; and a page recording our written evidence to the Committee, which we intend to submit when its call for evidence opens. A plain-terms summary of the changes we are asking for was published briefly and withdrawn the same evening for revision after a further review; the companion piece was corrected at the same time, and its version history says what changed.
• 10 October 2026 · Correction · Conversion Practices Bill
  The Threshold (2/4): two corrections
  Part 2 said the Bill covers conduct intended to change “or suppress” a person’s orientation or identity; clause 1(2) does not mention suppression. It also described the health care exclusion as applying to exploratory care, when it applies to conduct carried out with a conversion intention. Both are corrected, and recorded in the Evidence Transmission Register as ET-066.
• 10 October 2026 · Update and correction · NHS Wales
  A second Welsh Government release, and the points we had held for review
  A second freedom of information release, ATISN 27436, says the Committee told the Welsh Government on 18 August that concerns would be discussed at the sub-committee on 24 August, and told officials the outcome on 25 August, the day before Level 3. It is added to our analysis as its nineteenth document and to our running record; it changes no finding. We have also settled the points we had held for review. On The pause may be right, the claims that a proportionate alternative existed in August and that a later equality assessment shows the duty was not discharged now carry notes saying they go further than the record and the law. “After ministers intervened” is corrected. The scope is now described as never justified “in public” there and on our position page, beside the Chief Commissioner’s account that other options were considered. The position page’s closing line no longer rests on the assurance premise we withdrew. On The papers justifying the pause do not hold up, “the risk is not on the register” and one sentence about two different papers are corrected. Smaller corrections are on the running record, the commitments and correspondence pages, the terms of reference and the meeting pages. Our running record and position page also now note the Senedd petition on the pause.
• 10 October 2026 · Correction · Editorial
  How we describe the author’s name
  Our pages described the author’s name in five different ways, and two of them were wrong. Our research page and the Deposit Standard called it a pseudonym, and our Welsh Gender Service correspondence page called it “a name that is not a legal name”. Eden is the author’s legal first name; her surname is not published. The Independence page now gives the full policy. Other pages point to it, directly or through our correspondence page. Each corrected page carries a dated note. On the Freedom of Information requests, the open question is now stated correctly: it is whether a request signed with a first name only meets the Act’s requirement to state the applicant’s name, which the Information Commissioner reads as their real name. The same policy is now stated on the Eden Institute’s founder page, in English and Korean, and logged in its change record. Two of our notes earlier that day, on the running record and on The pause may be right, had also said “a name that is not a legal name”. Both are amended and marked, and both link to the correspondence page, which links to the Independence page. Amended 10 October 2026: this entry no longer restates the reasons for the policy, which are set out on the Independence page only, and no longer says that every other page points to it directly.
• 10 October 2026 · Correction · NHS Wales
  Welsh Gender Service: corrections across our coverage
  We checked every page in our Welsh Gender Service coverage against the Committee’s papers and against each other. The errors it found are corrected on ten pages and in eight entries on this page, each with a dated note at the passage concerned and the original wording recorded. The ones that matter most: the Committee’s papers of 17 September went to it “For Noting”, not for assurance; only the equality assessment, not both, lists reviewing whether the pause remains “necessary, objectively justified, proportionate and time-limited”; the Quality Impact Assessment lists twelve standards and scores six; one sentence was attributed to the wrong assessment; and our piece on the meeting of 22 September still said the decision was attributed to a body which says it did not take it, a correction we made on four other pages on 6 October and missed there. The Welsh Government’s freedom of information answer now supports that correction in writing. Also corrected: 24 and 26 August are the dates of two different events, not a discrepancy; the health board did publish an update on 25 September; our counts of letters, questions and documents; two entries on our commitments tracker that were in the wrong list; and the conditional review of the second 30 patients. Our statutory deadlines are now stated subject to the open question about requests signed with a first name only. None of this changes our position. A second check later the same day found three errors in these corrections: a document numbered wrongly, one page missed, and a date attributed to the wrong document. It also found places the first pass had left alone. All are now fixed and marked. A third check found that our fix of the date had gone too far, and that some corrections had reached only one page; those are fixed too. Our correspondence page now also records Llais’s reply of 25 September, which was cited elsewhere in our coverage but missing from the list.
• 10 October 2026 · New · Advocacy
  KCSIE 2026 and children questioning their gender
  A landing page for our work on the statutory safeguarding guidance in force in schools in England from 1 September 2026. It brings together the evidence appraisal, the resources for schools and the guide for staff. It sets out our position, the six questions put to the Department for Education, and a correspondence register for every letter we have sent. The finding: the Department’s policy paper puts age limits on prohibitions that the statutory guidance applies without any. As at 10 October there has been no reply to any of the three letters, twenty-six working days after delivery.
• 10 October 2026 · Updated · Evidence Transmission Register
  Evidence Transmission Register
  A new section for the Department for Education, and the first entry arising from a guidance appraisal rather than an evidence review. ET-064 records the disagreement between the KCSIE 2026 policy paper and the statutory text, as reported on 3 September. The entry does not assume which kind of defect it is: the paper may accurately describe a draft that the enacted text departed from, and our fourth question to the Department asks which. One error of ours corrected: ET-060 had dated our replacement letter 4 September when it went forty minutes after the first, on 3 September, because one date was taken in UTC and the other from a +0900 email header. Recorded as ET-065.
• 9 October 2026 · Updated · Editorial Briefing
  The Threshold: status of the draft Conversion Practices Bill
  The briefing, its landing page and all four essays now carry a dated status note: as of 9 October 2026 the Bill is still a draft, shared with Parliament for pre-legislative scrutiny, with no date given for its introduction. The opening of essay 01 no longer says the phrase is “everywhere this week”, and the landing page no longer calls the draft “the UK’s new law”. The analysis is unchanged. Each change is logged on its page.
• 9 October 2026 · Updated · Page
  Appraising the Cass Review: how we fix things in advance
  How we commit to records before outcomes exist, and how the appraisal’s random choices are drawn from public randomness that no one can predict. With a link to the new commitments page.
• 9 October 2026 · New · Page
  Appraising the Cass Review: commitments
  The fallback venue for the appraisal’s commitment manifest, and how to verify an entry.
• 9 October 2026 · Update · NHS Wales
  The Welsh Government’s freedom of information answer on the pause
  It says the escalation and the pause were clinical decisions for the Joint Commissioning Committee, and confirms it holds ministerial briefings and correspondence on the pause, which it withholds. Added to our running record and analysis. The release: ATISN 27435.
• 7 October 2026 · Updated · Declared interests
  Register of declared interests: entry (a) expanded
  Entry (a) now describes the education programmes of the non-profit organisation the author founded and funds, and states that the standards of care it teaches address the same questions as the guidelines and standards of care we appraise. The interest and its start date are unchanged; the change is logged on the register.
• 7 October 2026 · Registered · Guidance Appraisals
  The method for appraising the guidelines is registered
  The Guideline Appraisal Protocol and the Verdict Series Standard, version 0.6, are registered publicly on the Open Science Framework, before any appraisal under them is released. The registration also holds versions 0.4 and 0.5 as superseded records, and a log of every independent review of the drafts with how each finding was resolved. Version 0.5 was withdrawn before registration after an external review found defects; version 0.6 corrects them. Registration 10.17605/OSF.IO/SY4GP.
• 7 October 2026 · Updated · Guidance Appraisals
  Guidance Appraisals: the series, the registered method and the work in progress
  The Guidance Appraisals page now lists the registered method, the three documents in progress (WPATH SOC-8, AAP 2018 and the Endocrine Society 2017 guideline) and the appraisal under its own method. Appraising the guidelines and Our research are updated to match, and now note a second declared interest that can pull the other way: the author’s non-profit organisation teaches its own standards of care.
• 6 October 2026 · New · Research
  Our research: everything in one place
  A single page for all our work: what is in progress and how far each project has got, everything published with its permanent DOI, what the work has found so far (including findings that cut against our own position), and the standards and bias controls behind it.
• 6 October 2026 · New · Guidance Appraisals
  Appraising the guidelines: every guideline, every ruling, one method
  We are appraising 85 guidelines, policies, evidence reviews and court rulings on gender-affirming care, from 29 countries and international bodies, by one method and in an order fixed in advance. First are WPATH Standards of Care 8, the American Academy of Pediatrics 2018 policy statement and the Endocrine Society’s 2017 guideline. The full list, the method and the five documents still waiting to be confirmed are published.
• 6 October 2026 · New · NHS Wales
  The Welsh Gender Service pause: an analysis of the published record
  Seventeen published documents read against each other, including the new terms of reference for the clinical review. Every finding is graded and independently checked.
• 6 October 2026 · New · NHS Wales
  The Welsh Gender Service pause: where the record stands
  Our view after the terms of reference, and eight things we ask of the Joint Committee.
• 6 October 2026 · Correction · NHS Wales
  Who decided the pause: a correction
  On four pages we said nobody had said who decided, or that the only body meeting on 24 August was one said not to have decided. That overstated the record: at the 22 September meeting the Chief Commissioner said “We took the decision”. Each page now carries a dated correction at the passage concerned. On our position page the paragraph has been reworded; on the other three the original text is kept. Corrected 10 October 2026: five pages carried the claim, not four. The fifth, What the Joint Committee said, and what it did not, was corrected on 10 October.
• 5 October 2026 · Update · NHS Wales
  Welsh Gender Service: the terms of reference are published, ten days late
  Cardiff and Vale published the terms of reference for the Independent Clinical Review on 5 October, on its own website rather than the Joint Committee’s, and ten days after the week in which the Chief Commissioner said they would appear. The same day it rewrote its FAQs, adding twenty-three questions on how the review will work — who is in scope, who carries it out, whether patients are seen and how, and what can follow a review. It is the most substantial patient-facing information published since the pause began, and it says plainly that a patient needing further assessment does not mean anything was wrong with their referral. Our appraisal is at Clearer safeguards, figures that do not reconcile, and a screening method that needs explaining: the document records masculinising chest surgery, 201 of the 403 referrals, as progressing at a rate comparable to England, without explaining procedure by procedure what keeps it paused; it gives a progression figure that differs from the Quality Impact Assessment’s, over a differently described population; and it proposes a desktop screen on BMI, smoking and hormone duration without stating how that will respect the NHS England specification it adopts, which permits referral on all three. Fifteen questions have gone to the Committee across four letters that evening, the last five arising from reading the NHS England specification and the two impact assessments in full; they are set out in our correspondence record. The commitments tracker is updated, and carries a correction: for part of today we read the FAQ deletions as a commitment being dropped, when in fact they marked it being met. Corrected 10 October 2026: the specification does not permit referral “on all three”. It permits referral despite smoking or a raised body mass index, does not require hormone therapy before chest surgery, and qualifies the hormone criterion for genital surgery. And eighteen questions, seventeen of which stand, went to the Committee across four emails that evening; fifteen of them were in the two question letters.
• 1 October 2026 · Update · Protocol
  Models of Gender-Affirming Care in Asia: clinic sampling seed published
  Where a system has more than 20 private clinics, the study reads a random sample of 20. The protocol fixed the source of that randomness before registration: a public value published by the drand randomness beacon after the registration went public, so that no one could know or choose it in advance. The value (round 6512726, published 1 October 2026 at 00:00 UTC) and the sampling script are now posted in the OSF project and recorded in a dated update to the registration. Anyone can rerun the draw. The study page is updated.

September 2026

• 30 September 2026 · Registered · Protocol
  Models of Gender-Affirming Care in Asia: protocol v1.0 registered
  The protocol, codebook, search strings, ethics statement and review log are frozen on the Open Science Framework (DOI 10.17605/OSF.IO/UVHDA) before any data are extracted, with an archived copy on Zenodo (DOI 10.5281/zenodo.23057857). The review log records every independent check of the protocol and how each finding was handled. The South Korea pilot comes next; the study page is updated.
• 30 September 2026 · Update · Pages
  Models of Gender-Affirming Care in Asia: native-language extraction, and a call for extractors as well as verifiers
  Before registration, the study’s design changed. Non-English sources will be read and recorded in the original by paid native-language extractors, and checked by a second, independent reader, rather than extracted by the author through machine translation. A machine translation read first still shapes how a passage is understood, and the change also moves extraction to arm’s length from the author’s declared position. The call is now for extractors and verifiers, at the same rate; the study page is updated to match.
• 30 September 2026 · New · Page
  Models of Gender-Affirming Care in Asia: a comparative study, in preparation
  What the health systems of South Korea, Japan, Taiwan, Hong Kong, Thailand, Malaysia and Singapore formally require of a person seeking gender-affirming hormone therapy or surgery, and what each provides and costs, read from original-language sources. No data have been extracted; the protocol will be registered on the Open Science Framework first. The page sets out what the study does and does not do, where it stands, the author’s position and interests, and how the method guards against them.
• 30 September 2026 · New · Page
  Call for language verifiers: paid, part-time, remote
  Verifiers check every data point against its original-language source, and extract a random sample blind. Roles for Korean (first), Japanese, Chinese, Thai, Malay and legal English, with Tamil on call, at US$30 an hour for every language. Apply by email; there is no form.
• 30 September 2026 · New · Page
  Declared interests: the dated register behind every paper
  One definitive list of the author’s interests, each with the date it began: the position and declared prior, items (a) to (h), and funding. Entries are added and closed, never edited or deleted, so any paper can be read against the interests that applied on its date. It includes a commercial interest not previously declared anywhere on the site: the author co-owns a skincare business and is planning a general aesthetic hospital, item (h).
• 30 September 2026 · Update · Clinical Reviews, Evidence Reviews and Notes, Clinical articles
  A commercial interest added to fifteen skin and hair articles and the hair removal series page
  The author co-owns a commercial skincare business and is planning a general aesthetic hospital. That bears directly on what we publish about skin and hair, and it had not been declared on those pieces. Each now carries a competing-interests section and a dated entry in its revision history: ER-006 and its Evidence Note, EN-010, CR-001 Acne, Rosacea, six skin and laser articles in the Clinical section, the four articles in the hair removal series, and the series page itself. Nothing else in them has changed.
• 30 September 2026 · Update · Page
  Appraising the Cass Review: interests linked to the register
  “Our position” now links to the register of declared interests and states the commercial interest at item (h), which does not bear on the appraisal. The appraisal-specific interests, including the overlap with ER-014 and ER-015, are unchanged.
• 30 September 2026 · Update · Page
  Independence: interests now summarised, with the register as the definitive list
  “What we have a stake in” now links to the register of declared interests instead of listing each one, so the two cannot fall out of step. The sentence “None of these relationships are commercial” stopped being true once item (h) was declared, and now reads “Apart from the commercial interest at item (h) of the register, none of these relationships are commercial”.
• 30 September 2026 · New · Page
  Evidence Transmission Register: every error we have found, and every error we have made
  A single register of errors found in published documents — national evidence reviews, clinical guidance, journal articles, systematic reviews and primary papers. Each entry states what the document said, what the source said, the level of the error, the date it was reported and what has happened since. Our own errors are in the same list, on the same terms, with the same styling and the same fields as everyone else’s, including a notice of ours that was false in every particular and withdrawn seventy-seven days later. Entries ET-001 to ET-062, with accusations of ours that were wrong recorded in a section of their own. Where a correction has been directed but not yet made, the register says so and leaves the interval open rather than closing it.
• 30 September 2026 · Update · Page
  Deposit Standard 1.1: the register linked, and a rule broken on the day it was published
  “When we find an error in someone else’s work” now points to the Evidence Transmission Register, which is what makes its second rule — report first, publish afterwards — checkable rather than asserted, because the register shows the interval between a report and a correction including the intervals still open. The section also records that the notice we sent on 13 July 2026 broke its first rule, that verification means the document was opened, on the day this page first published that rule. The notice was withdrawn in full on 28 September 2026, seventy-seven days later.
• 30 September 2026 · Update · Page
  Corrections: our own corrections are entered in the transmission register
  “How corrections are recorded” now states that corrections to our own work go into the Evidence Transmission Register alongside errors found in other organisations’ documents, and that our entries are not styled differently, summarised more kindly, or grouped apart to be read separately.
• 28 September 2026 · Update · Page
  Appraising the Cass Review: AI calls and earlier reviews set out in full
  The page now states exactly where an AI model makes calls of its own in the appraisal, and how those calls are kept separate from Eden’s. It also names the earlier Eden Openly reviews that graded some of the same evidence (ER-014, ER-015 and their Evidence Notes), and says that the complete list is fixed and sealed before registration.
• 28 September 2026 · Update · Page
  How We Use AI: the Cass Review appraisal added
  A new section sets out where an AI model makes calls of its own in the Cass Review appraisal: as a check on Eden’s judgements, made blind to hers, with every disagreement published. The same wording appears on the appraisal’s page. The page’s statement that AI does not determine conclusions now points to that exception.
• 28 September 2026 · New · Page
  Appraising the Cass Review
  What our meta-appraisal of the Cass Review is and is not, where it stands, and how the method guards against its author’s declared position. Opens with a note from Eden. No findings have been published, and none will be until the whole appraisal is complete.
• 27 September 2026 · New · Page
  The Welsh Gender Service surgical pause
  A position page for the whole thread, and the entry point to everything we have published and filed on it. What was decided and when; the referral-rate concern, which is real and now published in full; why the scope has never been justified, the low-progression figure belonging to the smallest of the three surgery categories; the four different descriptions given of the complaints relied upon; proportionality still listed as work to be done; and the fact that nobody has said which body took the decision. Sets out the four things we are asking for, none of which would delay the review, and links to the six pages beneath it. Corrected 10 October 2026: the Chief Commissioner had said “We took the decision” at the meeting of 22 September, so it was wrong to say nobody had said which body took it. The page itself was corrected on 6 October. Added 10 October 2026: the page now says the scope has never been justified in public, since the Chief Commissioner described at the meeting the options the Committee considered; and it now links to nine pages, not six.
• 27 September 2026 · New · Page
  The single patient record
  A standing hub for our work on the single patient record in the Health Bill: our position on the confidentiality and access gap, and everything we have filed on it, split between the Commons and the Lords.
• 27 September 2026 · New · Page
  The single patient record: in the House of Commons
  What we filed as the Bill passed through the Commons — written evidence published on the parliamentary record as HB130, the published argument, and what happened at Committee and Report, where the safeguards gap was never reached.
• 27 September 2026 · New · Page
  The single patient record: in the House of Lords
  The live phase: our submission to the Delegated Powers Committee and our briefing to peers ahead of Second Reading on 13 October 2026, and what comes next at Committee stage.
• 27 September 2026 · New · Page
  Our submission to the Delegated Powers and Regulatory Reform Committee
  The full text of our submission: why the access-and-confidentiality safeguards belong on the face of the Bill rather than in regulations Parliament can approve or reject but never amend.
• 27 September 2026 · New · Page
  Our briefing to the House of Lords: single patient record safeguards
  The full text of our briefing to peers ahead of Second Reading, with the drafted amendment and explanatory statement in full.
• 27 September 2026 · New · Page
  About Eden Openly
  What Eden Openly is, what you will find here, and why it exists.
• 27 September 2026 · New · Page
  Independence
  Our statement of independence — the funding, interests and relationships we do and do not have, set out as facts a reader can check.
• 27 September 2026 · New · Page
  Open Access
  Why everything here is free to read, permanently, under CC BY 4.0, deposited with a DOI, and read without being tracked.
• 27 September 2026 · New · Page
  How We Evaluate Evidence
  How we appraise a study and mark the certainty of the evidence: narrative reviews conducted to a formal, written method, with our own editorial certainty scheme, set out in full so the work can be checked rather than trusted.
• 27 September 2026 · New · Page
  How We Use AI
  Where we use AI tools in our work, and where we do not.
• 27 September 2026 · Update · Page
  Corrections: “What we don’t change” added
  Added a section to our Corrections policy making explicit that we do not alter a conclusion merely because it is unpopular, uncomfortable or contested, and that only a factual error is a correction.
• 25 September 2026 · Correction · Advocacy
  Correction: the Committee does publish its statements
  We told readers we could not find the NHS Wales Joint Commissioning Committee’s statement of 23 September on its website, and that it appears not to publish its public statements. That was wrong. There is a news section at jcc.nhs.wales/news/, and both the statement of 4 September and the progress update of 23 September have been there since the day each was issued. We searched and did not find it; the error is ours. Corrections applied to all four pieces. Reading both has also sharpened one finding and softened another: the 4 September statement names masculinising genital surgery specifically as the category with lower progression — eighteen days before the meeting at which the figure was presented without any category named — while the reviewer-count contradiction is now supported only by a secondary account, so we record it as softened rather than settled.
• 25 September 2026 · New · Page
  Welsh Gender Service: commitments made
  A standing record of what NHS Wales bodies have promised about the surgical pause, in their own words, and whether it has been kept. Nine commitments: four carry a date, five do not. The dated ones all concern a process — a document, a meeting, a review completing. The undated ones all concern patients getting their surgery back. Scored against four states, including “unverifiable” for commitments whose fulfilment would not be visible from outside; we record those as unverifiable rather than as failures. Updated when something is met as promptly as when something is missed. Corrected 10 October 2026: the dated commitments do not all concern a process, and the undated ones do not all concern patients getting their surgery back. Most do, and none of the commitments to restore surgery carries a date. Two entries on the page were in the wrong list and have moved.
• 25 September 2026 · New · Page
  Welsh Gender Service: our correspondence
  A standing page listing every approach we have made to a public body on the Welsh Gender Service surgical pause: what was asked, when, the deadline where one exists, and where each stands. Two of our letters are now statutory requests under the Freedom of Information Act — a route we did not ask for in either case. The Joint Committee referred our follow-up of 23 September to Cwm Taf Morgannwg University Health Board, which handles its information requests; and since the eleven questions we sent on 1 September had gone unanswered for twenty-four days, we resubmitted those under the Act too. The page also records where bodies have answered well, and the one question we have asked twice that has no route at all. Corrected 10 October 2026: this entry contradicts itself. We did ask for the statutory route for the eleven questions, because we resubmitted them under the Act ourselves. Three letters are now statutory requests, two referred by the Committee and one submitted by us, and their validity is subject to the open question about requests signed with a first name only.
• 25 September 2026 · Updated · Advocacy
  The pause may be right. The process cannot show it and what the published record shows
  Both updated. The terms of reference for the independent clinical review have not appeared. At the meeting of 22 September the Chief Commissioner said they were agreed or in the final stages of agreement and would be published later that week; the Committee’s update of 23 September instead said patients would be contacted once arrangements were finalised and the terms of reference would then be published. They are the document in which the review’s scope, its reviewers and the criteria for ending the pause would be set out. We have also recorded, from press reporting rather than a primary source we have been unable to locate, that the Committee apologised on 23 September, said this remains a pause and not a permanent change, and confirmed a wider review scope taking in patients awaiting surgery in 2027 and those awaiting assessment. Both are to the Committee’s credit.
• 23 September 2026 · New · Advocacy
  The pause may be right. The process cannot show it
  Where the Welsh Gender Service pause stands twenty-eight days on, stated as a view rather than a report. The referral-rate comparison is real and now fully published, and the Committee has done things that matter to patients — queue position protected, cases proceeding without waiting for the whole review, reimbursement, an apology. But the scope has never been justified, the complaints have been characterised three different ways across three documents, necessity and proportionality remain listed as work still to be done, and nobody has said which body took the decision. The piece argues the mechanism is structural rather than malicious: with no mapped pathway, a signal produces only continue or stop, and stopping carries no career risk. Also sets out what our eleven and four questions did and did not get. Corrected 10 October 2026: the complaints had been described three ways in two documents and at the meeting, and a fourth description was later found. The Chief Commissioner had said at the meeting that the Committee took the decision, so it was wrong to say nobody had said which body did. Both are corrected on the page. Added 10 October 2026: the page now says the scope has never been justified in public, since the Chief Commissioner described at the meeting the options the Committee considered.
• 23 September 2026 · New · Advocacy
  What the Joint Committee said, and what it did not
  An account of the NHS Wales Joint Commissioning Committee meeting of 22 September, taken from the published recording. The Chief Commissioner told the Committee three reviewers had been appointed; twelve minutes later the clinical director said one had, with two others being appointed. The Committee Secretary said the Quality, Safety and Outcomes Committee “isn’t a for[um] that’s made this decision”, which leaves the body that did take it unnamed. The dropout rate was presented as a feature of the pathway, without the disaggregation in the Committee’s own Quality Impact Assessment showing 97% progression for masculinising chest surgery against 36% for masculinising genital. And the complaints were characterised a third way, as coming from families. The piece opens with what the meeting did deliver, which was substantial: terms of reference, minutes dated to 21 October, a tiered plan for the 451 affected, waiting-list position protected, and an apology. Corrected 10 October 2026: at the same meeting the Chief Commissioner said “We took the decision”, so the body that took it was not left unnamed. That was missed in this piece until 10 October. The terms of reference were not published that week but on 5 and 6 October. 451 is Cardiff and Vale’s count of people who may be affected.
• 21 September 2026 · Corrected · Evidence Review · ER-005
  Feminising Hormone Therapy
  Corrected to version 2.2 after every citation in the review was checked against its source. The most consequential error overstated the outcome readers ask about most: the review said the breast–chest difference increased by about 7.9 cm in the first year, when 7.9 cm was the measurement at one year and the increase was 3.7 cm. The check found few other wrong figures, but a number of claims whose framing outran their sources, and most of those ran in the reassuring direction. The review had described stroke risk against cisgender men as at most modestly raised; it now reports a US cohort’s finding of raised ischaemic stroke among people who started oestrogen alongside the recent Dutch cohort that found no statistically detectable increase, and lists stroke as an open question. Its own summary had said fracture risk was not raised, when in trans women aged 50 or over it was higher than in reference men. Conclusions about mortality are now attributed to the study’s authors, whose data could not compare hormone regimens, and recovery of sperm production after stopping is no longer described as usual. One correction runs the other way: the case-report evidence linking cyproterone to meningioma in trans women had been overstated. The progesterone section now reports the Amsterdam trial arm by arm from the investigators’ own abstract, and a separate placebo-controlled trial that stopped after five participants. The reference list now has 44 entries, 38 read in full. The revisions followed adversarial review conducted with AI assistance; the review is not peer reviewed. The version published on 20 September, which rewrote the cardiovascular and fertility sections, was not logged here at the time; this entry covers it, and both are set out in the review’s revision history.
• 21 September 2026 · Corrected · Evidence Note · EN-005
  Feminising Hormone Therapy
  The five-minute companion to ER-005 had not been updated since June, as the review was corrected around it, and had come to contradict it. It carried several statements the review had already withdrawn: that the excess mortality in long-term cohorts points to smoking and comorbidity rather than the hormones, which is its authors’ inference from data that could not compare regimens; that transdermal oestradiol has the lowest clot risk and that this extends to trans women, where direct comparative evidence is insufficient; that pushing oestradiol higher mainly adds risk; and that breast growth largely plateaus after the first year. It also left out the mixed evidence on stroke. Four of the errors made the note more reassuring than its evidence and two made it less so. It now matches version 2.2 of the review, and a revision history has been added to the note.
• 20 September 2026 · New Evidence Review · ER-023
  Erythrocytosis and Raised Haematocrit in Testosterone Therapy
  Testosterone reliably raises haemoglobin and haematocrit in trans-masculine people, and professional guidelines recommend thresholds that trigger clinical action. This review grades what those thresholds rest on. The change is certain; the consequence is not. No numerical action threshold in current guidance is calibrated to a trans-masculine outcome, and the most cited comparative figures come from crossings of a number rather than from measured harm. The review is the first in the corpus published in two parts: the review itself, and its correction record as a companion page of seven hundred and three entries. Neither part is the whole on its own — the review states its evidence, and the correction record is its only credential for method. Also published on its face: a claim-level census of the review itself, one quarter complete. 111 of 447 citation-bearing sentences have been audited against their sources, nine defects were found and all nine are repaired here, and on the observed rate the remaining 336 should be expected to hold of the order of twenty-five to thirty further defects of the same kind — predominantly qualifier loss rather than numerical error. Completing that audit is of the order of ninety-four further source reads, and that is what version 2.0 will be. Zenodo deposit pending; the version DOI is reserved and will be recorded here when the record is published. A five-minute plain-language companion is available: read EN-023 →.
• 18 September 2026 · New · Advocacy
  The papers justifying the gender surgery pause do not hold up
  NHS Wales published two impact assessments on 17 September in support of pausing gender affirming surgery. The Quality Impact Assessment scores every quality standard positive — including rows recording that the pause may increase mental health risk and reduce trust in the NHS — while its arithmetic is inflated by one in every row and its own conclusion says the impact should be treated as mixed rather than positive. The accompanying equality assessment concludes the overall impact is negative. Also: four irreconcilable counts of the affected cohort, an equality form still carrying another health board’s name, and a risk that twenty-two days after escalation is not yet on the risk register. The piece sets out what it is not claiming — nothing was fabricated, backdated or done deliberately — and closes with the four questions put to the Committee for its meeting on 22 September. Corrected 10 October 2026: the assessment lists twelve standards and scores six, so it scores every scored standard positive, not every standard; the four counts of the cohort come from three documents, and the piece itself says two pairs may reconcile, so they are four counts the documents do not reconcile rather than four irreconcilable ones; and the papers went to the Committee for noting, not for assurance. The risk was not shown to be absent from the register either: the published extracts predate the escalation, and the papers describe the risk as still being developed.
• 17 September 2026 · Updated · Advocacy
  The Welsh Gender Service pause: what the published record shows
  Third update, following publication of the papers for the Joint Committee meeting of 22 September. An equality impact assessment now exists, so our earlier statement that the published record contained none is superseded. The referral data is published in full, and the progression figures for the first time: 97% of patients listed for masculinising chest surgery proceed to surgery against 36% for masculinising genital surgery. The decision dates are corrected — the Sub-Committee endorsed on 24 August, the service was placed in escalation on 26 August. Also recorded: a precedent that cuts against us, Caswell Clinic having had admissions suspended at Level 3 in 2025.
• 12 September 2026 · New resource library · Practitioner testing
  KCSIE 2026 Resources for Schools
  We have added a free downloadable library of 17 practical resources for schools and trusts in England responding to children who are questioning their gender. The toolkit includes a Start Here guide, school readiness and governance checklists, a MAT implementation tracker with Excel workbook, a customisation worksheet, a policy framework, DSL checklists and decision records, a 20-minute staff briefing and quick-reference materials, facilities and trips guidance, parent and pupil explainers, communication templates and a practitioner feedback form. Download individual PDF, DOCX, PPTX and XLSX formats where available, or the full-toolkit ZIP containing all 26 files. The resources are v0.1, released under CC BY 4.0 and open for practitioner testing; they should not be adopted as final policy until testing is complete. We welcome feedback on errors, unclear wording, practical problems and additional resources needed at [email protected].
• 11 September 2026 · Deposited · Guidance Appraisal · GA-001
  Grading the Guidance: An Evidence Appraisal of KCSIE 2026 on Children Questioning Their Gender
  Version 2.0 deposited to Zenodo and now live on the page, replacing the interim correction notice. Version DOI 10.5281/zenodo.22703225; concept DOI 10.5281/zenodo.22285831; version 1.2 remains available at 10.5281/zenodo.22285832. Three findings change, and all three weaken the appraisal’s own argument: the grading table now grades the association paragraph 267 actually states (Low) rather than a causal claim the guidance does not make; the section on how the Cass Review’s principles reached schools is rewritten to reflect the Review’s own statement that school guidance should draw on them; and the claim that the gender-related consultation questions were uniquely left without figures is withdrawn. The deposit adds a correction record listing all 27 corrections made to GA-001, with where each error came from and the direction in which they ran, and a claim-to-reference map.
• 11 September 2026 · Corrected · Advocacy
  When a Pupil Comes Out as Trans: A Guide for Schools
  Corrected to v2.2 after a line-by-line re-check against the statutory text of KCSIE 2026 and the guide’s other sources. The most important error changed practical advice. The guide said a disclosure should ordinarily be passed to the designated safeguarding lead, and that KCSIE expects this; KCSIE paragraph 271 says that where a child confides without asking the school to change how they are treated, there is no reason to break any confidence unless there is a related safeguarding risk, and the guidance on engaging parents applies to requests for support. The guide also described the PATHWAYS trial as paused, when a modified protocol was approved in June 2026 and the High Court refused permission for judicial review on 31 July; and it attributed the 74 and 73 percent figures, which come from the 2023–24 consultation on the earlier non-statutory draft, to the 2026 consultation. Smaller corrections are listed in the guide’s change log. The entry below dated 3 September should read 2 September, the day the guide went live.
• 11 September 2026 · Correction notice · Guidance Appraisal · GA-001
  Grading the Guidance: An Evidence Appraisal of KCSIE 2026 on Children Questioning Their Gender
  A re-check of v1.2 against its primary sources found errors, three of which affect the appraisal’s findings. The grading table attributes to paragraph 267 a causal claim about the trajectory of gender development that the guidance does not make. The section arguing that the schools framework is an extrapolation the Cass Review did not make is contradicted by the Review’s own final report, which says school guidance should be able to utilise its principles and evidence. And the three gender-related questions are not the only ones in the KCSIE 2026 consultation response answered without figures. All three cut against the appraisal’s own argument (an earlier wording of this entry said the second and third). A correction notice listing these and the smaller errors now sits at the top of the page, which otherwise continues to match the deposited v1.2; a corrected version will be deposited under the same concept DOI. The re-check also found that the appraisal’s note on the policy paper, and our letter to the Department for Education of 3 September, described paragraph 115 as concerning undressing only, when that paragraph and paragraph 276 also prohibit access to changing rooms designated for the opposite sex; we are writing to the Department to correct the letter.
• 8 September 2026 · Correction & restructure · Advocacy
  The Welsh Gender Service pause: what the published record shows
  Two changes. First, a wording correction: our correction panel of earlier today paraphrased the commissioner as saying the review scope needed shaping “before the process can be considered thorough and robust”. The source wording, relayed by Llais, was “to ensure the process is thorough and robust”. The first implies the current state falls short; the second describes what proper scoping does. Only the second is supported and the panel now carries it. Second, a structural change: three dated panels had accumulated above the text, making the piece hard to enter. A dated “where this stands” summary now sits at the top and the three panels have been moved unchanged to a revision history at the foot of the page. Nothing deleted, no other wording altered.
• 8 September 2026 · Correction · Advocacy
  The Welsh Gender Service pause: what the published record shows
  Our update of 7 September stated that Llais had been given an outline of the independent review’s proposed scope. That was wrong. Llais has checked its records and confirmed that the commissioner did not share the scope of this review with it at all, the earlier answer having conflated it with other reviews. The commissioner has told Llais it has developed an initial indicative scope which will need further shaping and refinement with the expert review team. The error came from information given to us in good faith and corrected promptly and unprompted; it appeared in something we published, so it is corrected on the same terms as any other error. Original wording marked, not removed.
• 7 September 2026 · Updated · Advocacy
  The Welsh Gender Service pause: what the published record shows
  Second update, following Llais’s statement of 3 September and its answers to questions we put directly. Two facts narrow the effect of the pause and had not been reported: it does not affect people progressing through a planned series of procedures, those needing treatment for complications, or those requiring clinically necessary aftercare, and waiting-list position will be preserved on resumption. On governance, Llais said it first learned of the change from the public announcement, did not see the information behind the decision, and would have expected earlier engagement; it confirmed to us that it was formally notified on 1 September and has still not received the review’s terms of reference.
• 5 September 2026 · Updated · Advocacy
  The Welsh Gender Service pause: what the published record shows
  Updated after the commissioner set out its reasoning publicly on 4 September, having met, as ITV Wales reported that day, the Health Minister, the Social Justice Minister and the Deputy First Minister (corrected 10 October 2026: the Social Justice Minister added and the source named). It cited a significantly lower rate of progression from referral to surgery than in England for some procedures, cases in which patients did not meet the basic requirements for surgery with body mass index arising as a factor, concerns about whether wider health needs had been considered, and concerns raised by clinical professionals about parts of the assessment process. That is the specific concern this piece said the published record did not contain, and it is a more coherent account than the referral rate alone — referrals for patients who do not meet the provider’s criteria would produce a higher referral rate and a lower progression rate from one cause. The Welsh Government said the decision is a pause rather than a stop and that each case will be reviewed. The governance findings are unaffected: the decision, the authority for it and any equality impact assessment remain absent from the published record. Superseded passages are marked on the piece rather than removed.
• 4 September 2026 · Deposited · Guidance Appraisal · GA-001
  Grading the Guidance: An Evidence Appraisal of KCSIE 2026 on Children Questioning Their Gender
  Deposited to Zenodo as v1.2 under the Eden Openly community. Concept DOI 10.5281/zenodo.22285831; version DOI 10.5281/zenodo.22285832. The deposit is the first in the Guidance Appraisal series and the first built to v1.1 of the GA Presentation Specification, which was amended during the build: the classification token set was closed at four and given a companion field recording what each claim is drawn from, and the gathered grading table now carries claim type as a column of its own. Six questions remain outstanding with the Department for Education; the answer, or its absence, will be reported here.
• 3 September 2026 · Corrected · Guidance Appraisal · GA-001
  Grading the Guidance: An Evidence Appraisal of KCSIE 2026 on Children Questioning Their Gender
  Updated to v1.2 after every quotation and figure was checked against the primary texts. The 15,315 responses and the “highly contested” characterisation belong to the 2023–24 consultation on the draft non-statutory guidance, not to the consultation on KCSIE 2026; the earlier version ran the two together. The 11 per cent figure is restored to its actual scope, which is decisions about inclusion in PE and sport. The paragraph range for the gender-questioning section is corrected to 254–284, the modal verbs to the “should” the guidance actually uses, and the parental-involvement discussion now records that the guidance draws its exception more tightly than the Cass recommendation it invokes. Six questions have been put to the Department for Education; the answer, or its absence, will be published here.
• 3 September 2026 · New Guidance Appraisal · GA-001
  Grading the Guidance: An Evidence Appraisal of KCSIE 2026 on Children Questioning Their Gender
  The first in a new Guidance Appraisals series, which grades the claims a policy or guidance document makes against the evidence those claims rest on, and holds the evidence question apart from the legal one. KCSIE 2026 became statutory on 1 September. Its load-bearing claim — that social transition is an “active intervention” — is graded Low; the causal reading beneath “do not initiate” Very low; engaging parents as the default Moderate–high; the desistance claim Low–moderate; and the single-sex rules are recorded as a legal question rather than an evidential one.
• 3 September 2026 · New · Advocacy
  When a Pupil Comes Out as Trans: A Guide for Schools
  A new version for the start of term, superseding the June guide. KCSIE 2026 — including its section on children questioning their gender (paragraphs 254–284) — became statutory from 1 September 2026, alongside the revised RSHE curriculum guidance. The practical steps for staff are carried over and now largely track the framework; the framing moves from a guidance gap still open to one now closed and restrictive. The earlier version is preserved unchanged as a record.
• 1 September 2026 · New · Advocacy
  The Welsh Gender Service pause: what the published record shows
  NHS Wales has paused gender affirming surgery referrals, assessments and already-scheduled operations. The committee paper published for the 24 August meeting does not propose a pause, the escalation framework locates measures that stop delivery a level above the one applied, and the analysis said to justify the decision was recorded as still in progress. Eleven questions have been put to the commissioner; the answer, or its absence, will be published here. Note added 10 October 2026: the running record now says it more precisely. A pause is not among the measures the escalation framework lists for Level 3, though the Committee suspended admissions to another Level 3 service, Caswell Clinic, in 2025.

July 2026

• 20 July 2026 · Updated · Advocacy
  A fine gets an appeal. A child gets ‘have regard to.’
  Now records that amendments requiring access controls and audit logging were put to a division on 2 July and defeated; and corrects the account of the National Data Guardian’s position, which was that the provision should be removed. The argument is unchanged.
• 18 July 2026 · New · Advocacy
  A fine gets an appeal. A child gets ‘have regard to.’
  Why the Health Bill’s single patient record clause protects a person facing a fine in far more procedural detail than a patient facing disclosure of their medical record — and what a new clause would fix.
• 18 July 2026 · New Evidence Review · ER-018
  Venous Thromboembolism, Myocardial Infarction and Ischaemic Stroke in Feminising Hormone Therapy
• 18 July 2026 · New Evidence Note · EN-018
  Venous Thromboembolism, Myocardial Infarction and Ischaemic Stroke in Feminising Hormone Therapy
• 16 July 2026 · New · Clinical
  In the Dark: Harm Management for People Already Sourcing Hormones
• 12 July 2026 · New Evidence Review · ER-015
  Masculinising and Feminising Hormones in Adolescents
• 12 July 2026 · New Evidence Note · EN-015
  Masculinising and Feminising Hormones in Adolescents
• 11 July 2026 · New Evidence Review · ER-014
  Puberty Suppression in Adolescents
• 11 July 2026 · New Evidence Note · EN-014
  Puberty Suppression in Adolescents
• 10 July 2026 · New Evidence Review · ER-013
  5α-reductase Inhibitors: Finasteride and Dutasteride in Feminising Therapy
• 10 July 2026 · New Evidence Note · EN-013
  5α-reductase Inhibitors: Finasteride and Dutasteride in Feminising Therapy
• 9 July 2026 · New Evidence Review · ER-009
  Anti-androgens Compared
• 9 July 2026 · New Evidence Note · EN-009
  Anti-androgens Compared
• 9 July 2026 · New Evidence Review · ER-008
  Hormone Monitoring & Target Ranges
• 9 July 2026 · New Evidence Note · EN-008
  Hormone Monitoring & Target Ranges
• 8 July 2026 · New Evidence Review · ER-007
  Masculinising Hormone Therapy
• 8 July 2026 · New Evidence Note · EN-007
  Masculinising Hormone Therapy
• 7 July 2026 · New Clinical Review · CR-002
  Rosacea in Gender-Affirming Care
  How rosacea differs from acne here, the genuinely contradictory hormone evidence, the diagnostic trap of hormone-related flushing, and phenotype-led management.
• 7 July 2026 · New · Advocacy
  Designed to Silence, Not to Enforce
• 6 July 2026 · New Clinical Review · CR-001
  Acne in Gender-Affirming Care
  Acne across gender-affirming hormone therapy, in both directions, and how to manage it in a way that fits transition goals.
• 6 July 2026 · New Evidence Note · EN-012
  Breast Development Timelines on Feminising Therapy
• 6 July 2026 · New Evidence Note · EN-011
  Finasteride and Feminising Hormone Therapy
• 6 July 2026 · New Evidence Note · EN-010
  Why Skin Changes Vary on Feminising Therapy
• 5 July 2026 · New Evidence Review · ER-006
  Skin Effects of Oestrogen in Transfeminine People
• 5 July 2026 · New Evidence Note · EN-006
  Skin Effects of Oestrogen in Transfeminine People
• 3 July 2026 · New · Clinical
  Laser vs Electrolysis for Facial Hair Removal
• 3 July 2026 · New · Clinical
  Body Hair Removal: Laser vs Electrolysis
• 3 July 2026 · New · Clinical
  Pre-Vaginoplasty Hair Removal: Laser vs Electrolysis
• 3 July 2026 · New · Clinical
  Pre-Phalloplasty Hair Removal: Donor Sites and the Neo-Urethra

June 2026

Eden Openly launched through June 2026. These publications went live during that opening run and are grouped by month rather than dated individually.

Evidence Reviews & Notes · Briefings

• New Evidence Review · ER-005
  Feminising Hormone Therapy
• New Evidence Note · EN-005
  Feminising Hormone Therapy
• New Evidence Review · ER-004
  Healthcare Avoidance
• New Evidence Note · EN-004
  Healthcare Avoidance
• New Evidence Review · ER-003
  Chosen Names and Pronouns
• New Evidence Note · EN-003
  Chosen Names and Pronouns
• New Evidence Review · ER-002
  Readiness, not diagnosis
• New Evidence Note · EN-002
  Readiness, not diagnosis
• New Evidence Review · ER-001
  The First Five Minutes of Care
• New Evidence Note · EN-001
  The First Five Minutes of Care
• New Editorial Briefing
  The Threshold
• New Editorial
  Reading the Evidence

Clinical

• New · Clinical
  Stopping Is Not Neutral: Why Withdrawing Hormone Therapy Asks the Same Rigour as Starting It — Anatomy of Good Care (1/7)
• New · Clinical
  Thorough Is Not Slow: What Informed Consent Actually Requires — Anatomy of Good Care (2/7)
• New · Clinical
  What Monitoring Is For: The Safety System That Makes Continuous Care Possible — Anatomy of Good Care (3/7)
• New · Clinical
  The Experience Is Clinical: Why How Care Feels Is Part of Whether It Works — Anatomy of Good Care (4/7)
• New · Clinical
  There Is No Standard Patient: Why Hormone Therapy Has to Be Titrated to the Person — Anatomy of Good Care (5/7)
• New · Clinical
  Before the First Dose: Fertility and the Conversation That Can’t Wait — Anatomy of Good Care (6/7)
• New · Clinical
  The Anatomy of Good Care: One Discipline, Seen From Six Sides (7/7)
• New · Clinical
  Oestrogen and Your Skincare Routine: What Actually Changes on HRT
• New · Clinical
  What Laser Hair Removal Actually Does to the Follicle
• New · Clinical
  Sunscreen on HRT: The Mechanism, the Evidence, and What Non-Negotiable Actually Means
• New · Clinical
  AHAs vs Retinoids: They Are Not the Same Thing
• New · Clinical
  The Ceramide Barrier: What It Is and Why It Matters on HRT
• New · Clinical
  How Oestrogen Changes Your Skin at the Cellular Level
• New · Clinical
  Why Standard HRT Doses Don’t Work Equally for Everyone
• New · Clinical
  Progesterone on HRT: The Evidence, the Uncertainty, and the Honest Picture
• New · Clinical
  How Strong Is the Evidence Behind the 100–200 pg/mL Estradiol Target?
• New · Clinical
  Testosterone Suppression on HRT: What the Target Actually Is
• New · Clinical
  Oral Estradiol and Hypothyroidism: Why Levothyroxine Requirements Can Change
• New · Clinical
  Prolactin on HRT: What Your Result Actually Means
• New · Clinical
  Oral vs Injectable Estradiol: Not Pharmacologically Equivalent
• New · Clinical
  SHBG: The Protein That Controls What Your Hormones Actually Do

Personal

• New · Personal
  The Threshold (4/4): Only If It’s Bad Enough
• New · Personal
  Still Dad
• New · Personal
  The wrong therapist is information
• New · Personal
  One letter
• New · Personal
  Finding out at fifty-two
• New · Personal
  The right word
• New · Personal
  Out loud
• New · Personal
  Baby blues
• New · Personal
  The thunderstorm
• New · Personal
  A million angles
• New · Personal
  The hair bow
• New · Personal
  Don’t worry, I’m a dermatologist
• New · Personal
  The façade
• New · Personal
  Carrying the pain for the people I love
• New · Personal
  The finish line
• New · Personal
  Why I’m doing this in the open
• New · Personal
  The first effects
• New · Personal
  Five days
• New · Personal
  The dysphoria that never existed — until it came
• New · Personal
  Something always off
• New · Personal
  Built the knowledge
• New · Personal
  Born

Advocacy

• New · Advocacy
  The Threshold (3/4): Where the Bill Goes Quiet
• New · Advocacy
  The Threshold (2/4): What the Conversion Practices Bill Actually Does
• New · Advocacy
  The Threshold (1/4): What Conversion Therapy Actually Is
• New · Advocacy
  When a Pupil Comes Out as Trans: A Guide for Schools
• New · Advocacy
  The Social Media Ban Doesn’t Protect Children. It Abandons the Ones Who Need It Most.
• New · Advocacy
  Why Your Clinician Might Not Know Enough
• New · Advocacy
  Why Trans Health Research Is So Poor — And Why It Matters
• New · Advocacy
  The Waiting List Is a Medical Problem
• New · Advocacy
  What Good Endocrinology Care for Trans Women Actually Looks Like
• New · Advocacy
  The Informed Consent Model: What It Is and Why It Matters
• New · Advocacy
  The Problem With How Trans Healthcare Is Delivered
• New · Advocacy
  The EHRC Code of Practice 2026: What It Actually Means for Us

Skincare

• New · Skincare
  Active Ingredients That Don’t Work Well Together — And the Ones That Actually Do
• New · Skincare
  What Non-Comedogenic Actually Means
• New · Skincare
  Niacinamide and Vitamin C: Why the Warning Is Outdated
• New · Skincare
  SPF: Why You’re Probably Applying It Wrong
• New · Skincare
  The Cleanser Most People Are Using Is Wrong for Their Skin
• New · Skincare
  Skin Cycling: What It Actually Is and Whether It Works
• New · Skincare
  The Order Your Products Go On: Why It Matters (And Why It Matters Less Than You Think)
• New · Skincare
  Retinoids at Night: Why Convention Exists and What the Exceptions Are
• New · Skincare
  Morning vs Night: They Are Not the Same Routine

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