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I thank all authors for their commentaries. I particularly appreciate the invitation to reflect on deeper commitments driving questions around evidence and medicine’s legitimate role. I share Carroll-Beight’s1 concern that sex/gender minorities are largely excluded from shaping clinical and research standards affecting them—a gap in my analysis. Wiesemann’s2 is insightful to note that, although commissioned as a review of services, the Cass Review offers clinical advice without adhering to the required international standards, and without ethical consideration (as Brierley and Larcher also note).3