Methodology

This page describes how every piece of HRT Pharmacopoeia content is written, reviewed, and updated. It is our commitment to readers: text that has not gone through this process does not ship.

1. Three Core Principles

No claim without a citation: every medical claim must carry at least one DOI or international guideline reference; if a claim cannot be sourced, it is either marked X or removed.
Cross-source dosing data: prescription doses must appear in at least two independent authoritative sources (WPATH SOC 8 · Endocrine Society 2017 · UCSF · EMA, and similar).
Avoid absolute language: skip “must / always / never” in favor of “typically / suggested / in the vast majority of cases”.

2. Full Workflow

1. Topic selection

Topics are chosen based on search demand, reader questions, guideline updates, and major safety alerts (EMA/FDA)
Each page lists the 3–7 specific questions it must answer
The target audience (patient / primary care clinician / family member) is defined up front

2. Literature search

Primary channels: PubMed, Cochrane, official guideline sites, Transfemscience reviews
Excluded: anonymous forum posts, commercial sites, blogs without peer review
Every key claim records its original citation (DOI preferred; otherwise journal publication info)

3. Evidence grading

Graded by study design strength:

Level	Meaning	Example evidence
A	Strong	Multiple RCTs, systematic reviews / meta-analyses, explicit international guideline recommendation
B	Moderate	Single RCT, multiple prospective cohorts
C	Weak	Case reports, retrospective studies, expert opinion
X	None	Community lore, personal experience, inference

4. Drafting

Use shared components: <DrugInfoBox>, <DoseTable>, <CitationRef>, <WarningBox>, <EmergencyBanner>, etc.
Frontmatter records evidenceLevel, lastReviewed, and references (enforced by CI)
Dose tables automatically validate upper limits and contraindicated combinations

5. Two-person cross-check

Author finishes a draft → a second editor independently verifies every <CitationRef> against the primary source
Mismatches or overreaches → returned for revision
If the original source has been retracted or corrected → site-wide search and replace

6. Medical advisor review

Endocrinology / psychiatry / legal advisors are assigned by topic
Review records, including dissent and final decisions, are archived
If no qualified reviewer can be reached, the topic does not ship

7. Publication and accessibility QA

npm run astro check + Lighthouse (SEO ≥ 95 / A11y ≥ 95)
Color contrast, keyboard reachability, screen-reader semantics validated
Mobile breakpoints and prefers-reduced-motion fallback verified

8. Rolling review

Default re-review every 12 months, refreshing lastReviewed
High-risk pages (risks, dose red lines, emergencies) are re-reviewed every 6 months
A major guideline change → incremental update within 48 hours

3. Error Correction

When readers find factual errors, citation drift, or outdated content:

Submit through the feedback form or GitHub Issue
Initial reply within 72 hours
Once confirmed as a factual error, an erratum notice is added to the top of the page, and version history records the original error and correction date
Major corrections are pushed to email / RSS / Telegram subscribers

4. Conflict-of-Interest Statement

This site has no commercial sponsorship, no drug advertising, and no purchase commissions
Operating costs are paid out of pocket by volunteers; we accept open-source community donations
Editors and medical advisors sign conflict-of-interest disclosures; medications with active prescribing relationships are not independently reviewed by the conflicted party