On January 15, 2024, the World Health Organization (WHO) issued an updated announcement regarding its plan to develop healthcare guidelines for “trans and gender diverse [TGD] people.” The earlier announcement, issued at the end of December 2023, generated much public concern. Various stakeholders—clinicians, LGBT groups/detransitioners, parent groups, and women’s rights champions—expressed alarm that WHO seemed to be proceeding on the basis of an unproven assumption that expanded access to gender-affirming hormones is universally beneficial. In addition, the groups also objected to the apparent WHO assumption that legal recognition of self-declared gender is a key human right and must be adopted by legal systems worldwide. In the wake of the WHO’s December announcement, the initial set of concerns focused on the biased composition of the GDG, which is tasked with articulating the final recommendations. However, our additional analysis of the WHO guideline development process suggests that the process may have been inadvertently biased early on. if WHO continues on the current track with only minor changes, there is a serious risk that it will create a treatment guideline that may harm, rather than help, vulnerable trans and gender-diverse subpopulations, undermine the rights of women and girls, and lead to a loss of trust in the WHO guideline credibility more generally. More time—and a more open, transparent process that takes a wider range of perspectives into account—can only further WHO's mission to promote the right to health worldwide.