We welcome the opportunity to respond to the letter by Höfler and Trautmann (2019) entitled “When does selection generate bias in clinical samples?” Höfler and Trautmann argue there are limitations of our study which compromise the validity of our findings. There are three main concerns raised by Höfler and Trautmann. First that our findings conflict with a well-established body of theory which emphasises the broad problem of selection bias and its impact on research findings. Second, that our findings are population based and may have little relevance to “clinical’ samples. Third, our findings may not be generalizable to many studies.