By Charlotte Webster-
A landmark review conducted by paediatrician Dr. Hilary Cass has shed light on significant deficiencies in gender care services for young people in Britain, highlighting a lack of research and “remarkably weak” evidence guiding medical interventions.
Published on Wednesday, the Cass Review expresses an urgent need for gender services to match the standards of other NHS care, emphasizing the alleged detrimental impact of the toxic debate surrounding gender on professionals’ ability to openly discuss views and provide appropriate care.
Commissioned by NHS England in 2020 following concerns raised by whistleblowers regarding care at the Gender Identity and Development Service (GIDS), the Cass Review focused on gender identity services for under-18s.
It comes in the wake of the closure of GIDS, which had been rated as “inadequate” by inspectors, and the subsequent opening of regional hubs in London and Liverpool aimed at tackling long waiting lists.
Dr. Cass highlighted clinicians’ concerns about the lack of guidance, evidence, and training regarding gender care interventions.
She pointed out the absence of conclusive evidence on the long-term safety and outcomes of interventions like puberty blockers, cautioning against their routine prescription without robust clinical trials.
In response to the review’s findings, NHS England announced that puberty blockers would no longer be routinely prescribed and should only be used in clinical trials for gender-distressed children.
However, clinics under NHS Scotland’s oversight can continue to prescribe these medications.
The 388-page report makes 32 recommendations for improving gender services, emphasizing the need for evidence-based care and research into outcomes for young people. Dr. Cass stresses that children deserve the highest standards of care and research, lamenting the failure to base gender care on evidence.
The report also highlights the need for holistic assessments, including screening for conditions like autism and mental health assessments, to address issues beyond gender identity.
It warns against overlooking other healthcare needs in cases of patients questioning their gender.
Moreover, Dr. Cass recommended a cautious approach to prescribing cross-sex hormones for adolescents and emphasized the importance of considering the potential impact of social transitioning on younger children’s mental health.
The review’s recommendations include the establishment of a follow-through service for young adults aged 17-25 and provision for detransitioners – individuals who regret medical interventions.
The findings of the Cass Review have been met with both concern and support.
Prime Minister Rishi Sunak stressed the need for caution regarding medical treatments and social transitioning, while Shadow Health Secretary Wes Streeting pledged to work towards implementing the recommendations.
Critics of gender re-assignment have long warned of caution, stating that most gender dysphoric children change their sexual identity due to a host of complex reasons.
Helen Joyce, authour of Trans: ‘when Ideology Meets Reality’ has always had a gender critical view of the trans movement.
In her book, one of the reasons she cites for gender identification is discontentment of gender dysphoric individuals in their natural gender, making reference to effeminate boys who feel they were born in the wrong body.
She also highlights individuals of the opposite sexual orientation, and in some cases due to a feeling of rejection from parents who may have expressed disappointment in producing the less preferred gender.
Joyce describes gender self identification as a demand for validation by others- a view disputed by advocates gender transition.
Contrary to her stance that individuals should see their natural gender as ‘constant and immutable’, Dr Hilary Cass shares the view of libertarians that individual responsibility should be embraced, and young people who are gender dysphoric must be fully supported.