Pediatrician and consultant Dr. Hilary Cass conducted a comprehensive and lengthy review of international research into gender medicine for children for NHS England.
Dr. Cass concludes that a lack of research and evidence on transgender medical interventions, such as puberty blockers and body-altering surgeries, is failing children.
Cass’s prior findings led to the banning of puberty blockers from children outside of clinical research in the UK.
After the publication of the landmark 388-page report, Dr. Cass shared that she is now under constant attack.
In an interview with The Times, Dr. Cass shared the disturbing backlash she is facing for simply sharing her well-researched report and discussed her concern about disinformation spreading in the aftermath.
She revealed that she has been sent “vile” abusive emails, has been given security advice, and has been told not to travel on public transport.
Cass said: “There are some pretty vile emails coming in at the moment. Most of which my team is protecting me from, so I’m not getting to see them.” Some of them contained “words I wouldn’t put in a newspaper”, she said.
She added: “What dismays me is just how childish the debate can become. If I don’t agree with somebody then I’m called transphobic or a Terf [trans-exclusionary radical feminist].”
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Asked if the abuse had taken a toll on her, she said: “No … it’s personal, but these people don’t know me.
“I’m much, much more upset and frustrated about all this disinformation than I am about the abuse. The thing that makes me seethe is the misinformation.”
One of the particularly vexing examples of the misinformation being spread is that Cass used only two out of 100 studies for the report.
Labour MP Dawn Butlers perpetuated this misinformation when she told the House of Commons, “There are around 100 studies that have not been included in this Cass report, and we need to know why.”
Cass refutes that claim, explaining that researchers appraised every paper “but pulled the results from the ones that were high quality and medium quality, which was 60 out of 103.”
She also shared that six clinics refused to cooperate with research focused on the long-term impact of prescribing puberty blockers and sex hormones, which she called “co-ordinated” and “ideologically driven.”
Some of the key findings of the final report include:
The rationale for early puberty suppression remains unclear, with weak evidence regarding the impact on gender dysphoria and mental or psychosocial health. The effect on cognitive and psychosexual development remains unknown.
The use of masculinising / feminising hormones in those under the age of 18 also presents many unknowns, despite their longstanding use in the adult transgender population. The lack of long-term follow-up data on those commencing treatment at an earlier age means we have inadequate information about the range of outcomes for this group.
Clinicians are unable to determine with any certainty which children and young people will go on to have an enduring trans identity.
For most young people, a medical pathway will not be the best way to manage their gender-related distress. For those young people for whom a medical pathway is clinically indicated, it is not enough to provide this without also addressing wider mental health and/or psychosocially challenging problems.
You can read the full report here.
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