The Cass Report Upends The Transgender Treatment Debate

Throwing a wrench into the fight over puberty blockers and more

The most important story of the day isn’t anything that happening in Washington, Wall Street, Arizona, or on the presidential campaign trail. It’s in England, the long-awaited report by Dr. Hilary Cass has been released on the NHS’s gender treatment regime. The conclusions threaten to roil the entire world of puberty blockers and debates about the treatment of gender dysphoria around the world. The Telegraph summarized the key findings:

Last month, the NHS banned the prescribing of puberty blockers outside of clinical trials. However, Dr Cass has gone further and said children who think they are transgender should not be given any hormone drugs at all until at least 18.

The former president of the Royal College of Paediatrics and Child Health said there was no evidence the drugs “buy time to think” or “reduce suicide risk”.

While the drugs can suppress puberty, research commissioned by the review and carried out by the University of York found the drugs have no effect on the person’s body satisfaction or their experience of gender dysphoria – where the person feels they are a different gender to the sex they were born – despite this being the reason they had been prescribed.

More from Debbie Hayton in The Spectator:

British hildren who identify as transgender have been let down badly by a National Health Service that succumbed to an activist lobby.

That is the obvious conclusion to make after Dr. Hilary Cass published her final report this morning as part of the Independent Review of Gender Identity Services for Children and Young People.

In her report, Cass suggests that there is a serious lack of evidence about the long-term impact puberty blockers and other cross-sex hormones are having on children.

While the original rationale for puberty blockers was to give children “time to think” about transitioning, the report dismantles this argument, pointing out that the “vast majority” of children move from puberty blockers to cross-sex hormones, and:

…there is no evidence that puberty blockers buy time to think, and some concern that they may change the trajectory of psychosexual and gender identity development.

Despite this, the report says researchers could find no evidence that puberty blockers improved children’s body dysmorphia or body image.

The medicalization of children who might simply have been distressed by the idea of puberty and growing up is a scandal of epic proportions

Cass concludes that most young people should not be going down the medical route if they have gender-related distress, adding that for 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 such as family breakdown, barriers to participation in school life or social activities, bullying and minority stress.”

She argues that the treatment of children with “gender-related distress” should be “more closely aligned with usual NHS clinical practice that considers the young person holistically.”

The days of NHS England handing out puberty blockers and cross-sex hormones to children — some of whom had complex needs — is hopefully behind us. These children need support, not unquestioning affirmation. The stakes are enormous, as Cass indicates.

The medicalization of children who might simply have been distressed by the idea of puberty and growing up is a scandal of epic proportions. Never before have doctors told children they could press pause on puberty, and never before have children — or in some cases, their parents — demanded it.

More on what comes next, particularly on the enforcement question, from Anna Hutchinson. And here is a new interview on the study with Dr. Cass: