The Cass Review, published this week, has sent gender extremists into a tailspin.
Britain’s taxpayer-funded National Health Service in 2020 commissioned consultant pediatrician Dr. Hilary Cass to examine the care given gender-questioning children.
After a three-year investigation, her report is a bombshell.
Importantly for those watching the debate from overseas, it reveals the safeguarding risks that gender transition creates for kids: risks made worse by gender clinicians’ deliberate refusal to follow safeguarding best practice or even to collect outcome data.
And it challenges the now-widespread belief that a kid’s stated gender identity can’t be questioned, only “affirmed.”
As the report shows, the evidence base for this approach is weak.
More shocking still, Cass revealed her own efforts to build a better evidence base were “thwarted” by British adult gender services, which colluded to withhold data during the research period.
Let that sink in.
In the United Kingdom, health care is socialized.
Treatments are often not funded without years of evidence.
Even in a system that demands this level of scrutiny before funding, gender medics did their best to avoid looking at the evidence.
And they don’t want anyone else to look at it, either.
But this isn’t surprising: When someone does, it swiftly becomes clear that the emperor has no clothes.
Cass isn’t the first to show this.
Take the widespread claim that unless you “affirm” gender-confused kids in their preferred identity, they’ll kill themselves.
It’s routinely used to guilt worried parents into agreeing to irreversible medical interventions: “Do you want a live son or a dead daughter?”
A recent Finnish study found that once you control for patients with psychiatric issues, this simply isn’t true.
The Cass report supports this.
Parents can take courage: There’s no evidence that kids will kill themselves unless you go along with their gender demands.
The Finnish study showed the reason gender-questioning kids are at slightly higher risk of suicide is not because their identity is being “invalidated.”
The truth is those kids were already mentally ill.
And kids who are mentally ill often also identify as the opposite sex.
The Cass Review reinforces the obvious conclusion.
Kids with mental health issues should be treated for those issues.
But the report revealed that when kids add “trans” to an already long list of social, familial and psychiatric issues, clinicians often ignore the other issues to focus on gender.
Cass calls for practitioners instead to take a holistic view of kids’ troubles.
Quite right, too.
And the review confirms something else parents already know.
Kids’ identities are too fluid to justify access to irreversible medical treatments just because they say so.
Clinicians in the report admitted that many kids grow out of gender confusion, and they don’t really know how to tell which children will do so.
And when kids’ identities are so fluid, Cass confirms, puberty blockers and cross-sex hormones should not be part of the treatment standard for minors.
This should be welcome news to those Americans concerned that kids are being loaded onto a medical conveyor belt by opportunistic clinicians keen to create new lifelong patients.
The report was especially damning on many gender clinicians’ self-serving nature.
It shows how “influential” the World Professional Association for Transgender Health has been in setting treatment standards internationally — while the review found its guidelines to “lack developmental rigor.”
Though Cass describes these issues in the careful language of doctors and bureaucrats, what comes across clearly is that a self-serving cabal has manufactured a consensus to suit themselves, based on flimsy evidence and appeals to emotion.
Let’s hope this ends the racket in Britain.
Will it move the needle in North America?
“Affirmation” is so entrenched in some US states, it defines policy in schools, social work and family courts.
In January, Montana’s Child and Family Services removed a 14-year-old girl from her parents’ care because they objected to medics’ decision to “affirm” their child’s desire to use male pronouns and present as male.
In February, Indiana parents Mary and Jeremy Cox appealed to the Supreme Court after state authorities removed their son after a disagreement over his identification as a girl.
But the boy has a host of mental health issues.
As the Cass Review shows, this is typical.
Will such issues be helped by removal from loving parents into state custody? I doubt it.
And when the Cass report highlights the safeguarding issues baked into pediatric gender treatment, we should be worried that such practices not only fail to help kids but actively create new dangers.
Gender changes mean vulnerable kids can easily disappear.
Cass points to cases where UK medics lost the ability to track at-risk kids after their name and gender changed on official documentation.
So let’s not forget the shocking 2021 case of a Virginia teen who was trafficked not once but twice after her school concealed information from her parents about her gender transition.
In sum: There’s no evidence for the affirmation-only approach.
Gender confusion should not be allowed to obscure other issues.
Puberty blockers and hormone treatments shouldn’t be available to kids.
And gender-swapping vulnerable kids creates a bureaucratic nightmare where predators can flourish.
When activists say “Protect trans kids,” all I can say is: I quite agree.
The Cass Review shows we do need to protect gender-confused minors.
We need to protect them from the ideologues railroading kids into irreversible medicalization, with no evidence.
We need to protect them from medical malpractice.
And we need to protect them from being “emancipated” out of loving homes into the hands of possibly predatory adults.
Mary Harrington is a contributing editor at UnHerd and author of “Feminism Against Progress.”
