Cass Advised Against Using Public Transport Following Landmark Gender Clinic Review

The doctor said she has had online abuse over the report, but is more upset about disinformation which she says is ‘unforgivable’ and puts children at risk.
Cass Advised Against Using Public Transport Following Landmark Gender Clinic Review
Retired consultant paediatrician Dr. Hilary Cass speaking about the publication of the Independent Review of Gender Identity Services for Children and Young People (The Cass Review) in west London, on April 9, 2024. Yui Mok/PA Wire
Lily Zhou
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Dr. Hilary Cass, who conducted the landmark NHS review on treatment for gender-questioning children, said she’s currently not using public transport following security advice.

The leading paediatrician said she has received online abuse following the publication of her report, but she’s “much, much more upset and frustrated” over the false information spread about the report.

The final report of the Cass review, published earlier this month, said evidence for so-called gender care for children—which includes health care professionals simply affirming a child’s chosen gender and allowing young children to take puberty blockers—is “remarkably weak.”

The report called for more research into the effects on young people treated for gender confusion, finding there is currently “no good evidence on the long-term outcomes of interventions to manage gender-related distress.”

In an interview with The Times of London, published on Friday, Dr. Cass rejected the accusation that her team had excluded around 100 studies, saying it’s “straight disinformation.”

“I have been really frustrated by the criticisms, because it is straight disinformation. It is completely inaccurate,” she told the outlet.

“It started the day before the report came out when an influencer put up a picture of a list of papers that were apparently rejected for not being randomised control trials.

“That list has absolutely nothing to do with either our report or any of the papers,” she said.

“If you deliberately try to undermine a report that has looked at the evidence of children’s healthcare, then that’s unforgivable. You are putting children at risk by doing that.”

According to the report, Dr. Cass said her team had reviewed all 103 research and included the results of 60 high- and medium-quality papers.

The accusation, which was first shared on social media, has also made its way to Parliament, with Labour MP Dawn Butler saying on April 15: “Around 100 studies have not been included in the Cass report, and we need to know why.”

Ms. Butler also asserted that the report had been “used to perpetuate a broader hostile environment towards trans people in the UK.”

Commenting on Ms. Butler’s remarks, Dr. Cass said she doesn’t believe politicians would speak in Parliament “with an intent to spread misinformation,” but added that she’s “dismayed” about the MP’s understanding of the report.

The doctor said her report has not been “weaponized” by people on either side of the debate for the most part, but she has received some “pretty vile emails.”

“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,'” she said, referring to a label used by transgender activists that stands for ”trans-exclusionary radical feminist.”

Dr. Cass said she’s not using public transport at the moment, “following security advice.”

However, she also said, “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.”

As part of the Cass review, a data linkage study was commissioned to find out what happened to the around 9,000 young people who had been through the NHS gender identity development service (GIDS) when they were children, but the effort was “thwarted by a lack of cooperation from the adult gender services,” the report said.

On the eve of the report’s publication, NHS England National Director John Stewart said a review into the operation and delivery of the adult Gender Dysphoria Clinics (GDC) will be launched, and told GDC chiefs to prepare their clinics “to fully participate with the data linkage study and avoid the need for mandatory direction in this respect.”

Dr. Cass told The Times of London she will not lead the review into adult GDCs.

The interim Cass report, published in 2022, has already led to the NHS’s single GIDS being replaced by multiple regional centres, and the suspension of taxpayer-funded puberty blockers for under-16s, although children can still get so-called gender-affirming care and puberty blockers from private clinics.

The interim report also said that “early social transition”—meaning the practice of allowing children to change names, uniforms, or using different facilities, and treating them as if they are the opposite sex—should be viewed as an “active intervention” rather than “a neutral act.”

This has led to a draft government guidance that clarifies schools do not have a general duty to allow children to “socially transition.”

Rachel Roberts contributed to this report.