Transgender Charity That Gave Girls Chest Binders Told to Follow Cass Review

Dr. Hilary Cass, independent pediatrician, speaks 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

Groups that offer support to gender-questioning children should adhere to the guidelines of the landmark Cass Review, the charity sector’s watchdog has said.

The Charity Commission made a statement on wider issues as it published the report into its investigation of the transgender activist charity Mermaids, which has come under fire from parents, educators, and others concerned with child safeguarding because of its practices.

In its 22-page report into Mermaids, the watchdog said it had ordered the organisation to review factually incorrect information on its website about puberty blockers being “an internationally recognised safe, reversible healthcare option.” The false statements have now been removed.

‘Unclear’ That Opinion Isn’t Fact

The watchdog found the charity had been “unclear” about whether the information it was providing was a statement of fact or Mermaids’ own opinion, and said that by law charities are required to ensure information provided on an educational basis is accurate, evidence-based, and balanced.

The report said charity trustees working with vulnerable children “need to ensure that they have regard to the findings, conclusions and recommendations of the Cass Review.”

The independent review of gender identity services for children and young people, commissioned by the NHS and published in April, concluded children’s gender care is an area of “remarkably weak evidence” and that vulnerable youngsters have often been placed on “inappropriate” paths towards life-altering drugs and surgery.

Its author, consultant paediatrician Dr. Hilary Cass, now Baroness Cass, called for a more “holistic” approach to so-called gender care, and said there had been a “lack of high-quality research” assessing the use of puberty blockers in adolescents.

Cass called for a “more cautious approach” in allowing the social transitioning of children, because the changing of pronouns, names, and gender-appropriate clothes could lead to a greater sense of urgency for medical interventions, such as puberty blockers.

The comprehensive, 400-page review by Cass also made clear that “parents should be actively involved in decision-making unless there are strong grounds to believe that this may put the child or young person at risk.”

The Charity Commission said: “Trustees who work in this area need to ensure that they have regard to the findings, conclusions and recommendations of the Cass Review and ensure that they have reviewed their charity’s literature, website and guidance in light of them.

“Furthermore, trustees should have the mechanisms in place to ensure that they keep up to date with any future changes to guidance or legislation.”

‘Horrifying’

The charity LGB Alliance said in a statement it was “pleased and relieved” at the guidance, adding: “It is horrifying to consider how many children, distressed by their emerging same-sex sexual orientation, were persuaded by Mermaids that their bodies were ‘wrong’ and must be fixed by drugs, or even by surgery.”

The Children’s Society also welcomed the recommendation, saying said it should be a “watershed” moment, while NHS England said the health service is “very grateful” for its author’s work.

However, not everyone welcomed its recommendations, with the British Medical Association (BMA) pledging to “critique” the review and make recommendations to improve a health care system which it said has “failed transgender patients.”

Lack of Parental Consent

The two-year investigation into Mermaids cleared the organisation of misconduct, but found there had been mismanagement.

An inquiry was opened into the organisation in 2022 after a number of media exposés and complaints from the public raising concerns around the nature of the support Mermaids was offering to young people, including giving young girls chest-binders, sometimes without their parents’ knowledge or consent.

Concerns were raised in Parliament, with then-Conservative MP Miriam Cates highlighting “serious safeguarding failures” and then-Prime Minister Liz Truss saying the allegations “should be properly looked at.”

The watchdog’s 22-page report, published on Thursday, found the charity had issued 125 chest binders, used to flatten breasts, to girls between January 2021 and September 2022.

In total, 15 of these binders were given to girls aged 13–16, while 24 of those were provided to under 19s whose parents were not supportive of their daughters’ desire to try to present as a boy.

The commission noted that it is not a criminal offence to supply a young person with a binder, but found a “lack of transparency” in how Mermaids went about issuing them.

The charity suspended its breast binding service in September 2022 after it was exposed in the media.

The watchdog warned the charity that if it ever resumes issuing the binders, its policy should reflect the Cass recommendations that parents should be actively involved and informed of such decisions, unless there are serious safeguarding concerns.

Links to Paedophile Support Group

It also said there had been a failure to carry out adequate checks when recruiting trustees, referring to an incident where an ex-trustee of the charity, Jacob Breslow, had spoken at a conference organised by a paedophile support group known as B4U-ACT before being appointed, and had argued in favour of paedophilia being recognised as a “sexual identity.”

The commission also found mismanagement because trustees had failed to “properly adhere to their own internal HR policies” in dismissing its chief executive, Susie Green, in 2022 after six years at the helm, with the announcement at the time being falsely reported as a resignation.

Addressing concerns around alleged ties between Green, a trans-identified man, and the Tavistock and Portman NHS Foundation Trust—which ran the discredited and now closed Gender Identity Development Service (GIDS) for children—the watchdog said it saw “no evidence” to suggest that he or the charity had “inappropriate influence or ties to GIDS or that referrals were made without the support and knowledge of a parent or carer.”

Commission Chairman Orlando Fraser said that Mermaids had cooperated with the investigation, but concluded: “We have carefully scrutinised Mermaids’ activities through a statutory inquiry and have found mismanagement in a number of areas.

“Additionally ... we have required Mermaids to present a more accurate picture on its website as to the risks involved in the use of puberty blockers, and to follow Cass Review findings on the involvement of parents in social transitioning as regards any future provision of chest binders to children.”

Mermaids’ chair of trustees, Kathryn Downs, issued a statement saying the commission had “confirmed, as we have repeatedly asserted, that we have not provided medical advice or acted improperly in our work with children, young people and their families.”

On the findings of mismanagement, Downs said, “The trustees accepted that governance did not keep pace with the charity’s rapid growth linked to rising support needs from trans young people and their families.”

Downs described the issues as “historic” and said they had been addressed by the charity through two independent reviews and that the board has “strengthened due diligence processes for trustee recruitment.”

Founded in 2005, Mermaids has an income of almost £2.3 million and says it supports more than 10,000 people each year.