After four years, Hilary Cass produced a review of gender-affirming care for kids in the UK.
Start with these:
The Cass Review: Nothing But Anti-Trans Propaganda: When you thought it couldn't get worse, it did. Z. P.Hopkins, Gender Identity Today, 17 Apr 2024
The UK’s Cass Review Is Already Harming Transgender Young People: Despite finding no evidence of harm, the Cass Review has already led to restrictions on gender-affirming care, while further fuelling transphobic moral panic, Kaylin Hamilton, Prism & Pen, 22 Apr 2024
Erin Reed (Cass Met With DeSantis Pick Over Trans Ban: Her Review Now Targets England Trans Care, April 10, 2024) summarizes:
"Dr. Hilary Cass released a final report commissioned by the NHS, widely expected to target gender-affirming care. The report met these expectations, calling for restrictions on gender-affirming care and social transition, and even advocated for blocking transgender adults under the age of 25 from entering adult care. To justify these recommendations, the review dismissed over 100 studies on the efficacy of transgender care as not suitably high quality, applying standards that are unattainable and not required of most other pediatric medicine. Conducted in a manner similar to the anti-trans review by the DeSantis-handpicked Board of Medicine in Florida, which Cass reportedly collaborated on, the report and its reviews are likely to underpin further crackdowns on trans care globally.
The 388-page report featured 32 recommendations on how transgender care should be conducted within NHS England. It incorrectly claims that there is “no good evidence” supporting transgender care and calls for restrictions on trans care for individuals under the age of 18, although it does not advocate for an outright ban. ...it seemingly endorses restrictions on transgender people under the age of 25, stating that they should not be allowed to progress into adult care clinics."
The Cass Review, as Reed explains, used the subjective Newcastle-Ottawa Scale to declare that 101 out of 103 studies on gender-affirming care were low-quality, despite "connections between reviewers, Cass, and anti-trans organizations." In this, it resembles the Florida Review.
The Cass Review Buried Trans Youth Perspectives, Evan Urquhart, Assigned Media, May 15, 2024
Like sorry they found 10 detransitioners among the 3000 patients they looked at? Even if the records are spotty it's insane to try and claim the 30-80%(!) rates of desistance that people like to throw around.
— Turbo Duo Lipa (@cambrianera.radical.town) May 15, 2024 at 11:58 AM
Jesse Singal says that "objective" data is needed on whether trans people are OK, mentally and physically.
Also this
Fascinating and necessary analysis of the Cass Report from @gidmk.bsky.social, an epidemiologist who specializes in debunking shoddy science claims. This man is doing the lord's work. open.substack.com/pub/gidmk/p/...
— Lydia Polgreen (@polgreen.bsky.social) May 10, 2024 at 5:27 PM
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Here's the link that's inside the Bluesky post:
The Cass Review Into Gender Identity Services for Children - Part 4. Regret, persistence, detransition, and further mistakes in the Cass review. Gideon M-K: Health Nerd (Substack), May 10, 2024.
Trying to imagine if this were the standard for any other medical care.
— Matt Goldberg (@mattgoldberg.bsky.social) May 8, 2024 at 4:18 PM
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Here's the link that's inside the Bluesky post:
WBUR
Polgreen adds:
The first big boom of transgender medicine of the 1950s-70s ended when a researcher "discovered" that transition might make trans people happier but wasn't making trans people more likely to be "objectively" better members of society: straight, married, employed, etc.
— Lydia Polgreen (@polgreen.bsky.social) May 8, 2024 at 3:33 PM
Cass' version of this might seem kinder and gentler, but remember! People who are not trans are allowed to be unemployed, unhappy, have bad sex, etc, without being pathologized. That's just... life. A trans person should be entitled to the same ordinary unhappiness as anyone else.
— Lydia Polgreen (@polgreen.bsky.social) May 8, 2024 at 3:37 PM
Ask yourself: should a woman only be entitled to an abortion if it makes her more likely to have a job? Or get married? Or have children later? No, of course not. A woman is entitled to have an abortion because her body is her own and she can do what she wants with it.
— Lydia Polgreen (@polgreen.bsky.social) May 8, 2024 at 3:40 PM
"Although “sex-change” surgery was “subjectively satisfying” for the small sample surveyed, the operations they underwent conferred “no objective advantage in terms of social rehabilitation.”" A pretty good summary of this horrifying history: wapo.st/3UAZ5rj
— Lydia Polgreen (@polgreen.bsky.social) May 8, 2024 at 4:06 PM
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Washington Post (subscriber gift link)
"In an interview with NPR, Dr. Cass claimed that transgender individuals' care should be judged by their "employment," rather than their satisfaction with the care received. Later, during an interview with The New York Times, Cass misleadingly stated that she had not been contacted by any lawmakers or U.S. health bodies, despite having met with political appointees of Gov. Ron DeSantis to discuss banning trans care before her report was published."
"Endocrine Society And American Academy Of Pediatrics Respond To Cass, Reject Bans: In recent weeks, the Cass Review out of the United Kingdom has been used to argue for bans on care. The Endocrine Society and American Academy of Pediatrics respond, rejecting such arguments. Erin Reed, May 13, 2024
The Endocrine Society released a statement and pointed out that "they cite over 260 research studies to support their recommendations on transgender care," as Reed summarized.
Reed also pointed out:
"Interestingly, Cass herself advocated against care bans in her most recent New York Times interview released today, where she stated, “There are young people who absolutely benefit from a medical pathway, and we need to make sure that those young people have access,” although she added a caveat that those young people should be forced to consent to research in order to access care, leaving many to question the ethics of such an approach."
How this rhetoric works
"Its like there’s this system of coordinated transphobia where extremists like DeSantis give cover to Britain, who in turn give a formal basis to the ‘critiques’ of the NY Times. And the NY Times, in turn, give Britain the press attention they wanted."
— England’s Trying to Ban ADULT Trans Care After the Cass Report: It was never gonna stop at trans kids, ElizaBeth, Apr 14, 2024
Update: June 2024
Since the Cass Review came out, Cass has (according to Erin Reed) "blamed being trans on pornography and labeled the American Academy of Pediatrics as a "left-leaning organization" due to its support for the medical care of transgender youth."
"Last month, a handful of members of the RANZCP, some of which are notable figures in anti-trans activism in the country, wrote a letter to the organization stating that they had “serious concerns” about gender affirming care for transgender youth. They pointed to the Cass Review as justification for their concerns. The top signature on the letter is that of Jillian Spencer, who stated in an interview that she was fired for “being a danger to trans and gender-diverse children.” Now, the college has responded.
In a response posted to the RANZCP website, the college announced that the Cass Review is one of "a number of reviews,” and that it rejects the call for a “government inquiry” into trans care in the countries it represents. It further states that transgender care should be “patient centered” and individualized to a patient’s needs. Lastly, it expresses a full support for transgender youth and rejects claims that being transgender is a “mental health condition”..."
Another International Medical Org Rejects Cass Recommendations On Trans Youth Many of the largest medical and psychological organizations have rejected the Cass Review's recommendations on trans youth. The Royal Australian and New Zealand College of Psychiatrists is the latest. Erin Reed, June 14, 2024
Reed continues: "Conservative Women and Equalities Minister, Kemi Badenoch, admitted that 'gender critical' individuals were placed in health roles to facilitate the Cass Review — a mechanism remarkably similar to how Florida’s review led to the banning of care in the state, borrowing from DeSantis’ strategy."
Update: July 2024
Hilary Cass Repeats Transphobic Talking Points, Again, Alyssa Steinsiek, Assigned Media, July 3, 2024
Yet people are still saying no one is listening to J.K. Rowling?
The UK just banned puberty blockers, what would more engagement with her ‘concerns’ even look like
— Michael Hobbes (@michaelhobbes.bsky.social) Jun 24, 2024 at 5:56 AM
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Did the New York Times Call the Cass Report Fake? Its surprisingly good, ElizaBeth, Medium, August 20, 2024
Revealed: Over 200 Transgender patients have been refused hormone care by GPs, QueerAF, Medium, October 19, 2024
Previously, in 2023
Last year: The Myth Of "Low Quality Evidence" Around Transgender Care, Erin Reed, August 8, 2023
Here, Reed pointed out that "Gender-affirming care isn't unique in this regard. Some studies suggest that over 90% of medical care lacks "high-quality evidence" as classified by the GRADE system." That medical care might involve "individualized approaches," be justified by "observational evidence," or be ethical given that "withholding treatment would be considered unethical." Again, lots of medicine is like this — not just care for trans people. "No one labels gallbladder surgery as 'experimental," Reed says, even though there's no high-quality evidence for it if you ask GRADE.
Reed continued:
"Mischaracterizing the evidence around gender affirming care as 'low-quality' is a deceptive practice that relies on a layman understanding of the term. There is no level of evidence that will ever be acceptable to those seeking to ban gender affirming care, as controlled trials where trans youth are put through conversion therapy or denied medication are not ever going to ethically happen - especially given suicide risks among this patient population."
Kaylin Hamilton wrote that "literature reviews commissioned by the ongoing Cass Review into gender-affirming care for transgender youth, and similar reviews which were used as justification for the ban on gender-affirming care in Florida, all attempt to discredit the evidence base for gender-affirming care (at least partly) on the basis of these two issues," namely, "a lack of consideration for social factors and a comorbid approach to the relationship between gender dysphoria and mental illness."
— Gender Affirming Care isn’t a Panacea: We need to change the way we talk about — and research — the relationship between gender dysphoria and mental illness, Kaylin Hamilton, Substack, May 8, 2023
"If you’re in the UK, trans and your GP has refused you adequate care around your hormones get in touch with Dr Tlaleng at the UN who is collecting evidence for show down with the government in December.
Under Special procedures
spsubmission.ohchr.org"
Mrs Schwarzski, Bluesky, October 11, 2024
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