Cass Review: April 10, 2024

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

Also this:

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.

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

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