England’s Landmark Cass Report Hailed as ‘Single Most Notable Event in History of Youth Gender Medicine of Last Decade’

Shows ‘Significant Lack of Evidence’ for Experimental Treatments

A top organization that has been sounding the alarm in recent years that children are being subjected to experimental drugs and surgeries in a cave to gender ideology is praising the work of British pediatrician Dr. Hilary Cass and her independent review team for its bombshell final report clearly condemning the “remarkably weak evidence” that has been touted as research support for such invasive treatment for minors.

Calling Cass’ final report “the single most notable event in the history of youth gender medicine of the last decade,’ the Society for Evidence Based Gender Medicine (SEGM) reacted to its release this week:

For England, the Cass Report marks the end of the era of a highly medicalized approach to the treatment of young people with gender-related distress, which has come to be known as “gender-affirming care.”  While the treatment protocol for youth comprising of puberty blockers, cross-sex hormones, and surgery, known as the “Dutch Protocol,” was invented in the Netherlands in the 1990’s, the report points out the concept of “gender-affirming care” – the notion that the doctors must accept children’s declarations of identity at face value and must assist them in gender change as early as possible– actually originated in the United States, and only then spread internationally. 

Formed about five years ago in response to numerous treatment guidelines promoting the gender transition of children and adolescents without any systematic reviews of evidence for those guidelines, SEGM referred to Cass’ report as a “scathing assessment of the gender-affirming approach in general, and the gender-clinic model of care.”

The group underscored that England’s National Health Service (NHSE) welcomed the Cass Report's recommendations of treating minors with gender dysphoria using a “holistic assessment,” one that screens as well for “neurodevelopmental conditions, including autism spectrum disorder, and a mental health assessment,” as the report said. 

“Going forward, England will treat gender dysphoric youth <18 using standard psychological and psychotherapeutic approaches, with very few young people receiving endocrine gender reassignment interventions (gender-transition surgeries for <18s have never been allowed in England),” SEGM observed, pointing out that another outcome of Cass’ review is NHSE’s decision to launch a similar review examining England’s adult gender dysphoria clinics as well.

“In summary, the care for <18s in England will no longer be based on the ‘gender-affirming’ model of care but instead will treat youth with gender distress similarly to how it treats youth with other developmental struggles,” the organization says. “Further, with the announcement of the adult gender clinic review, England starts a new chapter in the history of gender medicine, with a new focus on vulnerable gender-dysphoric young adults.”

In her foreword to the report of the systematic review of studies and guidelines conducted by the University of York, Cass decried that although generally new treatments for young people must endure a lengthy trial period of study before available for use, “quite the reverse happened in the field of gender care for children.”

In fact, “[t]he reality is that we have no good evidence on the long-term outcomes of interventions to manage gender-related distress,” she said.

The British pediatrician did not hold back from denouncing the “toxicity” surrounding the controversy over “gender-affirming” treatments for children, citing it as likely among the contributing factors leading to such a push for puberty blockers and cross-sex hormones for young people.

“The knowledge and expertise of experienced clinicians who have reached different conclusions about the best approach to care are sometimes dismissed and invalidated,” Cass said, asserting:

There are few other areas of healthcare where professionals are so afraid to openly discuss their views, where people are vilified on social media, and where name-calling echoes the worst bullying behaviour. This must stop.

The key findings of the review include:

• No clear evidence that social transition in childhood – seen as the initial phase of so-called “gender-affirming care” – has any positive or negative mental health outcomes, and relatively weak evidence for any effect in adolescence.

“However, those who had socially transitioned at an earlier age and/or prior to being seen in clinic were more likely to proceed to a medical pathway,” the report pointed out.

• No support for the claim that administering puberty blockers allows time for children and their families to consider further medical intervention:

[G]iven that the vast majority of young people started on puberty blockers proceed from puberty blockers to masculinising/ feminising hormones, there is no evidence that puberty blockers buy time to think, and some concern that they may change the trajectory of psychosexual and gender identity development.

Studies pertaining to the use of puberty blockers for children also show evidence the drugs compromise bone density. However, “no changes in gender dysphoria or body satisfaction were demonstrated,” the report observed. 

• No evidence to support the “transition or die” claim that hormone treatment prevents a high risk of suicide in minors with gender dysphoria:

Tragically deaths by suicide in trans people of all ages continue to be above the national average, but there is no evidence that gender-affirmative treatments reduce this. Such evidence as is available suggests that these deaths are related to a range of other complex psychosocial factors and to mental illness.

The Cass final report comes on the heels of leaked internal documents from the World Professional Association for Transgender Health (WPATH) that revealed WPATH medical providers admitting children – and even their parents, in some cases – are unable to comprehend the far-reaching consequences of the drug and surgical treatments the “gender medicine” professionals recommend, particularly with regard to sterility. Yet, young people are prescribed them anyway.

In the past, the United States might have been at the forefront of protecting children from experimental and life-altering medical interventions for a disorder that the majority of children, Cass and her review team clearly state, “are most likely to desist before puberty.”

The impact of Cass’ blockbuster report on other Western nations, including the United States, remains a question, as SEGM observes:

Many more developments are expected from England in the coming months. To what extent the UK changes will impact the West’s approach to helping young gender-dysphoric individuals remains to be seen. In SEGM’s view, the impact will likely be significant, even if delayed, as other countries contend with England’s findings and their implications for evidence-based clinical practice.

Going so far as to appoint an assistant Health and Human Services (HHS) secretary who identifies as “transgender” and promotes the so-called “gender-affirming care” model for young children, Joe Biden has backed the experimental treatments for young people, framing a mental health issue as one whose focus is political “rights.”

Helen Lewis spelled out the conflict this week at The Atlantic:

Medicalized gender treatments for minors became wrapped up with a push for wider social acceptance for transgender people, something that was presented as the “next frontier in civil rights,” as Time magazine once described it. Any questions about such care were therefore read as stemming from transphobic hostility, full stop. And when those questions kept coming anyway, right-wing politicians and anti-woke comedians piled on, sensing an area where left-wing intellectuals were out of touch with popular opinion. In turn, that allowed misgivings to be dismissed as “fascism,” even though, as the British journalist Sarah Ditum has written, “it is not damning of feminists that they are on the same page as Vladimir Putin about there being two sexes. That is just how many sexes there are.”

Moving forward, the Cass report asserts “the nature and causes of gender dysphoria/incongruence are complex and poorly understood.”

The reviewers call for psychological intervention for children with gender identity issues, asserting specifically that it is "harmful to equate this approach to conversion therapy as it may prevent young people from getting the emotional support they deserve."