Thousands of children unsure of gender identity ‘let down by NHS’, report finds - "Thousands of vulnerable children questioning their gender identity have been let down by the NHS providing unproven treatments and by the “toxicity” of the trans debate, a landmark report has found. The UK’s only NHS gender identity development service used puberty blockers and cross-sex hormones, which masculinise or feminise people’s appearances, despite “remarkably weak evidence” that they improve the wellbeing of young people and concern they may harm health, Dr Hilary Cass said. Cass, a leading consultant paediatrician, stressed that her findings were not intended to undermine the validity of trans identities or challenge people’s right to transition, but rather to improve the care of the fast-growing number of children and young people with gender-related distress. But she said this care was made even more difficult to provide by the polarised public debate, and the way in which opposing sides had “pointed to research to justify a position, regardless of the quality of the studies”. “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.” NHS England commissioned her inquiry in 2020 amid rising concern over the care provided by the Tavistock and Portman NHS mental health trust’s gender identity development services (Gids). It treated about 9,000 children and young people, with an average age at referral of 14, during 2009-2020. Her inquiry has already led to NHS England shutting Gids, banning puberty blockers and switching to a new “holistic” model of care in which under-18s experiencing confusion about their gender identity will routinely receive psychological support rather than medical intervention. “For most young people, a medical pathway will not be the best way to manage their gender-related distress. For those young people for whom a medical pathway is clinically indicated, it is not enough to provide this without also addressing wider mental health and/or psychosocially challenging problems,” said Cass, an ex-president of the Royal College of Paediatrics and Child Health. The report recommends that all such young people should be screened to detect neurodevelopmental conditions, such as autism spectrum disorder or ADHD, and there should be an assessment of their mental health, because many who seek help with their gender identity also have anxiety or depression, for example. Some transgender adults “are leading positive and successful lives, and feeling empowered by having made the decision to transition”, Cass said. However, “I have spoken to people who have detransitioned, some of whom deeply regret their earlier decisions”, she added... the Tavistock trust began prescribing puberty blockers much more widely in 2014, despite a lack of evidence that they helped. In an interview with the Guardian, Cass said that gender-questioning children have been “let down” by the NHS, health professionals and a “woeful” lack of evidence about what treatment works. “One of the things that has let them down is that the toxicity of the debate has been so great that people have become afraid to work in this area. “A majority of people have been so afraid, because of the lack of guidance, lack of research, and how polarised this is that they’ve passed [patients] straight on to Gids.”... Sallie Baxendale, a professor of clinical neuropsychology at University College London, said that Cass’s report “has laid bare the worrying lack of evidence to support the treatments that were prescribed by NHS clinicians to children with gender distress for over a decade. “These treatments inflicted significant harm on some of the most vulnerable children in our society. “Exceptionalism often lies at the heart of medical scandals when services go rogue and start to operate outside the normal parameters of clinical practice.”... Cass disclosed in the report that six of the NHS’s seven specialist gender services in England for adults had “thwarted” an attempt by the University of York, at her request, to obtain and analyse the health outcomes of people who had been treated by Gids in order to improve future care. This refusal to cooperate “was coordinated”, she told the Guardian. “It seemed to me to be ideologically-driven.”. Clinicians caring for those with gender-related distress are very divided on how best to do that, she acknowledges in the report. It also documents how Gids experienced both an explosion in demand for its service from 2010, and also a huge increase in the number of birth-registered females, in a reversal of the pattern of referrals. Cass said that “online influencers” had played a key role in fuelling confusion among young people about their gender identity and what they needed to do to change it... “And some of them [young people] were told that parents would not understand so that they had to actively separate from their parents or distance their parents. All the evidence shows that family support is really key to people’s well being. So there was really some dangerous influencing going on,” she said."
Damn transphobes ignoring the "science" and refusing to provide "basic healthcare" to children!
GPs ‘scared off’ treating children over gender identity, says Dr Hilary Cass - "Her comments follow the publication of a review which concluded that an entire field of medicine aimed at enabling children to change gender had been “built on shaky foundations”. Cass found that there was no good evidence to support the global clinical practice of prescribing hormones to under-18s to halt puberty or transition to the opposite sex. Speaking on BBC Radio 4’s Today programme on Wednesday morning, Cass said: “Because of the toxicity of the debate, [children have] often been bypassed by local services who’ve been really nervous about seeing them. So rather than doing the things that they would do for other young people with depression or anxiety, or perhaps undiagnosed autistic spectrum disorder, they’ve tended to pass them straight on to the Gids service.” She said she wanted to “help clinicians from all backgrounds realise that they do have the transferable skills to see these young people”, arguing that this would help bring down long waits... Her final report has endorsed a fundamental shift in approach away from medical intervention towards a holistic model that addresses other mental health problems the children may have... The report contains 32 recommendations for overhauling services. “For most young people, a medical pathway will not be the best way to manage their gender-related distress,” Cass said, adding that children must be seen “as a whole person and not just through the lens of their gender identity”. She said it was vital that services take into account high rates of autism and mental health problems in children identifying as transgender. The report is the world’s biggest review into the contested field of trans healthcare, and involved patients, families, academics and doctors. Researchers at the University of York examined all available evidence on how to treat children questioning their gender identity. They concluded there was “wholly inadequate” evidence to support medical intervention, making it impossible to know whether it improves mental or physical health... The review found that the use of puberty blockers had “spread at pace” around the world, based on a single Dutch study that began in 1998. It said there was no good evidence that puberty blockers helped, and they may damage bone health and height... The review also found that debates on trans issues had led to fear among doctors and parents, with some worrying about being accused of transphobia. Since the Gender Identity Development Service opened in 1989, it has seen more than 9,000 young people."
How dare they ignore the "science"?! Time to deplatform them!
‘Children are being used as a football’: Hilary Cass on her review of gender identity services - "In the autumn of 2019, leading consultant paediatrician Hilary Cass agreed to conduct a review of international research into puberty blockers for NHS England. She expected it to be a short, straightforward task... The work has developed into “a 24-hour a day obsession to try to help improve things” and has placed her at the vortex of a debate she describes as toxic, politicised and ideological. Cass’s review is written in a calmly clinical tone but there are moments when her anger about how NHS England has cared for a generation of vulnerable children is barely disguised. Clinicians have become “fearful”. The available evidence is “poor”. Her efforts to conduct a vital and comprehensive study into the outcomes of all 9,000 children and adolescents treated at the Tavistock and Portman gender identity development service (Gids) clinic between 2009 and 2020 were “thwarted”... “We’ve let them down because the research isn’t good enough and we haven’t got good data,” she said. “The toxicity of the debate is perpetuated by adults, and that itself is unfair to the children who are caught in the middle of it. The children are being used as a football and this is a group that we should be showing more compassion to.”... In the future she wants services to offer a broad range of interventions, rather that having “tunnel vision” on gender. She is not even sure that future clinics should have gender in the name, noting that we should “move away from just calling these gender services because young people are not just defined by their gender.”... “The toxicity of the debate has been so great that people have become afraid to work in this area.” Medical professionals experienced a sense of fear “of being called transphobic if you take a more cautious approach”, she said. Others were worried that they might be accused of conducting “conversion therapy if, again, they take a cautious or exploratory approach” and some clinicians expressed “fearfulness about what colleagues might say if they speak up and express an opinion that is not consistent with theirs”. The consequence of this rising nervousness among clinicians over the past 15 years has been that many children exploring their gender (which Cass describes as “a normal process” in adolescence, not necessarily requiring any NHS input) have been prematurely diverted towards chronically oversubscribed specialist clinics, and left sitting on waiting lists for years, without any support. “There are many more young people now who question their gender; what’s really important is they have a space to be able to talk to somebody about that and to work that through. The problem has been that whilst they’ve sat on a waiting list, they just haven’t had that help. They’ve just had the internet to help them and that’s not always helpful. “Sometimes they’ve come to a premature conclusion and foreclosed options, when there might have been many different ways of resolving their distress. The aspiration – and I’m under no illusions this is going to happen quickly – is that they should have someone to talk to much earlier on before they narrow their options.” Cass believes that for a minority of young people medical transition will be the right option, but she is clear that there is no solid evidence basis justifying the use of hormones for children and adolescents. Her earlier research has led to a decision by NHS England to stop prescribing puberty blockers to children and the new research recommends “extreme caution” before prescribing masculinising and feminising hormones to under-18s. “We’ve got it locked into this focus on medical interventions. And certainly some of the young adults said to us, they wish they’d known when they were younger, that there were more ways of being trans than just a binary medical transition,” she said. A long section of her report looks at whether nature, nurture or other factors best help explain the soaring numbers of referrals to gender clinics. Cass’s conclusions are nuanced, but she acknowledges that Generation Z are facing unprecedented exposure to social media and the internet. “It’s a social experiment – we don’t know what that’s done for the generation that’s coming through – what has been good and what is bad,” she said. “Biology hasn’t changed in the last few years so it’s not that that’s changed things … We do have to think very seriously about the impact of social media, not just in terms of influencers, but about the effect of long hours on social media.” She added: “There was some very dangerous influencing going on. Some of them give them very unbalanced information. Some were told parents would not understand so that they had to actively separate from their parents or distance their parents; all the evidence shows that that family support is really key to people’s wellbeing,” she said. She acknowledged that some children may have been harmed by being misprescribed hormone treatments, but she said it was impossible to say how many... It was “unbelievably disappointing” that the research study she had hoped to conduct to look at the outcomes of 9,000 former Tavistock patients had been blocked by the adult gender clinics, who refused to contact former patients for permission on her behalf. The former health secretary Sajid Javid had changed legislation to allow researchers to link pre- and post-transition NHS numbers, but the research had to be abandoned when all but one of the adult clinics refused to cooperate, Cass said. “I do think it was coordinated. It seemed to me to be ideologically driven,” she said. “There was no substantive reason for it. So I can only really conclude that it was because they didn’t feel that it was the right thing to do to try and nail down this data.”"
Sajid Javid: NHS let gender ideology replace children’s best interest - "At every opportunity, and in each department I served in, I tried to advance the cause of child protection. In this case, the source of lessons lies within both the clinical practice, and political culture which enabled it to persist for so long. Unless each is resolved, more children will be harmed. In any other setting it is hard to imagine a patient meeting a doctor and the patient telling them what their diagnosis is. Yet the approach of self-diagnoses was the medical pathway adopted at Gids. This resulted in clinicians not showing enough interest in other potential factors, including trauma, social influence, sexual abuse or different conditions. Take the example of autism, which we know about 2 per cent of children in the UK are thought to have. At Gids, a review found that about 35 per cent had moderate or severe autistic traits. Compounding this was the widespread prescription of puberty blockers. Thankfully, that practice in the NHS is changing, but huge loopholes remain in the system. Both private clinics and prescriptions ordered from abroad remain significant problems. In the case of prescriptions, someone could simply order them online to any pharmacy in the country. The government must close this loophole without delay. But this is only one area and many more exist. Despite the specific data legislation I brought forward at Dr Cass’ request, parts of the NHS continue to block access and frustrate the express will of parliament. The common thread between all of these is an extreme gender ideology, which enables them to persist. Across political parties, we need to reassess how effective the commitment is to protecting children and keeping this militant gender lobby at bay; otherwise, this review will be wasted. Only the courage of whistleblowers and activists on this issue was able to provide the beginning of much-needed accountability. Without political support, advocates of the existing system will continue to dominate, as they have in other countries. The same theme of being afraid to tackle “uncomfortable” issues has existed in other areas before, to the detriment of children. Whether it is race, sex, gender or other identity characteristics, politicians cannot let a culture of silence prevail because of political sensitivities. As the introduction of the hate crime law in Scotland demonstrates, the consequence of compliance now risks people being forcibly silenced."
Rishi Sunak: Allowing children to change gender is ‘not a neutral act’
🙏🌧🌍 on X - "The saddest thing about this entire issue is that the Cass Report should never have been necessary. We should never have got to this point. As a society we've placed disproportionate weight on being tarred and feathered as bigoted or phobic, while simultaneously warping the definition of what bigotry is, ironically resulting in words like 'racist', 'nazi' or 'transphobe' becoming essentially meaningless. We've taken the idea of tolerance to an extreme degree, and as a result all sorts of dangerous crazy shit has been slipping through the net without being questioned."
Tall Dark & Grüesöme on X - "Its been as bad as Thalidomide was to kids back in the day! All that damage and the evil zealots who took advantage of them, and still do! Ugly inside and out!"
Clearly, we should "trust the 'science'" and not ask any questions, and history is irrelevant because science has improved
BBC Newsnight on X - "“We know next to nothing about the 9000 to 10 000 children who have gone through the Gender Identity Development Service”. Hannah Barnes, Author of Time To Think and former Newsnight producer discusses the Cass Report #Newsnight"
Stewart Maclean on X - "The remarkable @hannahsbee did more than anyone else to raise Qs over NHS' treatment for young people questioning their gender Brave and dogged reporting over many years for Newsnight & wrote the book while on maternity leave - always focused on welfare of those being treated"
justin webb on X - "On the toxicity issue raised by Dr Cass this morning, it's worth repeating: no major publisher would touch Hannah's book in spite of the fact that it was approved by the BBC as a piece of impartial reporting"
