The Cass Review: The Transgender Consensus is Collapsing

For years, critics of so-called “gender medicine” have made the case that it is not reputable medicine and that the evidence for cross-sex hormones, puberty blockers, and “sex change” surgeries is flawed, faulty, and in many cases, false. Those medical experts were shouted down, fired, and censored. Transgender activists and their political allies asserted that “gender medicine” was “following the science” and that its critics were a) extremist bigots and b) would cause the deaths of “transgender children” by opposing these interventions. 

Recently, a new narrative has begun to emerge. Detransitioners who endured the meatgrinder of the transgender medical complex have come forward to tell their horrifying stories (I interviewed “Scott” Newgent for my podcast). Studies highlighting the side effects of these interventions – side effects that were predicted by critics – have caused European countries such as Norway, Finland, Sweden, and the U.K. to abandon many interventions that transgender activists falsely claim are life-saving. Some leaders, like Joe Biden and Justin Trudeau, appear determined to ignore this evidence. 

The WPATH Files revealed that some doctors knew how destructive transgender procedures really are; now, the just-released Cass Report puts another nail in the coffin of these medical malpractices. It is the world’s largest review into transgender interventions for minors, and Dr. Hilary Cass, the pediatrician commissioned by the UK’s National Health Service to review the transgender “services” being made available to dysphoric minors, is scathing in her analysis. Cass found that “gender medicine” is “built on shaky foundations” and that while these drastic interventions should be approached with extreme caution, “quite the reverse happened in the field of gender care for children.” 

The evidence cited by transgender activists and their political allies, Cass concludes, is deeply suspect. “While a considerable amount of research has been published in this field, systematic evidence reviews demonstrated the poor quality of the published studies, meaning there is not a reliable evidence base upon which to make clinical decisions, or for children and their families to make informed choices,” she wrote in her report, which includes concluding “key findings” such as: 

• The rationale for early puberty suppression remains unclear, with weak evidence regarding the impact on gender dysphoria, mental or psychosocial health. The effect on cognitive and psychosexual development remains unknown. 
• The use of masculinising / feminising hormones in those under the age of 18 also presents many unknowns, despite their longstanding use in the adult transgender population. The lack of long-term follow-up data on those commencing treatment [sic] at an earlier age means we have inadequate information about the range of outcomes for this group. 
• Clinicians are unable to determine with any certainty which children and young people will go on to have an enduring trans identity. 

All of those key findings are in direct contradiction to the narrative pushed by the LGBT movement and their political allies. Consider how many thousands of children and young people have been profoundly damaged by the transgender medical industry and the cowardice of those who refused to speak up against what they saw unfolding. Cass’s evidence is of the highest calibre; she commissioned the University of York to conduct several analyses as part of her review, and the researchers found that 23 of the clinical guidelines that were reviewed “were not independent or evidence based.” 

That is because activists driven by ideology rather than medicine wrote them. 

Even the left-wing Guardian is essentially admitting that the consensus on transgender interventions has collapsed, noting that a paper “on puberty blockers found that of 50 studies, only one was of high quality” and that “of 53 studies included in a fourth paper on the use of hormone treatment [sic], only one was of sufficiently high quality, with little or inconsistent evidence on key outcomes.” In fact, the researchers found the guidelines on transgender procedures were largely uninformed “by a systematic review of empirical evidence” and lacked transparency; only two “reported consulting directly with children and young people during their development.” 

The York University researchers concluded: “Healthcare services and professionals should take into account the poor quality and interrelated nature of published guidance to support the management of children and adolescents experiencing gender dysphoria/incongruence.” Translation? The “evidence” that transgender activists have been pushing as the basis for their industry is bunk. Cass found that so-called “gender medicine” is “an area of remarkably weak evidence.”  

The National Health Service announced that it would cease prescribing puberty blockers outside of clinical trials in March; the Cass Report offers a list of other recommendations, as well, including: services that adhere to the same rigorous standards of others dealing with children; services for detransitioners; extensive, long-term data collection on the actual impact of these interventions into adulthood; holistic screenings of those with gender dysphoria for contributing factors; and “extreme caution” for cross-sex hormones even when prescribed to non-minors. In short, the Cass Report is a demolition of the so-called “affirmative model” of “gender care.” The consensus has completely collapsed. I hope that those political leaders still desperately clinging to their debunked narrative notice very, very soon.