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The UK’s Cass Review causes harm

Dr. Hillary Cass

The Cass Review causes harm

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Gaining access to gender-affirming puberty blockers is now near impossible in the UK, writes Glenda Harvey.

The confounding polarisation of anything to do with transgender rights in our modern world continues to baffle and adversely affect gender diverse people and those that care about them. This is especially true amongst our youth who are witnessing the impact of gender dysphoria on those affected and their ability to receive gender-affirming treatment. 

Recently in the UK, The Cass Review came to the conclusion that there was only weak evidence hormone blockers positively or negatively impacted gender dysphoria for youth under the age of 18 (although Dr. Hillary Cass even acknowledged she met persons who had benefited from the treatment). They advised that those already on treatment could continue but otherwise only those with extenuating circumstances or for research trials would be allowed. As a result, no private citizen below the age of 18 can access gender-affirming puberty blockers in the UK, even after psychological and medical evaluation.

It is right and healthy to have the right protocols and holistic treatments investigating and treating case by case those presenting to clinicians as having gender dysphoria. This screening process is important and is generally welcomed by those who are gender diverse. However, it becomes problematic in the overall societal discussion and laws regarding the health of the gender diverse community and especially those with gender dysphoria, with suicide rates for those with gender dysphoria consistently seen above the average due to a range of factors, both physiological (psychological factors are still brain based and therefore physiological) and from an ignorant society and culture. It is imperative we don’t leave out treatments that can save lives. 

In a study published in The Cureus Journal of Medical Science in 2019, it was found that gender dysphoric youth were at a significantly higher risk of mental health problems, including suicide ideation and attempts; and that a collaborative, multidisciplinary approach could help in the care and protection of vulnerable people to avoid tragedy, including with the use of puberty blockers. In 2020’s The Journal of Pediatrics it was found that there were favourable mental health outcomes for transgender adolescents who wanted and received hormone suppressing treatment. How do these studies align with the UK government’s decision following the Cass report? 

We don’t want to feed a conservative backlash to the higher visibility of trans people within our society. Peripheral ignorant commentators can have real political influence on these matters. While acknowledging there is always more room for study and learning, it does not justify conservative zealotry that will use scientific studies only if it suits their argument and that dismisses it when it doesn’t. 

As a trans woman who has a science degree, I trust the scientific method. I also know first-hand the pain of youth and adolescent gender dysphoria, which was never talked about in my youth in the 1970 and ‘80s. It is clear that the benefits of puberty blockers, with the appropriate protocols in place, can and does save lives.