Misinformation Rampant in Press Coverage of Cass Review
Right-wing media has repeatedly shared false and misleading claims about the findings presented in the Final Report of the Cass Review.
by Evan Urquhart
Right-wing media has unleashed a wave of misinformation about trans healthcare in the wake of the Final Report of the Cass Review, which investigated gender-affirming care for youth in the UK. Despite numerous false claims about the contents of the Report, few or no attempts have been made to correct the record, either by journalists or Dr. Cass herself. Instead, Dr. Cass and sympathetic journalists have focused their attention on litigating minor disputes over word choice and framing by trans writers and activists who have been harshly critical of the Report.
First, a small primer on misinformation: As with many words that have come into common usage to describe the dangers of our political moment, misinformation has gone from being a carefully defined term describing falsehoods spread with political intent to being an amorphous insult used when people disagree with others’ opinions or characterizations of the facts. At Assigned Media, we only use “misinformation” to describe clearly, provably false statements. We prefer words like misleading, oversimplification, exaggeration, or hyperbole to describe claims with a kernel of truth.
A Washington Examiner story from April 15 is one example of anti-trans misinformation relating to the Cass Report appearing in the right-wing press. The story, by editor Kaylee McGhee White, is not clearly labeled as opinion and mixes opinion statements with falsehoods and facts. It includes quotes from the Cass Report itself alongside false statements that directly contradict the findings of that Report. For example, McGhee writes the report “proves… ‘gender-affirming care’ is an evidence-free, failed approach that yields overwhelmingly harmful outcomes.” However, while describing the evidence overall as “remarkably weak,” the Cass Review found moderate evidence in favor of cross-sex hormones, and no evidence of harm from any treatment it reviewed.
In addition to this falsehood, McGhee’s article has passages of misleading, hyperbolic overstatement. Here’s one of those:
screenshot from the Washington Examiner
Coverage of the Cass Review in the right-wing press has been rife with overstatement mixed with opinion mixed with hyperbole mixed with (some) facts. You can find similar in opinion articles and news stories for the Telegraph, the Daily Mail, and other right-leaning outlets that have covered the release of the Report. For example, the writer for the linked opinion piece in the Telegraph falsely claims testosterone causes “a temporary sense of euphoria.” This is untrue.
screenshot from the Telegraph
No efforts have been made in mainstream British or American news media to combat falsehoods being represented as if they were part of the findings of the Cass Review. However, Dr. Cass herself, along with sympathetic journalists, have gone to great lengths to paint criticisms of the Report from the trans community as misinformation, stretching the definition of misinformation out of recognition as they do.
The transgender community has had an overwhelmingly negative response to both the Cass Report itself and to the misinformation surrounding it. One line of criticism has focused on the willingness for the Report to recommend severely restricting access to the only evidence-based treatments available for gender dysphoria based on a finding that this evidence is “weak.” The Report recommends “extreme caution” for providing hormone therapy, despite finding that the evidence in favor of such treatments is moderate, and finding no concrete evidence of any harm. Instead, it engages in speculations about possible harms as justification for this.
Instead of substantively engaging with these criticisms, Dr. Cass has pushed back aggressively, characterizing the criticisms as “misinformation.” This is misleading at best. Based on a press release that leaked a few hours before the full report, many trans people drew attention to the way the report treated the body of evidence in favor of gender-affirming treatment, characterizing Cass as having “disregarded,” “thrown out,” or “ignored” much of the evidence in favor of gender-affirming care.
screenshot from promotional materials emailed to Assigned and other outlets in advance of the release
Further questions have been raised about the Cass Review team’s approach to disregarding evidence after the pre-registered plan for the systematic reviews conducted on behalf of the Review was found. This suggests the team at York University originally planned to use a method of assessing studies that discouraged ignoring “low quality” evidence if it made up a substantial portion of the evidence available. The method they eventually used is much stricter about what evidence to include.
Asked for comment, a representative of the York team explained that different methods of assessing the quality of studies were chosen for the four systematic reviews. The representative declined to comment on whether, when, or on what grounds the original research plan had changed.
Among those accused of spreading misinformation has been Erin Reed, a prominent transgender activist and journalist who blogs at Erin in the Morning. Reed wrote that “the review disregarded 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.”
Whether the Cass Review’s decision to heavily restrict access to gender-affirming care based on systematic reviews that found only weak and moderate evidence in its favor (and no evidence against) counts as “disregarding” evidence would seem to be a matter of opinion. However, the characterization by Cass of this criticism as “misinformation” has been repeated numerous times, often without any comment from any of the trans critics whose words are being characterized this way. This decision not to allow trans critics to defend against the charge of spreading misinformation can even be seen in a story by BBC.
Ultimately, the bulk of the misinformation circulating around the Cass Review has come from tabloids and right-leaning press, as well as from anti-trans activists who view it as a vindication of their cause. Although a case could be made that some of the statements on social media and blogs from members of the trans community included partial information or mischaracterizations, no clear examples of false statements from the trans critics have been found. Instead, opinions differ between Cass and her critics over what constitutes “throwing away,” “discarding,” or “disregarding” evidence, with Cass feeling strongly that her approach did not discard evidence and critics feeling equally strongly that it did.
Evan Urquhart is the founder of Assigned Media and an incoming member of the 2024-2025 Knight Science Journalism fellowship class at MIT.