Dr. Hilary Cass is again expressing ambivalence about the impacts her work to undermine trans young people’s identity and cut off avenues for treatment has had in the aftermath of her review of trans youth health care two years ago.
After the Cass Review was published in April of 2024, a ban on gender-affirming care was made permanent by the Labour government. Now, a planned study into the effects of puberty blockers is itself under siege by anti-trans activists. The activists maintain, without evidence, that the drugs (which are entirely reversible and regularly used to treat early puberty in cis children), are too dangerous even for a study to examine their efficacy in helping young people with gender dysphoria.
In response, Dr. Cass has once again strayed into a few moments of honesty about what the research actually says about puberty blockers. Cass reportedly told the BBC that “some of the hype about risks have been exaggerated in that we genuinely don’t know if there are harms.”
The Final Report of the Cass Review concluded that the evidence for gender-affirming treatments was insufficient and called for further research. Notably, it found no evidence of harm whatsoever, alongside weak evidence of some benefit. To justify restricting care, the report focused on the possibility that some young people who grow up to be trans adults might not have been trans if they were denied the ability to socially or medically transition. Buried in the appendices, the report found fewer than 10 trans youth in the entire country who had detransitioned.
While the report was seen as a disaster by trans youth and their families at the time, subsequent developments have been worse than anyone imagined. The lack of evidence was used to support a care ban, which activists have twisted into a claim that the treatments were found to be harmful, which in turn is fueling the effort to prevent them from even being studied. Despite promises to the contrary, children who had responded well to care have recently been informed that the NHS is shutting the last remaining clinic that had taken over their care, with the intent being to forcibly detransition the 78 youth who had found treatment there.
It is supremely ironic that the hatchetwoman who was tasked with finding a pretext to end gender-affirming care in the UK is now protesting that she found no evidence of harm from the treatments her report vilified. Left unsaid is how unprecedented it was to ban a promising treatment with no known alternatives over the fact that the evidence isn’t robust enough yet.
