A new peer-reviewed study of the Cass Review, the UK project that was used to stop trans teens’ healthcare, has been published. And like all the other peer-reviewed studies of the Cass Review, it’s absolutely damning. It once again demonstrates that the review was skewed to deliver a pre-determined outcome that flies in the face of the evidence.
The study describes the review’s “disregard of international expert consensus, methodological problems and conceptual errors” and says that its internal contradictions are striking:
It acknowledged that some trans young people benefit from puberty suppression, but its recommendations have made this currently inaccessible to all.
It found no evidence that psychological treatments improve gender dysphoria, yet recommended expanding their provision.
It found that NHS provision of GAMT [Gender Affirming Medical Treatment] (GnRHa, oestrogen or testosterone) was already very restricted, and that young people were distressed by lack of access to treatment, yet it recommended increased barriers to oestrogen and testosterone for any trans adolescents aged under 18 years.
It dismissed the evidence of benefit from GAMT as “weak”, but emphasised speculative harms based on weaker evidence.
The harms of withholding GAMT were not evaluated.
The Review disregarded studies observing that adolescents who requested but were unable to access GAMT had poorer mental health compared with those who could access GAMT.
Despite finding that detransition and regret appear uncommon, the Review’s recommendations appear to have the goal of preventing regret at any cost.
The Review, and the UK Government, have taken the position that GAMT, an established treatment with observational evidence of early and medium term benefits and acceptable safety, should be actively withheld from trans adolescents due to lack of high certainty evidence of very long term efficacy and safety. Few treatments for any condition meet this criterion, and it is difficult to name another field in which regulators impose such a benchmark.
…The Cass Review, lacking expertise and compromised by implicit stigma and misinformation, does not give credible evidence-based guidance. We are gravely concerned about its impact on the wellbeing of trans and gender-diverse people.