Its author has had to fend off criticism and misinformation, but the report offers hope for a realistic conversation
As the dust settles around Hilary Cass’s report – the most extensive and thoroughgoing evidence-based review of treatment for children experiencing gender distress ever undertaken – it is clear her findings support the grave concerns I and many others have raised. Central here was the lack of an evidential base of good quality that could back claims for the effectiveness of young people being prescribed puberty blockers or proceeding on a medical pathway to transition. I and many other clinicians were concerned about the risks of long-term damaging consequences of early medical intervention. Cass has already had to speak out against misinformation being spread about her review, and a Labour MP has admitted she “may have misled” Parliament when referring to it. The review should be defended from misrepresentation.
The policy of “affirmation” – that is, speedily agreeing with a child that they are of the wrong gender – was an inappropriate clinical stance brought about by influential activist groups and some senior gender identity development service (Gids) staff, resulting in a distortion of the clinical domain. Studies indicate that a majority of children in the absence of medical intervention will desist – that is, change their minds.
David Bell is a retired psychiatrist and former president of the British Psychoanalytic Society
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