University of Sussex Students' Newspaper

Cass Review Threatens Trans Rights in the UK

Jude Budworth

ByJude Budworth

May 13, 2024

Published on 10 April, the Cass Review investigates the state of the Gender Identity Development Services (GIDS) for young people in the UK. The review has proven to be poorly researched and driven by a predetermined view of what it means to be transgender. Hilary Cass, the lead author of the 388-page review, is a paediatrician who follows extremist anti-trans organisations such as Transgender Trend and LGB Alliance on social media. In the review, she argues that there is little evidence for the safety of puberty blockers and gender-affirming hormones. Cass claims that “culture wars” have restricted the voices of objective science. 

The review disregards the majority of international research on transgender health on the basis that they were not conducted with double-blind testing. A double-blind study would have to involve a control group of young people receiving gender-affirming care. Given the sensitive nature of such studies, a double-blind approach would be highly immoral and, in some cases, impossible. The review also disregards any research that was not conducted in English or that was conducted in the past two years. Cass does, however, cite far-right YouTubers that upload anti-trans propaganda including material by “Gays Against Groomers” (a US anti-trans organisation). The research methods of the review are heavily flawed overall: Cass consulted with members of the Florida Medical Board who were specifically appointed by Governor Ron Desantis to help ban transgender care in Florida. Known supporters of conversion therapy were also heavily involved in the production of this review; trans people were excluded from its governing board. Do I need to explain the double standard here? 

It is with this biased catalogue of expertise that Cass claims wildly outdated and incorrect assumptions about the nature of being trans. Within the review, it is claimed that there is a direct link between a person’s height and their gender, as well as “prenatal and postnatal hormonal influence[s]” on young people when choosing between boy’s toys and girl’s toys that reflect their gender. The underlying message of the review is that being trans is not a simple case of a person’s chosen identity but a contagious ailment that is caused by things such as autism, poor mental health, or same-sex attraction, which are all theories that have been disproven by the American Psychological Association. The report also recommends that caution be taken when prescribing gender-affirming care for patients as old as 25. 

Image by The Times

In Cass’ ideal world, 25-year-olds could drink alcohol, smoke cigarettes, join the armed forces, get married, and drive a car freely without the need for psychological assessment but transgender people would be unable to access life-saving healthcare.

Unsurprisingly, Cass has already backpedalled on some statements made in the review. In an interview with the LGBT+ organisation The Kite Trust, she said that she believed in treating transgender youth based upon “individual need”. This contrasts with the statements in the review which recommended “extreme caution” when prescribing hormones and puberty blockers to people under 18. 

Despite the review being condemned by the World Professional Association for Transgender Health (WPATH), the European Professional Association for Transgender Health (EPATH), the Professional Association for Transgender Health Aotearoa (PATHA), the Asian Professional Association for Transgender Health (ASIAPATH), the United States Professional Association for Transgender Health (USPATH), trans rights organisations such as Transgender Action Block and Cass herself, the review has been published. Politicians have already called it a landmark report. The NHS is preparing for an investigation into adult transgender health services and has already stopped prescribing puberty blockers. The likely Health Secretary-to-be Wes Streeting has endorsed the Cass review as a “watershed moment” for the NHS and, in an interview with The Sun, says he has come to regret his position that “trans men are men and trans women are women”. If the Cass review has been accepted as “thorough science” what other terrible developments will come next?

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