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Mermaids responds to Dr Hilary Cass’ review into the care of gender-questioning children

Graham Robson

Dr Hilary Cass has today (Wednesday, April 10) published her review into the care of gender-questioning children in England and Wales, which has called for gender services to operate ‘to the same standards’ as other health services for children and young people, with ‘a holistic assessment’ of people referred.

According to Dr Cass the entirety of gender medicine – including the use of puberty blockers – is ‘built on shaky foundations’.

The Cass report urged the NHS to change some other standards of its gender care, including a review of its policy on giving children masculinising or feminising hormones from the age of 16, with the report urging ‘extreme caution’.

Dr Cass said there ‘should be a clear clinical rationale for providing hormones at this stage rather than waiting until an individual reaches 18’.

The use of such hormones, the review said, should be part of a research programme alongside a previously reported puberty blocker trial which is expected to be in place by December.

“Everyone deserves access to timely, supportive and holistic healthcare. However, across all of the UK, the NHS is failing trans youth.”

Dr Cass’s report also warned a ‘more cautious approach’ must be taken for children than for adolescents when it comes to social transitioning. When families are making decisions about social transitioning, it is important ‘parents are not unconsciously influencing the child’s gender expression’, the review said.

In total, Dr Cass made 32 recommendations on multiple aspects of gender care for child, which can be read HERE.

Following publication of the report, trans charity Mermaids said: “Everyone deserves access to timely, supportive and holistic healthcare. However, across all of the UK, the NHS is failing trans youth, with appalling waiting lists of more than six years, virtually no first appointments offered for over a year, and increased politicisation of the support offered to children and young people.

“Trans youth tell us they want services which are accepting and respectful, which offer supportive spaces to explore their gender, and provide access to medical transition if and when they need it.

“The Cass Review, an independent review of NHS England gender services for children and young people, published after almost four years, echoes much of this and recognises the current system is failing trans youth.

“We are concerned that some of the language in the report is open to misinterpretation and could be used to justify additional barriers to accessing care for some trans young people.”

“We are pleased the voices and experiences of trans young people appear to have been heard and respected, and we welcome Dr Cass’ calls for trans children and young people, and their families, to be “treated with compassion and respect”. We hope for the same, and for the sharing of clear, accurate information when discussing this topic.

“However, we are concerned that some of the language in the report is open to misinterpretation and could be used to justify additional barriers to accessing care for some trans young people in the same way the interim report has been. We will publish our full analysis of the Cass Review in due course.

“NHS England has published their immediate response to the Cass Review and written to all adult providers, explaining the changes they plan to make in the short to medium term. Very few of these will have an immediate effect on children and young people, and we will keep trans young people and their families informed about any changes that might impact them.

“In the meantime, we call on NHS England, and the NHS across the UK, to resist pressures from those who seek to limit access to healthcare, listen to trans youth directly, and act urgently to provide gender services which are timely, supportive and holistic.

“If you need support or have questions about what this might mean for yourself or your young person, please contact our helpline team. We’re here for you Monday – Friday, 9am – 9pm.”

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