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Final Report: Cass review suggests 32 recommendations for children’s gender care


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The review highlights “unclear” evidence supporting the “impact of Puberty Suppressing Hormones on cognitive and psychosexual development” as part of  children’s gender care

A final review of gender services provided by the NHS has uncovered significant shortcomings, leaving thousands of vulnerable children questioning their gender identity without adequate support.

The report, led by Dr. Hilary Cass, a prominent consultant paediatrician, highlights the use of unproven treatments and the detrimental impact of the polarized trans debate on gender care provision.

The investigation, commissioned by NHS England in 2020, focused on the Tavistock and Portman NHS mental health trust’s gender identity development services (Gids), which treated around 9,000 children and young people between 2009 and 2020.

Shockingly, the review found that despite limited evidence of effectiveness and potential health risks, puberty blockers and cross-sex hormones were routinely administered.

Dr. Cass emphasized that the “rationale for early puberty suppression remains unclear, with weak evidence regarding the impact on gender dysphoria, mental or psychosocial health. The effect on cognitive and psychosexual development remains unknown.”

She highlighted the toxic nature of the public discourse surrounding gender issues, which has hindered open discussion and led to the misrepresentation of research findings.

In response to the report’s findings, NHS England has taken decisive action, closing Gids and adopting a “holistic” approach to care.

Under the new model, psychological support will take precedence over medical intervention for under-18s grappling with gender identity issues.

The emphasis is on personalized care plans, including thorough assessments for neurodevelopmental conditions like ADHD, autism, and other mental health conditions.

The report also called for caution in the “use of masculinizing/feminizing hormones”, particularly for individuals under 18, stressing the need for clear clinical justifications for such treatments.

It also highlighted the need for “provision for people considering detransition, recognising that they may not wish to re-engage with the services whose care they were previously under.”

A spokesperson for the NHSE said, “the NHS is bringing forward its systemic review of adult gender services and has written to local NHS leaders to ask them to pause offering first appointments at adult gender clinics to young people below their 18th birthday.”

In conclusion, the report signals a pivotal moment for NHS gender services, recommending up to 32 suggestions to shift to evidence-based care for children dealing with gender dysphoria.


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