https://cass.independent-review.uk/wp-content/uploads/2024/04/CassReview_Final.pdf

The review feels frustratingly wishy washy at some points, but Dr Cass said from the outset she wasn’t adopting ideological stance with language and needed to adopt language the cohort of children used to be able to carry out the review.

It’s frustrating that she presents social and medical transition as any option, but, she covers not adhering to stereotypes and ‘partial’ transition and how transition includes hair/dress. Which feels like an attempt to address the girls wear pink, boys wear blue parents. And that partial transition in practice is likely what gc is in favour of anyways - acceptance of children’s gnc and no need to tie that to pronouns etc.

She addresses consent and informed consent covering evidence and understanding of evidence, while also covering that there’s no evidence in favour and some glaring risks. Children and parents can’t consent when the evidence indicates there’s not any real evidence either way. NHS staff starting any convo about transition by talking about fertility protection and a primary measure of bone density to assess against and the need to enrol on a study ( if they meet the criteria, which likely means not those who have other reasons -autism, trauma, mh etc) likely brings home how irreversible this is. And the need for autism & adhd assessments first, screening for complex reasons like mh, sexual orientation etc as the reasons theoretically helps. As does the idea of so many local services (so camhs +gi assessment presumably, with pressure for funding to address this mh increase) if it’s possible, shows how serious a contagion this is and the state of children & young peoples mh is.

Identifying mh/ autism/adhd/ace/truama/porn exposure means it becomes a safeguarding issue for schools. So it needs put in KCSIE. Which makes it much easier for parents to challenge schools and for teachers to speak up.

Identifying adult services non cooperation means gov need an adult version of the Cass review if they want data. And linking 17-25 year old services mean it comes in line with how other adolescents services work, with regard to brain development maturation. And ehcps run until 25 for children who have them (who are very vulnerable to this contagion). Any adult service review/research needs to cover the risk to sexual function not just fertility. Obviously not appropriate to quiz children about this but they deserve the data about how pbs & hormones will effect this in their future. They also need to understand what bone density risks mean in practice. And no research protocols for pbs or hormones should be happening until adult services are forced to be transparent with their data. Those who have the option of these research studies needing to have shown long term gender identity issues cuts out most girls who have ROGD. And she notes that watchful waiting resolves most cases of childhood gender dysphoria also. So clinicians will need to risk assess this when putting some forward for this experiment. Which presumably will have to go to ethics committees now it’s documented.

Making medication from outside uk prevented through statutory measures is a positive. As is cautioning against private uk services tor medical transition.

Detrans services being set up linked to this and listening to them to inform children’s treatments is positive also.

As is ensuring referrals come only from secondary care providers. (No more lgbtq+ club leaders sending kids to gids).

Any future services need set up with safeguards against ideological capture. Which doesn’t feel possible right now unless there’s firmer more cautious recommendation. And this doesn’t feel like it goes far enough in that respect. But it’s a catch 22 in that without an evidence base there can’t be absolute recommendations and an evidence base requires some children signed up to the research protocol. And it’s too easy for those affirmation only types to still do what they are doing, this doesn’t go far enough directly enough to do that.

What is needed is: a public inquiry into why nhs and those related are captured and research protocols set up for watchful waiting and/or other non affirmative approaches, to get data on these to counter the wishy washy non evidence currently. And kids won’t go for that.

Still, Labour will look utter muppets trying to scrape funds from under rocks to set up this approach and then there will be more data to make it clear it’s a no way in hell. By which point any hope of nhs funds will be bye bye, sadly with the lives or wellbeing of those who transition during this time. Maybe in the absence of any real medical or therapeutic approach for all the complex underlying issues, schools social work etc will start to reflect on their roll in propelling this contagion and follow the leads of schools who don’t have half a register with trans kids and half the girls off sick because they can’t use toilets safely. Maybe some grown ups will return to sanity and grow a spine when they realise this won’t be a magic wand that will fix the problem in their schools for them.