Surprised this isn't getting play around here. The Atlantic Piece is at bottom of post.
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By Helen Lewis
In a world without partisan politics, the Cass report on youth gender medicine would prompt serious reflection from American trans-rights activists, their supporters in the media, and the doctors and institutions offering hormonal and surgical treatments to minors. At the request of the English National Health Service, the senior pediatrician Hilary Cass has completed the most thorough consideration yet of this field, and her report calmly and carefully demolishes many common activist tropes. Puberty blockers do have side effects, Cass found. The evidence base for widely used treatments is “shaky.” Their safety and effectiveness are not settled science.
The report drew on extensive interviews with doctors, parents, and young people, as well as on a series of new, systematic literature reviews. Its publication marks a decisive turn away from the affirmative model of treatment, in line with similar moves in other European countries. What Cass’s final document finds, largely, is an absence. “The reality is that we have no good evidence on the long-term outcomes of interventions to manage gender-related distress,” Cass writes. We also don’t have strong evidence that social transitioning, such as changing names or pronouns, affects adolescents’ mental-health outcomes (either positively or negatively). We don’t have strong evidence that puberty blockers are merely a pause button, or that their benefits outweigh their downsides, or that they are lifesaving care in the sense that they prevent suicides. We don’t know why the number of children turning up at gender clinics rose so dramatically during the 2010s, or why the demographics of those children changed from a majority of biological males to a majority of biological females. Neither “born that way” nor “it’s all social contagion” captures the complexity of the picture, Cass writes.
What Cass does feel confident in saying is this: When it comes to alleviating gender-related distress, “for the majority of young people, a medical pathway may not be the best way to achieve this.” That conclusion will now inform the creation of new state-provided services in England. These will attempt to consider patients more holistically, acknowledging that their gender distress might be part of a picture that also includes anxiety, autism, obsessive-compulsive disorder, eating disorders, or past trauma.
This is a million miles away from prominent American medical groups’ recommendation to simply affirm an adolescent’s stated gender—and from common practice at American gender clinics. For example, a Reuters investigation found that, of 18 U.S. clinics surveyed, none conducted the lengthy psychological assessments used by Dutch researchers who pioneered the use of medical gender treatments in adolescents; some clinics prescribe puberty blockers or hormones during a patient’s first visit. Under pressure from its members, the American Academy of Pediatrics last year commissioned its own evidence review, which is still in progress. But at the same time, the group restated its 2018 commitment to the medical model.
The Cass report’s findings also contradict the prevailing wisdom at many media outlets, some of which have uncritically repeated advocacy groups’ talking points. In an extreme example recently noted by the writer Jesse Singal, CNN seems to have a verbal formula, repeated across multiple stories, to assure its audience that “gender-affirming care is medically necessary, evidence-based care.” On a variety of platforms, prominent liberal commentators have presented growing concerns about the use of puberty blockers as an ill-informed moral panic.
What Cass review says about surge in children seeking gender services
Report finds particularly complex factors may explain surge in birth-registered females referred to NHS Gids
Evidence around youth gender care 'remarkably weak', major English review says
The report concludes that young people with gender dysphoria deserve better care but stresses there is a lack of good evidence on how to provide it.
www.nbcnews.com
Britain Is Leaving the U.S. Gender-Medicine Debate Behind
The Cass report challenges the scientific basis of medical transition for minors.
Britain Is Leaving the U.S. Gender-Medicine Debate Behind
The Cass report challenges the scientific basis of medical transition for minors.By Helen Lewis
In a world without partisan politics, the Cass report on youth gender medicine would prompt serious reflection from American trans-rights activists, their supporters in the media, and the doctors and institutions offering hormonal and surgical treatments to minors. At the request of the English National Health Service, the senior pediatrician Hilary Cass has completed the most thorough consideration yet of this field, and her report calmly and carefully demolishes many common activist tropes. Puberty blockers do have side effects, Cass found. The evidence base for widely used treatments is “shaky.” Their safety and effectiveness are not settled science.
The report drew on extensive interviews with doctors, parents, and young people, as well as on a series of new, systematic literature reviews. Its publication marks a decisive turn away from the affirmative model of treatment, in line with similar moves in other European countries. What Cass’s final document finds, largely, is an absence. “The reality is that we have no good evidence on the long-term outcomes of interventions to manage gender-related distress,” Cass writes. We also don’t have strong evidence that social transitioning, such as changing names or pronouns, affects adolescents’ mental-health outcomes (either positively or negatively). We don’t have strong evidence that puberty blockers are merely a pause button, or that their benefits outweigh their downsides, or that they are lifesaving care in the sense that they prevent suicides. We don’t know why the number of children turning up at gender clinics rose so dramatically during the 2010s, or why the demographics of those children changed from a majority of biological males to a majority of biological females. Neither “born that way” nor “it’s all social contagion” captures the complexity of the picture, Cass writes.
What Cass does feel confident in saying is this: When it comes to alleviating gender-related distress, “for the majority of young people, a medical pathway may not be the best way to achieve this.” That conclusion will now inform the creation of new state-provided services in England. These will attempt to consider patients more holistically, acknowledging that their gender distress might be part of a picture that also includes anxiety, autism, obsessive-compulsive disorder, eating disorders, or past trauma.
This is a million miles away from prominent American medical groups’ recommendation to simply affirm an adolescent’s stated gender—and from common practice at American gender clinics. For example, a Reuters investigation found that, of 18 U.S. clinics surveyed, none conducted the lengthy psychological assessments used by Dutch researchers who pioneered the use of medical gender treatments in adolescents; some clinics prescribe puberty blockers or hormones during a patient’s first visit. Under pressure from its members, the American Academy of Pediatrics last year commissioned its own evidence review, which is still in progress. But at the same time, the group restated its 2018 commitment to the medical model.
The Cass report’s findings also contradict the prevailing wisdom at many media outlets, some of which have uncritically repeated advocacy groups’ talking points. In an extreme example recently noted by the writer Jesse Singal, CNN seems to have a verbal formula, repeated across multiple stories, to assure its audience that “gender-affirming care is medically necessary, evidence-based care.” On a variety of platforms, prominent liberal commentators have presented growing concerns about the use of puberty blockers as an ill-informed moral panic.
