The NHS trust which commissions services in Brighton and Hove says it will work with local providers to follow recommended actions set out in today’s Cass Report into gender care for children.
Dr Hilary Cass today said the pillars of gender medicine are “built on shaky foundations” as she presented her report into a review into NHS care for children.
A new chapter in Hannah Barnes’ book Time To Think, which covers the reasons behind the collapse of the Tavistock Clinic’s gender service for children, this month claimed a Hove clinic was prescribing cross-sex hormones to 16-year-olds after just a 10-minute appointment.
On its website, WellBN in Western Road, cites NHS guidance which allows GPs to prescribe hormones to adults on the waiting list for gender clinics, and cites Gillick competence, which states 16-year-olds are old enough to choose certain treatments.
Today’s Cass report warned giving such hormones to 16-year-olds should be an approach taken with “extreme caution”.
A spokesperson for NHS Sussex said: “We recognise Dr Cass’s thorough review, and after careful consideration of this final report and its recommendations, we will be working with healthcare providers in Sussex to follow the actions recommended.
“We remain committed to supporting people who live in Sussex to get the health and care they need and will work with local providers of services to make sure the care given to people is appropriate for their clinical needs.”
Research by the University of York was commissioned to inform the review’s final report, including on social transitioning and current evidence around medical interventions.
A review of 53 studies looking at hormone treatments – masculinising and feminising hormones testosterone and oestrogen – found a “lack of high-quality research” assessing their use in adolescents.
While it found there is moderate-quality evidence suggesting mental health may be improved during treatment, researchers said “robust study is still required”.
On the suggestion that hormone treatment reduces risk of death by suicide in children seeking gender care, the evidence found “did not support this conclusion”, the review said.
A spokesperson for NHS England said: “NHS England is very grateful to Dr Cass and her team for their comprehensive work on this important review over the past four years.
“The NHS has made significant progress towards establishing a fundamentally different gender service for children and young people – in line with earlier advice by Dr Cass and following extensive public consultation and engagement – by stopping the routine use of puberty suppressing hormones and opening the first of up to eight new regional centres delivering a different model of care.
“We will set out a full implementation plan following careful consideration of this final report and its recommendations, and the NHS is also 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.”
Utter madness that it took an official report to uncover the lunacy around some practices of gender care in children treated by the NHS. Common sense was all that was needed and anyone looking from the outside could see that serious errors were being made. How could the NHS have got this so very wrong. Scandalous really.
There are multiple problems presented by this report, not least the way Cass manages to discount and disallow almost all existing research and international expertise, taking us further away from accepted global practice.
The voices of trans people are not heard in this document, which seems to see gender dysmorphia as primarily a mental health concern to be fixed, and appears to be stretching childhood and bodily autonomy to age 25 for those seeking gender related care.
The chilling effect of this report is already being felt as 7 of the 8 promised new regional facilities cannot attract staff.
The real fear is that this report – and this may be its purpose – will restrict, limit and delay support for young people even more than is currently the case, essentially timing them out of support.
A big concern all round
The damage to young people, the toxicity of debate, including the misrepresentation of ‘evidence’ has been exposed by the Cass report. Gender services can’t attract staff because health care professionals have been bullied by trans activists and are terrified of speaking up- not conducive to quality, safe, effective healthcare provision and hardly attractive jobs in a sector already struggling with workforce. How ever much trans activists may continue to disagree with its findings or recommendations, thankfully, finally, the key issues are exposed in the Cass report and children and young people are now more likely to get the support and treatment they actually need and will help rather than harm them. Importantly they will also be better protected from those people still promoting unevidenced, ideologically based ‘health’ care regardless of the harm it is causing.
Well said, thank you
And so it begins….
you know the report is bogus when it says boys are “biologically programmed” to play with toy trucks. you couldn’t make it up!!
I haven’t read it yet, is that actually something said in there?
What page is that on please? I’ll be reading the report later today.
When these girls grow up maimed and infertile I hope they find those responsible and demand an apology. The surgery should be shut.
Never mind ‘recommendations’ The law is clear that children are children until they reach the age of adult consent.
Just prosecute and sack the doctor guilty of breaching it and safeguarding obligations.
Or the whole surgery has been brought into disrepute and could eventually face action.
Again Barry, you have a bad habit of misrepresenting an argument through oversimplification and disingenuous misrepresentation.
Are you suggesting that U18’s are not children?
And you use overcomplication as obfuscation Benjy boy. The law is crystal clear on this. A child is a child and subject to child safeguarding laws until that child reaches the age of consent. Any doctor, surgery or teacher in breach of safeguarding laws, whatever their excuse, opens themselves up to the risk of prosecution by the family of that child – or that child when they become a legal adult.
So pray tell, how does Gillick v West Norfolk fit into your half cocked statement?
The law is crystal clear, just not in the way you think it does, and that makes what you are saying disingenuous, and it’s disingenuous because we’ve spoken about this before, so you know this.
I refuse to think you are just stupid.
Gillick competency is based on the right to access evidence based health care without parental knowledge/ consent. Treatment for gender dysphoria is not evidence based, it is not low risk, and medicalisation causes significant life long health issues. No one can make informed decisions without the appropriate information, including children, young adults, and any professionals and idealists pushing this agenda. This is absolutely about the system and professionals failing to safeguard children and young people. In addition the right for any of us to demand un-evidenced ‘treatment’ that damages/removes healthy tissue under the guise of health care is also not tested- and if you think through the inevitable consequences of ‘health care’ becoming what people think they want, rather than what people need, good bye NHS, and access to safe and effective health care for all.
Indeed KL, that’s a very reasoned point. There is an interesting statistic that shows the NHS is not as evidence-based as you’d initially believe – doi: 10.3399/bjgp19X700313 talks about this and the factors of how this comes about: certainly an aspect of the NHS that can improve!
However, I believe there should be a consideration for patient-centric outcomes; and that can be as simple as understanding what a patient’s expectations are with that outcome. For example, palliative care may consider balancing pain management with lucidity; an important discussion.
This should also include young people as well. Barry was poorly articulating that lasting surgical interventions should be last line, and that other interventions like mental health support should be explored first. I agree with this. There are also loads of different factors that need to be considered, such as personal circumstances, social risks, potential risks for exploring certain interventions, the potential risks for NOT exploring certain interventions. It is a very complicated and individualistic issue.
So to reaffirm my stance, I don’t think Barry’s purposeful oversimplification, is particularly helpful, productive, or accurate, and is unfortunately very characteristic of his level of understanding on topics, and I sincerely wish he follows the advice that others have suggested to him before in improving his knowledge on a subject to engage in reasoned debate.
Again Benjamin, you have a bad habit of misrepresenting an argument through oversimplification and disingenuous misrepresentation.
Parroting my words doesn’t make a good argument Andrew. Prove you know what it means. Put some meat on that bone. I’m not afraid of criticism, I welcome good debate.
I do get to use that a lot, don’t I? It’s kinda Barry’s fatal flaw. Well, the alternative is belittling, so I don’t want to think poorly of Barry’s intelligence.
If you want to follow this discussion without the shouting, then there are several key issues here:
1) The child’s interests
2) Parenting
3) Gender identity versus sexuality
4) Age of consent.
5) Medical intervention
6) Economic realities of being in the NHS system
7) Noise
The child’s interests are of course paramount, but it is often difficult for parents to know what to do, and they may seek guidance from healthcare institutions. Lots of kids go through issues during puberty, some of which relate to their emerging sexuality and gender identity.
But most children also go through temporary phases in their development, and what seems important one day, may not seen so fundamental the next.
As an adult, you might remember that phase you went through as a fan of some pop star or of their type of music. Nowadays the same kids might latch on to some YouTuber, whose thoughts become their own. That’s not to belittle the feelings experienced, at the time.
As parents, you don’t actually know how a kid will turn out, until later. But we also have the issue of consent – where we adults agree there’s an age threshold where the kids themselves aren’t yet in a position to decide. We don’t vote until we are 18. We are not supposed to have sex before we’re 16. And a 14 year old is not allowed to go to war.
The teenage you is not the same as the 30 year old you. We do therefore need to protect the kids, from making decisions they may later regret, or which cannot be reversed.
The report published today establishes that medical intervention before the age of 16 is not a good idea, and that further trials are needed before we can predict the outcome of that medical intervention.
The report also calls for a more holistic approach, where the discussions about gender and transitioning are not separate from an understanding of social background, mental health, gender dysphoria, and of how gender identity works for those on the autism spectrum.
The local problems parents have found, until today, is where schools have acted without parental knowledge in allowing a child to start transitioning. It is said that some local charities have helped girls under 16 to wear binders to delay their breast development. But before we trip into Daily Mail territory, let’s also make it clear that many schools, charities, and medical institutions have been operating without national guidance, and without scientific or statistical backup for their approaches.
And this is why we maybe now have a toxic debate, fuelled by anger, and where what is right for the individual child is often downed out by the noise.
There is then, additionally, the economic realities of the NHS, where one doctor referral leads to another, but not until months or years later. And by then, you may be in some sort of rabbit hole of a system, which doesn’t necessarily have your best interests at heart.
My own niece and nephew have grown up to be fairly ordinary. With no obvious pressure from their parents, it turned out that my niece loves pink dresses, and Elsa from ‘Frozen’ is her hero. My nephew on the other hand loves mechanical gadgets, and he likes breaking things. Both of them now play football, but my niece has also asked to do ballet.
Their parents try to keep them away from Youtube – in the same way you keep kids away from biscuits and other sweet things. But there does seem to be a longstanding biological connection with who we often become.
I myself grew up in an earlier era, before mobile phones, and it turned out I liked building sheds and mending broken lawnmowers. I also like boys sports. At first I had a girlfriend, but later, after the teenage mist cleared, I turned out to be gay.
And even now, using modern language, I would not associate the term ‘non binary’ with my own gender or sexuality. (I’d maybe go further, to say that to be ‘Gender Queer’ is to live in an ideological cul de sac of your own making. But each to his, her, or their, own.) I personally have never confused my gender with my sexuality, or with my politics, or with my way of living.
Above all, let’s hope we start to live with each other again, and without the noise.
This report seems like a step in the right direction.
An excellently articulated and balanced set of thoughts Billy. That was very interesting to read.
A long overdue report highlighting the risks when ideology and activists drive healthcare and try and silence any rationale debate.
Now we also need to understand how standard processes, in place to ensure health care is safe and effective and protects people, have been bypassed, same for the role schools have unwittingly played in this scandal. The impact of activists on young minds via social media, and in positions of influence and the silencing of debate, health care professionals etc. cannot be underestimated and this needs to be better understood and mitigated in future.
Additionally shocking 6/7 national adult gender services refused to share data to understand longer term outcomes- what are they trying to hide and why? This is the NHS, it is publicly funded, and it needs to be fully transparent, including justifying how it best uses its limited resources to improve health care outcomes.
Local parents have tried to voice concerns about the propaganda & ‘social transitioning’ happening in schools. The council tried to deny this at the recent council meeting. Isn’t it time we put pressure on the council to remove harmful ideological propaganda (and Sex Ed written by activists, not child development specialists) from schools and libraries? It’s clear that social contagion is a big part of the problem, encouraged by the constant brainwashing coming from all directions.
Is Brighton and hove news gender critical? Could you just tell us that you are?
Gross. Nice hate crime committed here alluding that members of the lgbtqia+ community are detrimental to children, “onanistically” when by far its cis het folk abusing children. Where is the monitoring of these comments?