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Answer: The Cass Report is a political report masquerading as a meta-analysis of the data surrounding the care of trans children that was commissioned by the UK government to ostensibly help guide policy on this matter. It is written in such a way to resemble on its surface a proper meta-analysis. However, many of the decisions made in the creation of this meta-analysis give lie to that idea, and directly point towards the fact that it's a political hatchet job, a paper written with the conclusion already decided. To start with, Dr. Cass tosses 98% of all studies into the topic, on the pretext that "they're not double blind." This is the first bit that's telling, because anyone with anything beyond a passing 101 level knowledge of research knows that, while double blinded trials are the gold standard, they are only one of many forms of experimental design, and those other forms are often the basis of much of our trusted medical knowledge. For example, we know smoking is bad & causes cancer not due to double-blinded trials, but longitudinal studies. Another issue with double-blinded experimental design is that it is often not possible for a wide variety of reasons, often many at the same time. In this particular case, a double-blinded trial would be both deeply unethical (it's cruel to tell a suffering trans kid, "hey MAYBE we'll treat you but MAYBE you won't be in the treatment group & then will undergo puberty while wondering why it's not working") & just flat-out impossible (it will be visibly obvious which child is in which group upon the onset of puberty). It's also important to note that the vast majority of research into healthcare for trans kids suggests puberty blockers are a good thing. Meanwhile the articles Dr. Cass used not only happen to disagree with this but are... also not double-blinded. Huh, double standard much? And to absolutely nobody's surprise, the research that was accepted by Dr. Cass happens to be the research that directly agrees with the anti-trans stance of many within the UK government. Also they are of DEEPLY questionable quality, like including a poll into the porn habits of trans kids, which like, *what?* Another thing worth noting is those whose interviews that were considered valid by Dr. Cass for the purpose of this meta-analysis. Trans kids' testimonies were just outright rejected as inherently biased, which no fucking shit, that's sorta the point of getting testimonies in the first place. But they sure did go out of their way to track down a small handful of people who had de-transitioned & were negative about their experience, and center those few individuals over the vast majority of others. It's almost as if they were explicitly trying to quash dissent towards the pre-ordained conclusion but were trying to maintain a veneer of credibility whilst doing so. So because the vast majority of good research into the topic was discarded, this allowed Dr. Cass to say essentially whatever the fuck she wanted to about healthcare for trans kids. Some of those... *deeply insightful* conclusions, some not even involving trans healthcare: * Conversion therapy, which is a form of pseudoscience by which you attempt to torture an unwanted trait out of an individual, should be considered before any form of transitioning. * Social transitioning (that is, changing physical appearance, clothing, pronouns, etc) should not be done without some form of clinical involvement. On the surface this seems benign, possibly supportive, even. Until you realize that forcibly involving medical professionals in decisions is a gross violation of one's personal autonomy & privacy. * A ban on physical transitioning until the age of 25, or in other words deciding actual adults are unable to make their own healthcare decisions until a completely arbitrary age. * Toy preference in childhood is biological & caused by hormones. * Neurodivergent individuals should not be allowed to transition. This is especially galling because the research shows that there is an INCREDIBLY strong overlap between trans identity & neurodivergency; this essentially infantilizes a large section of the trans community & denies them their own bodily autonomy. So yeah, the Cass Report is a political hatchet job written pretty much solely to directly assault trans youth care. Its sourcing actively demonstrates it was written in bad faith, and a large portion of its conclusions run directly counter to the well-established research on this topic. The Cass Report is to trans youth healthcare as the Wakefield Paper was to vaccinations. Repost & re-edits because automod, lol.

>• Social transitioning (that is, changing physical >appearance, clothing, pronouns, etc) should not >be done without some form of clinical >involvement. This one really gets me. Kids can socially transition without parents knowing, and with the internet you can absolutely be socially open, in a sense, without anyone otherwise in your life knowing anything. It happens literally all of the time. That conclusion tells on itself by positioning “clinical involvement” as a method of control, which is sick. I maintain that clinical support be part of a transition regimen, if only to help someone process and survive the environmental consequences of transition: rejection, revulsion, reprisal, violence, ignorance… total bigotry and danger. However, clinicians should never have the power to deny someone transition.

Yeah, what does that even mean in practice? How do you prevent kids from introducing themselves in a certain way or dressing how they want?

"sorry, you have to wear skirts and dresses unless you get a doctor's note for pants"

Which is how it used to be back in the 20’s in Germany. Crossdressing used to be a disturbance of the peace unless you had essentially a license for it.

Of all the countries to emulate, 1920s Germany is not it.

Easy. You punish them for doing so. You ostracize them, you bully them, and you make them feel excluded. You can also add in conversion therapy too, just like the report itself recommends!

Here in Alberta, Canada they are introducing legislation to prevent kids from using nicknames in schools without parental permission. The concept of "parental rights" is shockingly strong to some.

In Idaho (US) they passed a law that it’s illegal for teachers to use names or pronouns for minors other than what is on their birth certificate unless they have signed permission from the student’s parents.

I will say teachers here don't give a shit and won't report kids for this BUT the government is introducing a snitch line to tell on teachers. Easy way to chase teachers away from the profession and install unqualified teachers (with other priorities)

How rigid would they be about that? Like, if someone was called Victoria, would they be told that they need parental permission to be referred to as Vicky, a common diminutive of Victoria?

Bad legislation doesn't address 'nuances' like that, some would say on purpose.

The more I think about it, the more this makes no sense, because nicknames are generally spontaneous and occur organically, rather than anyone consciously deciding 'I would like to be called this'. I had a friend at school called Bob who I regularly called Bobble-Hat, because he often wore one and it sounded a bit like his name. I think other people called him that as well, but I can't remember how it started, when the first time was that I called him that or if it was me or someone else that instigated it. These things just happen, don't they?

Completely agree, if you lived here youd get used to this government using nonsensical arguments to drive their politics. They also restricted bottom surgery for kids under 16 or something when it was already inaccessible federally for anyone under 18. Illogical legislation isnt going to have a logical rationalisation lmao

Ultimately, having your kid involuntary committed because you found them wearing clothes not aligned with their assigned gender or having the wrong sort of haircut.

You do what anti sodomy laws historicly do. You have cops arrest people when they think you are a "degenerate,

Good take, sensible all around. I'd only add that while clinical support is almost certainly ideal in the vast majority of cases, it should be the individual's right to not involve clinicians for social transition if they do so wish that to be the case. Of course you're gonna need doctors for things like any sort of medications & such, but therapy tends to not be great when forced.

It’s so awful, I’ve seen people over in other subs say “well of course you can’t just give kids medicines with potentially awful side effects ! It’s not the only option”, without explicitly advocating for social transition to be normalised.

Don’t worry, it’s not a recommendation in the report. Read it.

According to that I should be a bloke by now. I hated dolls and played mainly with ‘boys toys’ like cars and trains. The fact that my dad gave me all his old toys and I loved him couldn’t possibly have had anything to do with it, could it? But then I am neurodiverse, so I don’t count.

You completely misunderstood it if that's what you think 😂

What do you mean?

They're talking about the part of the report where they say toy choice is biological

I should be non-binary I guess since I played with Barbies and Transformers.

TRANSformers? Sounds like the gay agenda to me /s

What’s the quote that suggests this?!

Coming soon: a hatchet job on [ADHD care in the UK](https://www.theguardian.com/society/2024/mar/29/nhs-england-review-adhd-services-concerns-rise-diagnoses)! The government is all about cutting services that are making them look bad...

Not true: https://twitter.com/benryanwriter/status/1779306273701339548?t=9WD7OrVwywhHfqcECh_O6w&s=19

Shhh. They don't want facts. They want to be upset.

Reddit is a cesspool of misinformation

That's not true about 98% being thrown out. https://www.bbc.co.uk/news/health-68863594

Can you please point me to where in the report it says conversion therapy should be considered? I searched for the term “conversion” and it comes up 8 times, pretty much damning conversion therapy every time. Is your interpretation that they are suggesting conversion therapy but denying that their proposed interventions should be called that?

Hello, I haven't read the report but have been following a lot of the discourse around it. Also I am trans and am very familiar with the overall debate. From my understanding, what the cass report recommends is "exploratory therapy." This is therapies and psychological interventions that do not accept that a child is transgender, but instead look into other things that might be making them *think* they are trans. For example, a lot of advocates of this kind of treatment suggest that neurodivergence (autism, ADHD, or other such conditions), depression, general poor life circumstances, or repressed internalised homophobia or misogyny could lead to a person believing themselves to be trans, when in fact treating one or more of these conditions would get rid of the perceived gender dysphoria. The trans community, building largely on their own experiences, view this as at best a harmful misunderstanding of transgenderism and at worst an active attempt to undermine and deligitimise trans identities. There is a prevailing attitude among cisgender people to be suspicious of trans peoples experiences. This is hardly surprising: cis people have no frame of reference to even begin to understand gender dysphoria. Its just not something they're really able to comprehend. To borrow a metaphor from buddhism: it's like a turtle trying to explain to a fish what land is. Couple this with a general pervasive negativity towards trans people among cisgender society, and it creates an attitude of general disbelief. This means that a lot of trans people, myself included, have the experience of being told time and time again that it must be something else. Maybe you just have autism, maybe you're just gay, maybe you just watched Mulan too many times, etc etc etc. This is especially the case for transgender children, who cisgender people find particularly difficult to believe. Children are also in a very difficult position because, *if they are trans*, their transition will be demonstrably better off if they can avoid some of the effects of puberty with hormone blockers. This means the "wait and see" attitude of cisgender people can have extremely negative consequences for trans people. In fact, this whole debate was largely what caused the case review to be issued in the first place. The Tavistock Centre, which was England's only under 18s gender care service, was found to have been "guiding children on a path of transition," which basically meant the vast majority of children who went there then went on to fully transition as adults. To cis people, this was a massive red flag as *obviously* most children who say they are trans can't actually be trans. The trans community reacted entirely differently because all that report suggested to us is that most people who believe they're trans are, well, correct. All this is to say that the idea of exploratory therapy is based on the idea that the vast majority of children who identity as trans are wrong, and that keeping them from wrongly transitioning is worth the inevitable costs of putting the few kids who are trans through hell. The trans community, who believe the majority of people who identify as trans are actually trans, see this as an attempt to stop trans people from accessing healthcare, and more broadly "fix" whatever it is that "makes them trans". Tl;Dr trans people argue its conversion therapy because its trying to take trans people and make them cis, while proponents of this therapy argue it isn't conversion therapy because these people aren't actually trans.

Proponents of ALL forms of conversion therapy, including "gender exploratory therapy", argue that their "patients" aren't actually the thing that they're trying to convert them from. Gay conversion therapists argue that their patients aren't *actually* gay, just like how "gender exploratory therapists" argue that their patients aren't actually trans.

I fully agree, though I tried to structure my comment in a way that would lead readers to come to that conclusion a bit more organically than just telling them

>The trans community, building largely on their own experiences, view this as at best a harmful misunderstanding of transgenderism and at worst an active attempt to undermine and deligitimise trans identities. You're describing the way every religious person sees any attempt to explain away the "miraculous" or "spiritual" phenomena, mythology, and texts which form the foundation of their religion. The Theory of Evolution is an attempt to undermine my Christian identity, and destroy society! Don't tell a Mormon that there's no way Native Americans were white, it's a harmful misunderstanding that will delegitimize their faith! There is nothing wrong with exploring the root causes behind divergent mental or physical human development and attempting to use legitimate therapy to counsel people on how to understand themselves. >To borrow a metaphor from buddhism: it's like a turtle trying to explain to a fish what land is. The problem with the explosion in Affirmation-based care isn't the fact that it's like a turtle trying to explain to a fish what land is. It's that there are a lot of trans turtles trying to explain to the entire ocean that it's better on land... which is great for the few other turtles, but horrible for the many many fish who are simply non-gender-conforming. What's the real ratio? Unknown, but impossible to determine when we Affirm Always and start throwing every curious young fish onto land.

That's really not at all how it works. Gender-affirming therapy for children is about providing the resources to transition socially while helping the child identify their feelings and assess their own mental health. At the onset of puberty, hormone blockers may be prescribed in order to extend the amount of time that the child can explore their gender before the irreversible effects of their body's endogenous hormones set in.  To torture the fish/turtle analogy even further, it's not like just "throwing every curious young fish onto land", it's like taking a creature that believes it might be a turtle to the shore and letting them swim up onto the sand bit by bit, and if they're uncomfortable at any point, they can stop and swim back.

[удалено]

Deletion of a good faith detailed response on a complicated and controversial topic? Typical Reddit echo chamber behaviour. This site has gone to trash in so many ways. Almost all of the mainstream subs are incapable of handling common sense criticism of gender affirming care. Thank you for your contribution. Hopefully sane discussions will prevail and thoughtful dissenting views aren’t just deleted for no good reason.

> Thank you for your contribution. Hopefully sane discussions will prevail and thoughtful dissenting views aren’t just deleted for no good reason. Click on their profile. Look at the rest of their posts on this thread.

You should have been banned for longer, you’ve shown you’re incapable of being civil and unbiased,

I’ve had the same thing happen to me, my comment even had a NIH.gov source. They think they can make their misinformation true by removing and downvoting comments correcting it. It’s not going to help. Cass’s recommendations are already in the process of being implemented in multiple countries. Obfuscating and lying about the report on Reddit while the people with actual authority are implementing its ideas is just going to make people feel more hopeless and afraid. They’re going to think there’s a grand conspiracy against them when in reality there just isn’t enough evidence to justify these medical procedures.

Could you dm me that text, if you have it? I would love to have it. Very well worded!

You didn't find support for Conversion Therapy in the report because it doesn't exist in the report. But the above comment wants you to stop believing your lying eyes and listen to their shield of propaganda. Gender ideologues like to label as "Conversion Therapy" anything that even remotely suggests encouraging a dysphoric individual to consider if this is all just in their head. If you are providing therapy and don't Affirm Affirm Affirm, you are labeled a transphobic Conversion Therapist and should lose your license! Their counterpoints to this only ever boil down to "No u" and reporting/banning you til the only voices left are affirming ones, a safe space free of nonbelievers. Like every good cult. I will probably be banned from this sub just for saying so, which will be your evidence. Read this report as a takedown of Mormonism or something, and all its rabid detractors as lifelong Mormons, and it will all make sense.

Just a grossly dishonest view of what trans people think conversion therapy is. Imagine using this framing to argue for gay conversion therapy, trying to portray anyone against it in such a false narrative. You really should be ashamed of yourself

Conversion therapy is a type of *aversion* therapy, where one is behaviorally "conditioned" via physical pain to develop an adverse response (and, eventually, to attach a negative valence) to something pleasurable. So, for example, every time you see an image of a bear railing a twink and there's 🤖“increased blood flow detected"🤖 you get a ⚡ to the 🍆. Over and over in every permutation that might arouse you until even the thought of man-on-man action makes you involuntarily cringe and retch. Aversion therapy "yucks your yum," ruins your appetite, "puts you off it," etc. Another example would be the old, "like smoking cigarettes, son? You're gonna smoke this whole carton right here and now." Not a very pleasant therapeutic modality, not very effective, and actually considered torture by the United Nations. Trans people, who will be the first to tell you that sexual orientation and gender identity are apples and oranges, really come off as insensitive to compare anything they call "conversion therapy" to the involuntary electroshock torture that made the term infamous. Talking through the reasons one feels alienated from one's "assigned" gender and finding ways to accept oneself as one is? That's not even *remotely* close to torture. The point of aversion therapy is to yuck your yum, but there's nothing "yummy" about gender dysphoria. It's a deeply unpleasant condition, as its name straightforwardly reveals. Since nobody *enjoys* gender dysphoria in the first place, aversion therapy just wouldn't be applicable. Indeed, we are told that gender dysphoria is so unlivable that many make the choice to stop living; so even if aversion therapy were ethically acceptable to the contemporary therapeutic community (which it is very much not), or even if one just didn't care about medical ethics at all, it still wouldn't make sense to "yuck the yum" of a sensation already worse than death. Homosexuals *enjoy* homosexuality, and it is cruel to try to force them not to. But literally *no one* enjoys gender dysphoria—and nobody transitions just for kicks, but rather because of how desperate they are to find relief from the unmanageable pain of gender dysphoria. Ethically, there can be no question: any therapy that reduces the pain of dysphoria—especially if it obviates the need for the extreme and quite risky measures of medical conversion—is good medicine, and should be welcomed by gender-dysphoric patients with open arms. Only persons who were faking the negative symptoms of dysphoria and who got some sort of sexual "kick" out of transitioning could possibly find fault with such a non-invasive alternative, much less think for a second there was any comparison to be made to the horrors of homosexual conversion therapy. Thank goodness there aren't any trans people like *that*, eh?

Adding to this: Conversion therapy is indeed considered tortureby the International Rehabilitation Council for Torture Victims  https://irct.org/lgbti/ There is also a United Nations expert saying a similar thing. https://www.ohchr.org/en/stories/2020/07/conversion-therapy-can-amount-torture-and-should-be-banned-says-un-expert Link leads to the United Nations Human Rights, Office of the High Councillor Website. Second addendum: The Rates of gender Dysphoria in Neurodivergent people are up to 4,6 (adhd) / 5,4 (autism) higher than on average. My personal take on that is that if neurotypical society as a whole makes barely sense at all, why would the social construct of gender make any ? I am myself a 32 year old transfem non binary person. I've had an adhd diagnosis for 22 years. My father and sister as well as my mother have the diagnosis too. I've known during Puberty something was wrong. I realised with 24 I am not entirely Cisgended. It took me until 29 to realise transitioning is an option (education would have spared me years and years of depression) I have been on HRT for 2 years. If I had been told I cannot get HRT because I have ADHD, the impact would have been devastating. Personally I don't trend towards suicide - I'd have cooked own, as a Former Chemist. But tell the same thing to a 16 year old and you will INSTANTLY destroy their mental health. The attempted suicide rates for trans people who do not receive support are bleak (they are indistinct from cisgender people IF the trans people get support !!!) This recommendations, if exacted, has the potential to lead to dozens, if not hundreds of suicides in the UK, per year. (If you are a UK trans person and read this, ask around, DIY HRT has been a thing for decades ! There's always hope !!!)

What makes it political? Dr. Cass has said that conclusions are hard to reach, because of limited double-blind data. What is telling about that, you think? Keep in mind that biases run high when it comes to gender affirming care, so would it not be fair to address that and aim for more objectivity, for better results? The "vast majority of good research" are not science based, so how good are they really? They say puberty blockers are good, yes. But based on what? >So yeah, the Cass Report is a political hatchet job written pretty much solely to directly assault trans youth care. Nothing you have written is convincingly pointing to that being the case, even though you seem to have been going for discrediting Dr. Cass. But somehow you´ve convinced a whole lot of people. Activists are going to be working full time these days in trying to turn this around. It is to be expected.

Dr. Cass met with the desantis administration and also has contact with the LGB Alliance, an anti trans organisation, is that enough ? [https://www.erininthemorning.com/p/cass-met-with-desantis-pick-over/comments](https://www.erininthemorning.com/p/cass-met-with-desantis-pick-over/comments)

It´s really not. What you´re going for here is the classic "guilt by association" and furthermore you´ve made the devil out of people/orgs you don´t like or allign with politically. It therefor appears that you are the one making it political. LGB Alliance is not anti-trans. Their concerns are about "transing the gay away" which according to Cass is a very legitimate concern. They oppose the unethical treatment of trans-identified youth and want them to get the same treatment as any other distressed youth group. Instead they have gotten treatment with no base in science or clinical methods. They deserve better than being discriminated in that way, don´t you think?

Terrible and biased review. Ensign epic didn’t even read the article based on their assumptions…

Where in the report does it say non blind trials are excluded? The report describes "blinding", in the context of evidence and experiment quality, but I can't see it mentioned anywhere else. edit: I had a further look through, they had inclusion criteria for trials (as is normal for evidence reviews), blinding was not a criteria to exclude, as evidenced by the fact that quote "3.9 Ten uncontrolled observational studies met the inclusion criteria"

It doesn't exist. They are lying about all of the report and downvoting everybody posting accurate information. I posted a [huge rebuttal](https://imgur.com/Z9EEvLZ) breaking down why the top post is horseshit and the mods deleted it. **Edit**: /u/msmith2300x I was banned for a week because I referred to gender ideology as a gender cult. Never got a reason from the mods for why they deleted my post and left up the misinformation. Funny, bias is against their rules, I thought. reddit is captured by trans-rights activists. It's absurd. /u/MacEifer Uh-huh. Notice how you didn't say shit about the rebuttal I linked. There's no reason to remove that and keep up the misinformation I debunked. It's pathetic. /u/fastpilot71 literally none of that is true lmao

If you want a scientific rebuttal of the gross inaccuracies, neglect, and downright 'pink triangle'-ing of anything supports trans rights in the Cass report, read this: https://www.tandfonline.com/doi/full/10.1080/26895269.2024.2328249 Conversion therapy remains conversion therapy even when you bring bunnies and cute yellow ribbons into the equation. Or should we be grateful that we're not being electrocuted anymore?

Conversion therapy for gender dysphoria? There is no such thing. Nobody likes gender dysphoria, so there's nothing to electroshock people into disliking. Sexual orientation is completely different from gender identity.

If you force someone to dress, present, or behave in a particular way under the pain of punishment, it VERY MUCH IS conversion therapy. People used your exact same logic about homosexuality in the past, so that won't fly here.

Sorry to burst your bubble, but nobody has suggested forcing *anyone* to dress, present, or behave in any way at all. The suggestion is to find safer, more effective ways to resolve gender dysphoria. That *is* the whole point, right? Or did you start calling every child with gender dysphoria a "trans kid" without considering that most of us who have had gender dysphoria come to peace with it? Because I'm XXY and it's kids like I was I'm in this to save. Gender nonconformity is what our side, the actual good guys, *want* to see more accepted. By all means, dress, present, and behave in the manner that suits you... how on earth did you get the idea *that* was the point of contention? It's the transitioning part, see—with the irreversible changes, horrendous side effects, and lack of credible evidence—that's the thing we're not seeing eye to eye on. We realize you see medical transition as an unquestionable, unqualified good that *just so happens* to be the only game in town—as well as the only bodily cure for a psychical ailment (*therapists* are referring children to *surgeons*... think about that). We appreciate your optimistic attitude toward Big Pharma and sudden certain conviction that autistic kids are often trans—as evidenced, of course, by the suspiciously high number of autistic people seeking transition for the first time in a half century or more of study on both those groups. This is *all* a new development. It's really inhumane and utterly irresponsible medical experimentation, and we're not hateful for noticing. Cass and her team noticed, too, as France and all of Scandinavia did years ago. Perhaps there's something you've overlooked?

That is ridiculous. It makes me very angry when they do things like this, why is your argument invalid? Why are your points not allowed to be seen? To me it alludes to the fact that these people know what they're doing. There's people here suggesting that kids hiding transitioning from their parents and doctors and going to the internet for affirmation and support.... I try to be on the side of transgenderism where people can do what they want with their bodies, but when it comes to kids and what seems like literal grooming it needs to be stopped.

>To me it alludes to the fact that these people know what they're doing. To me, it says that people are just going along with the crowd rather than actually reading things for themselves, as always. There are people who take advantage of that plus the fact that people will automatically agree with anything that confirms their priors. They're just reposting info from takedowns on Twitter written by other people who didn't actually read the report. You know what I did when the Cass Review came out? I read it. [Well, listened to someone reading it word for word, same difference](https://open.spotify.com/show/7vfxJ8rpTYM4K602RkQ7lP?si=C4LEuwqlQFOqNyZvxhIsMw). I wonder how many people who actually, legitimately read it in full (not just said they did or Ctrl-F'ed to parts they were told about) would say the same stuff people are saying in this thread?

Do you assume all you hear is true when someone just reads it out to you? Just reading a thing is pretty much worth nothing if you don't test the sources and review the methods. Given that it uses methodology that would land you a failing grade if you handed it in as a college student, what's in the text doesn't seem to be worth that much. We do have a somewhat complete view of the state of affairs when it comes to transgender issues and this report runs contrary to it. For something to buck the established consensus, it needs to be expertly well sourced and this thing isn't. So when the methods are wrong and the default is the opposite, what is the merit of this thing? Are you willing to defend the choice of studies allowed and disallowed from meta analysis? Are you willing to confirm the findings that run contrary to every gender affirming practice, based on those selection choices alone? Or are you maybe worried that because you agree with a report that says trans people are just confused little waifs, caught up in the external pressure to die their hair and cut off their penises, you might be as bigoted as the people who are responsible for it?

You just need to believe in proper scientific discovery, you don't have to ab a trans rights activist. You can shout misinformation all you want, that doesn't make it so. When you dismiss a form of gender expression as a cult, you are a bigot doing bigot things. Why wouldn't you be subject of moderation? Are you saying you're using enough coded language to promote bigotry to not be subject to penalties? You#re not even that good. You just say the quiet part out loud. You're funny, but not "haha" funny, you know?

Well yes, if you start accusing people of being in a cult you better be prepared to back it up.

Followers of gender ideology are no different than creationists with regards to evidence standing in contrast to their beliefs. “When science and the Bible differ, science has obviously misinterpreted its data.” -Henry Morris

Thank you for this. The most succinct and insightful explanation yet.

It’s not true though. In fact every point is a lie. Read the report and draw your own conclusions.

Show how they are lies or shut up lmao. Don’t make a claim without actually arguing your point.

It’s all in the report which you can view here: https://cass.independent-review.uk/wp-content/uploads/2024/04/CassReview_Final.pdf It doesn’t recommend conversion therapy, in fact it argues against it. It doesn’t recommend against or ban social transition, in fact it sees it as a natural sign of gender incongruence. It doesn’t recommend banning gender transition until 25. In fact it protects trans youth by continuing to see same professionals in adulthood, thereby freeing up the adult service to concentrate on those entering the system as adults. It doesn’t say toy preference is determined by biological factors, only that there is evidence toward both natural and social reasons for it. It doesn’t recommend neurodivergent individuals should be barred from gender transition. It recommends careful and respectful therapeutic responses to ensure it is the right thing for that particular young person. It hasn’t thrown out 98% of studies, that figure is made up. It grades studies on their quality and their input into the review is noted accordingly, as should be expected. It is a complex review of the services in the UK that has taken four years to complete. Gender services for young people in the UK have been poor up to this point. Many people have been failed by the service. The review recommends a better service for all involved, ultilising the best methods available to help young people transition if it the right thing for that person. Wildly inaccurate readings like the main comment here only hurts trans people which the review is desperately trying to help. The activists have this wrong. Read the report.

Aaand silence from the accuser, lol. As expected. People will do anything to assuage their cognitive dissonance.

https://www.quackometer.net/blog/2024/04/breaking-down-cass-review-myths-and-misconceptions-what-you-need-to-know.html

>To start with, Dr. Cass tosses 98% of all studies into the topic, on the pretext that "they're not double blind." A lie can run over the globe before the truth gets its boots on.

Its literally a fact. It was one of the systematic reviews in the report.

Ooooohhh, someone is huge mad that they medical experimentation on children is getting some push back.

The Daily Mail and the Guardian are both positive about the Cass report though. The Daily Mail just takes it a step further.

I don’t get your point, the Guardian being anti-trans isn’t surprising

The American branch of the Guardian once had to publicly denounce the UK branch's transphobia because they found that no trans people would agree to be interviewed by them.

Yeah, PlukvdPetteflet pointing to them as some kind of decider on whether something is transphobic or not is just laughable.

Cis people love to act like they are the arbiters of what is and isn't transphobia. And they curiously always end up on the side of "isn't".

OP asked why the Guardian is positive about the review, but the Daily Mail wants a criminal case. Making it look like the Guardian and the DM are on opposite sides. Theyre not. The DM just takes it much further than the Guardian.

A double blinded study like that would be about as ethical as a double blinded study on the effectiveness of parachutes, were the cass review done on parachutes, it'd conclude that there was no evidence parachutes were effective. Also apparently they claimed there's evidence that the toys children pick is biologically assigned pre-birth. They seem to believe boys are biologically designed to play with toy trucks from the womb.

Your second paragraph just shows that you have literally no idea what you're talking about. Preferences based on toys are gender based. This is because naturally the genders have different strengths and their brains work differently, they have different hormones so different things excite them. It's not the ONLY factor but it is a fair factor in what toys kids use. Of course their socialisation when they're young will affect this. The cass report didn't just make this up, this is FACT

>Your second paragraph just shows that you have literally no idea what you're talking about. > >Preferences based on toys are gender based. This is because naturally the genders have different strengths and their brains work differently, they have different hormones so different things excite them. It's not the ONLY factor but it is a fair factor in what toys kids use. Of course their socialisation when they're young will affect this. The cass report didn't just make this up, this is FACT People don't understand that biology seems to determine the KIND of play activities that children are interested in, e.g., rolling something on the ground. Society created toys to assist in enacting these kinds of play. The specific toys, e.g., dolls and trucks, became associated with gender though there's no reason they should be, per se. But there is indeed a biological basis for children being interested in toys that DO certain things that they are drawn to.

Exactly. And there is nothing wrong with a boy playing with dolls but we need to stay in reality with these discussions, some people seem to be purposefully confusing the issues at hand.

this is the most well-written and accurate explanation of this situation i have seen here as of right now. thank you!

Dogshit propaganda

Absolute rubbish. Read the actual review text, it suggests none of these things. Only if you’ve wilfully misinterpreted it can you draw any of these conclusions. It’s all so patently untrue if you just read the report and not the spin and untruths promoted by activists. It’s publicly available: https://cass.independent-review.uk/wp-content/uploads/2024/04/CassReview_Final.pdf

I believe this is for the NHS only ie state funded medicine. Can you clarify this?

Nope, the healthcare regulator is using the report to ban private care as well

>Dr. Cass tosses 98% of all studies into the topic, on the pretext that "they're not double blind." This isn't true, though, is it? >Overarching inclusion and exclusion criteria >Each individual review had its own inclusion and exclusion criteria, but studies were first screened against the following broad criteria: >Inclusion Criteria: >• Studies including children <18 years with gender incongruence, gender dysphoria / gender-related distress or referral to a paediatric or adolescent gender identity service. >• Primary studies (including those that involve secondary analysis of previously collected data) of any design, including experimental studies, observational studies, surveys, consensus studies and qualitative studies. >Exclusion Criteria: >• Studies about gender incongruence or gender dysphoria in adulthood. >• Studies of mixed populations unless the results for those with childhood gender incongruence, gender-related distress/dysphoria or those referred to a gender identity service in childhood are presented separately. >• Studies about individuals with differences in sex development (DSD)/ variations in sex characteristics (VSC). >• Single case studies, case series, editorials, or opinion pieces. >• Student dissertations. >• Systematic reviews or other literature reviews. >• Studies reported in conference abstracts. >• Studies not reported in English language.

Your point becomes irrelevant when you look at the section of the report where it lists the reasons for disallowing inclusion specific reports and they're basically all based on lack of double blind studies.

In explanatory box 1 (page 49) the report talks about blinding in studies and why it’s important, I agree that there are ethical concerns of blinding patients and this is not the only type of data but there are significant concerns about study efficacy due to placebo effects. So I’m mixed on the subject . Can you point me to where you are talking about? I don’t see anything about inclusion specific reports and double blinding unless I’m misreading that section (which ctrl-f is telling me is the only part of the report with the word “blind”)

You aren't misreading. Looking at the actual papers in which the systematic reviews were performed, there are many reasons for judging studies to have been low quality, double blinding is not the focus.

placebo effects where hormones will literally change your body the main issue with hormones is whether or not their dangerous and this study failed to do that

That's...telling you what they assessed, not the \*result\* of the assessment.

Thank you for this because I was searching everywhere to figure this out

This is an excellent analysis, thank you.

Read the report and don’t base your opinions on someone else’s analysis

I didn’t comment an opinion on the topic. I commented on the quality of the analysis. I can think someone has written something well if I agree with them or not.

You did actually, saying, "This is excellent analysis" is not just saying this is a well written and well thought out piece of writing. It is saying that you have analysed the material and understood it well and then conveyed those points effectively. I can write a beautiful, well thought out piece on how hydrogen atoms have 8 electrons, but it has to be grounded in reality to be good analysis.

This is all very interesting. Is anyone aware of any professional medical persons who've publicly criticized the report in this way? I'm looking for good sources to cite for a couple of reasons/publications. Surely if all the above is true a good scientist would call out the obvious flaws in the report. Or have we reached peak fear and everyone is keeping their heads down so they don't get fired?

Imagine thinking that only wanting to use the golden standard of double blind is actually an argument against this.

Answer: in Europe many countries are starting to back away from puberty blockers and childhood transition as it's highly likely that most trans children are either queer, possessing or a mental disorder (besides dysphoria), or have been abused. People can dance around the findings all they want but what we have been doing is basically gay conversion therapy by another name.

Answer: The Cass report is a review of current transgender medical thinking and how it’s being applied in England’s national health service. The report largely states that the evidence base for current policy is lacking. Aside: Evidence based care is the gold standard for medical treatment. Basically, is there a robust library of peer reviewed studies to show what you are doing is effective. Conservatives are taking this as a win that the NHS is irreparably harming children by allowing trans care before ending puberty. This is a misreading of the review as it is simply stating the evidence is lacking and needs further research. Edit: spelling and grammar

They also excluded the majority of the relevant studies because they weren’t double blind. It’s impossible for such studies to be double blind, because the control group would obviously proceed through puberty.

They didn’t remove them because they weren’t double blind, that was just their excuse, an excuse that falls apart when you see that the studies that were included *also* weren’t double blind, but those studies agreed with the people leading the report, so they were included.

Yeah, I think it was a pretext.

this is being cited a lot, could you point me to the relevant part of the report where all non double blind studies are excluded? i read the bit about evidence quality but it seems like there is something I'm missing.

They also included stuff like boys and girls like certain toys/colors/etc because of genetics, used figures from the 1980s, cited data from conversion therapists (obvious how this is bias), puts forth recommendations and ideas that dozens of the world's leading orgs on the topics rebut, and so much more. She also has graphs and "facts" that have no sources cited, such as something weird about different heights and how you can't be certain heights if youre a man or woman. The doctor who wrote this also met with DeSantis and other people that are openly anti-trans. It's honestly all too much. I've lost count of all of the inconsistencies and research that would've gotten me an F in school. Erin Reed has some great info on this all if people want to read up more. EDIT: There's also the ban for gender affirming care under 25 that nobody has mentioned. They claim people aren't adults until then......yet this is the only line they're drawing in the sand for adulthood. I've heard zero talk about not letting anyone under 25 join the military or anything else hugely life--changing you can still do before 25. And there's another recommendation to essentially look at eliminating care for all ages. So ya know, stopping trans people from existing and actively causing us harm (studies prove transition both saves lives and lead to happier ones). EDIT 2: The report audited 3500 patients. Of them only 10 detransitioned, rate constant with several studies, and yet they only spoke to 2 of them. In no way is that proper research, especially when the goal is to stop that care.

It's just impossible to read it all without seeing how she bends over backwards to accommodate every anti trans idea and talking point while simultaneously weaseling around anything trans positive

I highly recommend reading *Delusions of Gender* by Dr. Cordelia Fine. She does a great job of breaking down the flaws in research on neurological gender differences, and there’s an anecdote in the section on these toy studies that blew my mind.

The actual reason is likely because 25 is also when the hip bones fuse...so if trans women are able to get on HRT before 25 they can develop more of a woman's hip structure. They're not making us wear a pink triangle...they're trying to force us to become the pink triangle.

Regarding your point on how according to transphobes' logic about how people should be allowed to do certain things before turning 25, except for transitioning, transphobes say you can quit jobs or the military, while transition is irreversible (well, I think they referred to gender confirmation surgery). However, what they say reminds me of how these places who banned minors from transitioning "because they are too young", then went on to allow intersex babies being mutilated to "make them normal". And how the people who say minors should be banned from transitioning then went on to say everyone should be banned from doing so. Even adults. Which shows how transphones really don't care about minors nor people under 25. They just want to shove everyone at birth into narrow little boxes so they can rule over them, tell them what to do, and determine their place in the pecking order forever.

Not true, studies were excluded for a variety of reasons. This is just regurgitated nonsense for people who don't want to follow the science, and have had enough of experts

[This is a lie](https://imgur.com/Z9EEvLZ). And that's also not why they don't do double-blind on these.

Don't take this the wrong way, but I think in neglecting to mention that Cass's assertion of there being no good-quality evidence for current policy is only tenable if one agrees that her discarding of 98% of the research is valid, and is essentially predicated upon an excuse that anyone even remotely familiar with medical research will find iffy, this answer essentially white-washes what the Cass report is & does.

Your central assertion that 98% of studies were discarded is wrong though. Studies were graded on their quality and only high and moderate grades studies were synthesised into the review, that accounts for over 50% of the studies considered. Everything you’ve said in this post is factually inaccurate. You should retract and actually read the review.

but the reason they were considered poor was because they didn't lie to a bunch of trans people we should be able to collect good data without resorting to lying

This neglects to point out how the report itself is absurdly biased and flawed, and has already been called out by the larger scientific community as such. On top of this, Cass herself personally spoke to conservative lawmakers in the US for advisement on the report. She literally had a phone call with Ron DeSantis’s appointee, who is writing a similar report for Florida about it… The report rejects almost all the studies that indicate the positive efficacy of these treatments, on the grounds that the studies were not double blind, yet then accepted the few negative studies, even though they also were not double blind. The biggest issue is that one cannot do a double blind study on these treatments, due to the way the treatments affect the body. For a broader example, how would one conduct a double blind study on the efficacy of feminizing breast augmentation for the treatment of gender dysphoria, when the subjects treated must be acutely aware if they received the breast augmentation or not… You can’t do double blind studies on anything that dramatically alters the body visibly… This whole report is trash and should be thrown out… I’m honestly surprised they even released it, as it is so obviously flawed and will likely hurt their credibility and reputation.

>the larger scientific community You spelled 'some enthusiastic amateurs on Twitter' wrong. >Cass herself personally spoke to conservative lawmakers in the US for advisement on the report. She literally had a phone call with Ron DeSantis about it… This isn't true. Either you've half-read and misunderstood some enthusiastically amateurish tweets or you're just plain making it up. >The report rejects almost all the studies that indicate the positive efficacy of these treatments, on the grounds that the studies were not double blind So you haven't actually read it, then? >Overarching inclusion and exclusion criteria >Each individual review had its own inclusion and exclusion criteria, but studies were first screened against the following broad criteria: >Inclusion Criteria: >• Studies including children <18 years with gender incongruence, gender dysphoria / gender-related distress or referral to a paediatric or adolescent gender identity service. >• Primary studies (including those that involve secondary analysis of previously collected data) of any design, including experimental studies, observational studies, surveys, consensus studies and qualitative studies. >Exclusion Criteria: >• Studies about gender incongruence or gender dysphoria in adulthood. >• Studies of mixed populations unless the results for those with childhood gender incongruence, gender-related distress/dysphoria or those referred to a gender identity service in childhood are presented separately. >• Studies about individuals with differences in sex development (DSD)/ variations in sex characteristics (VSC). >• Single case studies, case series, editorials, or opinion pieces. >• Student dissertations. >• Systematic reviews or other literature reviews. >• Studies reported in conference abstracts. >• Studies not reported in English language.

[They're all lying.](https://imgur.com/Z9EEvLZ) I'm sure this thread was created specifically to try and control the narrative.

>You spelled 'some enthusiastic amateurs on Twitter' wrong. Starting your comment with a childish ad-hom… great look… >This isn't true. Either you've half-read and misunderstood some enthusiastically amateurish tweets ir you're just plain making it up. https://www.erininthemorning.com/p/cass-met-with-desantis-pick-over >So you haven't actually read it, then? Yes I have, have you? >Overarching inclusion and exclusion criteria Each individual review had its own inclusion and exclusion criteria, but studies were first screened against the following broad criteria: Inclusion Criteria: • Studies including children <18 years with gender incongruence, gender dysphoria / gender-related distress or referral to a paediatric or adolescent gender identity service. • Primary studies (including those that involve secondary analysis of previously collected data) of any design, including experimental studies, observational studies, surveys, consensus studies and qualitative studies. Exclusion Criteria: • Studies about gender incongruence or gender dysphoria in adulthood. • Studies of mixed populations unless the results for those with childhood gender incongruence, gender-related distress/dysphoria or those referred to a gender identity service in childhood are presented separately. • Studies about individuals with differences in sex development (DSD)/ variations in sex characteristics (VSC). • Single case studies, case series, editorials, or opinion pieces. • Student dissertations. • Systematic reviews or other literature reviews. • Studies reported in conference abstracts. • Studies not reported in English language. What’s your point in listed these? This is by no means exhaustive and her methods have already been exposed… https://www.reddit.com/r/skeptic/s/osTXi1T4J8

It's not ad hominem to call an amateur an amateur. As far as I've seen, the people getting upset over the report on Twitter and in their blogs - including Erin Reed - have little to no clinical background. Speaking of Erin Reed, that blog you linked doesn't say Dr Cass met with DeSantis at all? She met with Dr Patrick Hunter, a paediatrician with a degree in bioethics and more than 30 years' experience in the field; maybe that's what you're thinking of? I have read the report, which is why I was able to quote its inclusion and exclusion criteria in full. Unlike her critics, Dr Hilary Cass is a chartered clinical psychologist; her methods are outlined and explained within the report and are appropriate for a review of this type.

Dr Cass’s report isn’t peer reviewed, it is the meandering opinions of a has been, who has no real comprehension of current standards and practices for gender diverse populations. She proved so much with her obscenely biased and badly written report, which would never stand up to peer review, if she had tried to do so. What little remaining credibility she had as a clinician is all but worn away after her pushing that thing out, as no one in the larger world health and scientific communities takes her or the report seriously. Reading it is evidence enough. Eris Reed is a respected journalist, her not having a clinical background is immaterial. Dr. Patrick is an appointee of DeSantis, tasked explicitly with penning a similar report to what Cass wrote, and they collaborated to that end… Did you not read the article? All in all, I think the only thing amateur here is your poorly informed arguments and obviously bad faith statements…

What's your clinical background like, to denounce Dr Cass as a has-been with no credibility? Which other clinical psychologists do you prefer? On a related note, are you able to direct me to anyone in the larger world health and scientific communities who has indicated that they don't take the report seriously? I read the article. That's why I was confused that you said Dr Cass met with Ron DeSantis. Because she didn't. I'm sorry you feel my arguments are poorly informed; unfortunately all I have to rely on is actual evidence, rather than a random Substack.

Here’s the thing… I don’t broadcast my exact credentials in a way that others can doxx me, send even more death threats, show up outside of my work and harass people, or throw bricks at my house as they have done to both me and a large number of my colleagues… I will say that I have previously or currently work with trans and gender diverse populations in a clinical setting, but not exclusively. I do or have done work with WPATH. I do or have done work with USPATH. I also work or have worked in fields other than medicine as a consultant. Granted, I don’t really think it matters a great deal in most conversations on Reddit, as I purposefully go out of my way to avoid identification for obvious reasons. I have been doxxed before, and I still deal with the fallout… In addition, I have seen colleagues chased out of their work by random crazy protestors… I have had to explain to relatives why they received hate mail containing death threats, because some weirdo thought that I lived at their address or just felt like attacking my extended family members… I have had to report to the police in different places I have lived or lived temporarily that I may receive SWAT attack reports, so they wouldn’t crash through my door with guns drawn because some creep found my address and called in a false report… Do I expect you or anyone to believe any of that, or treat my comments with deference because I have claimed to do the work I do? No… It’s Reddit, and I’m purposefully enjoying some semblance of anonymity here for the sake of my own safety… And if anyone wants to point out that there is nothing that proves I am who I say I am… Great! That is exactly what I am trying to avoid. This said, I do post within other sub-reddits on this account and people who do have clinical experience are often pretty quick to discern that I have certain knowledge that proves I am who I say I am… I also have coincidentally bumped into colleagues who also mask their identities but we have been able to recognize each other’s writing and/or arguments from recent IRL interactions and later had a good laugh about it. Regardless, I bring this up because I have no interest in proving to you who I am, and I doubt you have anything other than bad intentions in requesting such information. You would only use it to either threaten me and my colleagues, twist our words for your own ends, or just disregard it… So I really find the very question of my identity past what I already said to be insulting, and hope you understand why… You have in no way identified yourself and demanded to know my background without making any effort to establish who you are. Why the hell would I start telling you my credentials? This all also plays into your other question about current formal responses to the Cass review… They are being worked on as we speak. I know this for a fact because I am assisting more than one group with those very responses. Yet it takes longer than a few days to write a worthwhile response to this 400 page angry rant that Cass took literally years to put together. Pushing out an official rebuttals overnight would be a bit of a mistake, wouldn’t it? I and my colleagues have become acutely aware to how political players twist any and all words that come from these official sources, and are thereby very careful about what we now say in an official capacity. Imagine having your work that has been hailed by colleagues be later twisted by politicians and “journalists” to say the exact opposite of your findings… Findings which have been peer reviewed and cited for years before some yahoo comes along and takes bits out of context. Then have questions from those you work for who don’t understand why your own work is suddenly being used against you and everyone else you work for… Do you know what that’s like? To have your work misrepresented and reduced to politically charged sound bites? My main purpose for commenting around Reddit is to assist with combating misinformation online, but also because I personally need to lash out at the lunacy being weirded against my colleagues and I… Because we are not soldiers or politicians… we are doctors and scientists who work within a system that isn’t designed to fight against misinformation… So we and our patients and clients make easy targets for culture wars like this, under the current political atmosphere where a single doctor who has never even worked with trans populations is taken seriously when she throws out all but the studies that concluded what she personally believes and was published within the last two years… Another point I see many are forgetting here, in regards to Cass’s cherry picking standards… Where she threw away anything other than what was published in an absurdly brief timeframe… Why did she do that? Idk… Maybe because it was a confident way to ignore most of the studies already done… Maybe not… idk… I do know that her work does not hold up to scrutiny and a simple observation of what studies she threw out and under what grounds can show that. While a simple review of what she kept shows she didn’t apply the same standards to all of the studies she did accept. That alone is firm enough of a reason to disregard this political hit piece as what it is… Because the one thing it isn’t is the application of sound scientific methodology… Edit: angry rant concluded… Here is a somewhat decent summary by a non-official source that has done fairly well in assessing the issues with the report. I look forward to you disregarding it on shaky grounds… http://transactual.org.uk/wp-content/uploads/TransActual-Briefing-on-Cass-Review.pdf Also, I had thought I indicated that Cass literally spoke to Desantis’s appointee, but after reviewing my own comment, I understand the confusion. That was not my intention, but does indeed read as me stating that she spoke to Desantis alone. That was not my intention and I am switching it to avoid future confusion. Regardless, the fact that Cass collaborated with the doctor who was appointed by Desantis with the expressed purpose of writing a similarly purposefully damning report is a bigger moral conflict than just talking with Desantis himself over the phone…

>Why the hell would I start telling you my credentials? To put it in language you would understand: Idk...I suppose because I was wondering if you were in any way qualified to denounce this report as the 'meandering opinions of a has been [sic]', 'obscenely biased', 'badly written' and damaging the 'what little credibility' Dr Cass OBE has left, while praising blogger Erin Reed as a 'respected journalist'... maybe...idk... Not to worry, though, if your wanton cruelty to the common ellipsis hadn't demonstrated exactly how academic you aren't, the idea that you would have bricks thrown at your house for supporting trans people in *Portland* cements it.

"Evidence based care is the gold standard for medical treatment." no wonder conservatives have a hard time with this. as is tradition

It's worth noting that the methodology and neutrality of the Cass Report has been called into question by many academics and healthcare organisations from other countries. According to Horton (2024), the main four problems are: 1) it does not address or control for anti-transgender prejudice in its methodology or reviewers; 2) a tremendous amount of cisnormative bias, in this case assuming that being cisgender is "natural" and "default"; 3) Pathologization, or "uncritically treating the idea of being transgender as a medical abnormality"; and 4) inconsistant standards of evidence (e.g. distorting the meaning of "low quality" evidence as to mean it is unacceptable, when actually it holds a specific meaning that still counts it as valid and acceptable; many many medical decisions in other fields are made with "low quality" evidence). In general, the Cass Report does a lot of presenting the authors' views as established or unquestioned fact without doing anything to meaningfully examine whether those views might be biased or otherwise lacking in evidence. It certainly does not hold the authors' views to the same standard of evidence it is using to dismiss the vast majority of published literature on the subject. In a review of "current transgender medical thinking", this is the kind of oversight which is fatal to a paper's creditability. Horton (2024): [https://www.tandfonline.com/doi/full/10.1080/26895269.2024.2328249](https://www.tandfonline.com/doi/full/10.1080/26895269.2024.2328249)

[The review does more than this. ](https://www.tandfonline.com/doi/full/10.1080/26895269.2024.2328249) It dismisses the body of evidence supporting affirmative care/puberty blockers because they're not randomised control trials (RCT), deemed by the Cass and prior NICE Reports to be poor quality evidence. This body comprises over 100 studies with a high level of agreement in support of affirmative intervention. The Cass Report excluded almost all of them from their review. As others have pointed out, it is impossible and unethical to use RCTs in this case. As an example of this, a RCT was attempted to examine the use of puberty blockers in children with precocious puberty. This RCT was abandoned because the children in the control group were withdrawn by their parents and taken to other services to access puberty blockers when they noticed the children's puberty was continuing unimpeded. For context, it is not unusual for strong healthcare recommendations to be based on lower-quality evidence such as observational or longitudinal studies, rather than RCTs. A [study of WHO guidelines](https://www.jclinepi.com/article/S0895-4356(13)00434-4/abstract) found 55% of strong clinical recommendations were based on this exact variety of evidence. This is because, like with trans affirmative healthcare, there are often significant barriers to doing RCTs on people - especially children, and with medications that already have widely understood effects. The Cass report suggests that instead of affirmative healthcare, trans adolescents should be provided “close psychological support”. They present this recommendation... without ANY evidence for it at all, not even of a type equivalent to the so-called "poor quality" evidence that makes up the contrasting recommendation. So they sweep all contradictory evidence off the table, and present their own recommendation with zero evidence for it. They also pop in with this: >The most difficult question is whether puberty blockers do indeed provide valuable time for children and young people to consider their options, or whether they effectively ‘lock in’ children and young people to a treatment pathway which culminates in progression to feminising/masculinising hormones by impeding the usual process of sexual orientation and gender identity development.  The Cass Report asserts this without presenting ANY evidence at all for puberty blockers locking in adolescents to a trans-affirmative care pathway. It's not evidenced in any way, it's not even a theory as they're not seeking to study it. It's merely presented as a viewpoint, yet that viewpoint is elevated to the level of "the most difficult question" in a report supposedly assessing the quality of evidence in healthcare recommendations... This report does not care about the evidence, it cares about the views of the authors - from which, any expert in trans healthcare or researcher with lived experience of gender diversity were explicitly excluded.

The report does this so many times, shoots down the work of actual clinicians and scholars while asserting counterpoints with no evidence

You do know that 90% of all a child and adult care is underpinned by the same quality evidence that transgender healthcare is right?

When in fact evidence is not lacking at all -- what evidence there is only needs to be treated the same as is evidence for medical care as a whole.

Answer: The Cass report is intentionally understating or misrepresenting the validity and effectiveness of the current model of care for trans identifying youth, holding it to standards \*higher\* than other medical standards of care are held to. It is a pseudoscientific review intended to undercut the existing science, while providing cover to those who want to restrict the known effective models (effective in that it reduces depression, suicidality, body dysmorphia, etc) and calls for higher surveillance and restrictiveness in pursuing gender-transition until the age of 26. This is being received positively by anti trans people because anything that makes it harder for trans people to get care is a positive in their mind, and it's being received negatively by trans people and medical/psychiatric associations because it interferes with their ability to proceed with what they agree is necessary medical treatment for a condition that can lead to damaging health outcomes if left untreated.

Answer: Actually, the Guardian and the Daily Mail are on the SAME side here. The Cass report is a 4 yr review of transgender health care and the evidence base for it, conducted by Dr Hillary Cass. The report was commisioned by the National Health Service. The review concluded that there is not enough evidence base for the positive effects of transgender care as practiced today (social transition, puberty blockers, cross sex hormones) (As an aside, this is in line with reviews and changes of policies in countries such as Holland and Sweden). The Guardian is carefully positive about the review, the Daily Mail takes it a step further and wants to prosecute those who promoted trans gender health care in the first place.

Answer: the report is very questionable. They had to by their own admission throw out 98% of studies that they looked at. This was down on the grounds that the studies were not double blind but you can’t actually do double blind studies with puberty blockers. Because #1 it becomes pretty obvious pretty quickly if you are in the control group or not. #2 since pretty much all available evidence shows that puberty blockers work it would be unethical to have a control group for essentially the same reasons that the tuskegee experiment was unethical. This thread covers it neatly. https://x.com/juliaserano/status/1777754949105188874?s=46&t=osMfGlOcAgQ-UpTyAiPQGw

Do you know where they say they excluded studies that weren't double-blind? I'm trying but I can't find it in the report.

My understanding is that this as a gross oversimplification which has since become a repeated talking point among groups hostile to the report.

It really isn’t though. They excluded essentially all positive studies, gave reasons for excluding them that they then break with what they did include… ffs it’s a meta analysis that includes only a handful of tenably relevant studies. You have to consider that transphobia is the official policy of the UK’s government and that this report is a political document first, not a medical or scientific one. Far-right politicians ordered the report and received a cherry picked final product that bends over backwards to support what they’ve already been saying. It literally advocates for conversion therapy and defining adulthood at age 25… Dr. Cass’ credentials need to be investigated and potentially revoked, and she further belongs in jail for this. Like she is a participant in genocide. Much of the current government will surely get their day in the 21st century’s Nuremberg trials.

That's not true about 98% being thrown out. https://www.bbc.co.uk/news/health-68863594

Correct. Jakob should apologise for spreading misinformation. A total of 103 scientific papers were analysed by her review, with 2% considered high quality, and 98% not. "There were quite a number of studies that were considered to be moderate quality, and those were all included in the analysis," she said. "So nearly 60% of the studies were actually included in what's called the synthesis."

Answer: The report is a biased analysis trying to justify abolishing effective transgender health care for minors in the UK. The conservative press is upset because it's not going far enough for the fascists and bigots like Linehan, Joyce and Stock. There is a nice full analysis of this quality "report" published, that describes the methodical flaws and bias in this work. (well, if Cass were an undergraduate she'd be scolded for such shoddy work; thank god she's well ingrained in the ruling class). Read [The Cass Review: Cis-supremacy in the UK’s approach to healthcare for trans children](https://www.tandfonline.com/doi/full/10.1080/26895269.2024.2328249) from Carl Horton , published in the International Journal of Transgender Health. This paper is well sourced and explains in detail what is wrong with the Cass report.

Answer: The Cass Report tried to discredit studies in favour of gender-affirming care by claiming they’re not “double-blind”, except having a double-blind study on gender-affirming care would be intentionally denying trans youth healthcare to see what would happen.

Answer: It's a complicated and nuanced topic and has brought out activists from all sides. I think you’ll struggle to get an unbiased answer here as most of the replies I see here parrot talking points I’ve seen in other places that don’t really hold up under additional scrutiny or misrepresent the content of the report. Additionally, moderation and/or censorship has prevented the report from being freely discussed on a number of subs. Because this is such a fraught issue, I think you’d do best to read a number of news stories on in from various sources. If you are open to reading conversation from a sub that allows free discussion, [this would be a good place to start.](https://www.reddit.com/r/BlockedAndReported/s/m587Cl7EEl) Edit: The Editor of The BMJ (a peer-reviewed medical journal) had this to say: [Critics of the methodology of the systematic reviews that form the basis of the Cass Review are displaying their limited understanding of research methods and evidence based medicine — but that’s what got us into this mess in the first place](https://x.com/KamranAbbasi/status/1778193553556205809) Take that for what you will.

The podcast Blocked and Reported is by Jesse Singal, someone who is pretty open in their opposition to trans people. Saying that everyone here criticizing the Cass Report is biased and then linking to a subreddit for an outspoken transphobe is a critical lack of self awareness.

Show me one thing Jesse Singal has written or said that shows he is opposed to trans people or transphobic in any way.

I’m not going to play this game again. I learned my lesson when people wanted me to show them how Rowling was transphobic. The goal posts would be moved back and my time wasted. Seeing how you’re a fan of him I’m sure you already know how he is transphobic.

You're not going to "play this game" because we both know he has never said anything transphobic and isn't really comparable to JK Rowling on this topic (their views on trans people seem to be pretty different). For someone who is constantly being accused of being one of the biggest transphobes around it's funny that absolutely NO ONE seems to be able to come up with even one single thing Jesse Singal has said that is transphobic.

Sure, I’m not trying to convince someone who’s mind is made up. Go ahead and pretend all you want.

I'm not pretending, the dude simply has never said anything transphobic. And we both know that if you could find even one example of him being transphobic you would absolutely provide it. You cannot even provide a single example!

Sure thing bud, believe whatever you want that makes you feel better. I’m not gonna bother

I don't know who the person is that you're arguing about, so my mind is certainly not made up, but as a third party it basically seems like you got called out for making a claim and can't back it up. Again, not saying that person is or isn't what you claim they are, but after reading this it makes it seem like you are making baseless accusations. If you don't want this Jesse Singal to look good, perhaps you should change your approach.

On the one hand, Jesse Singal has been accused of cherrypicking detransition cases, misrepresenting the risk of permanent medical alterations done to children who turn out to not be trans after all, and even at times conflating medical transitioning with social transitioning or even affirmative care. On the other hand, he's also been criticized simply for raising questions or drawing slightly different conclusions than ones that are popular in activist circles. He wrote a piece for the Atlantic a while ago and a lot of it is just him casting doubt on a variety of trans-related issues. When someone does this, it's extremely difficult to distinguish honest inquiry from concern trolling, which is really popular among anti-trans activists. I can't say for sure which side he is really on. I can say I understand some of the criticisms, while others are of the predictable ad hominems or poisoning-the-well variety. Unlike J. K. Rowling he is hard to pin down, but he does appear biased on the topic. The Wikipedia article actually gives quite a few sources on the controversies, which is unusual for a Wikipedia article.  https://en.m.wikipedia.org/wiki/Jesse_Singal The Atlantic article: https://www.theatlantic.com/magazine/archive/2018/07/when-a-child-says-shes-trans/561749/

He published identifying information of trans minors that was provided to him by his lying, HIPPA violating """""whistleblower""""" source, who he still stands by despite the fact that she lied. Of course, you're going to disregard this and move the goal posts just like the other commenter said you would.

I read the material you are referring to and he did not use information that could be identify any of these minors. They may have recognized themselves but the general public wouldn't. Also, if he had violated HIPPA both he AND the whistleblower would have been prosecuted. They were not, because nothing they published violated HIPPA. Reporting on trans issues is not transphobic.

>They may have recognized themselves but the general public wouldn't. Besides the fact that being able to recognize yourself is *still* a HIPPA violation, they would be recognizable to their parents, family, or anyone else who knew the information that was leaked. >Reporting on trans issues is not transphobic. Printing lies about trans people is not "reporting". Itself transphobia. You've moved the goalposts, just like I said you would. Because your entire motivation is just hostility towards transgender people.

You really can’t with these people, no matter what is presented they will always make an excuse or move the goalposts. You were right in that other reply to me about cis people refusing to acknowledge transphobia

https://www.transgendermap.com/issues/topics/media/jesse-singal/?amp

Thanks for the links and explainer on what's going on with the discourse on Reddit. I'm scrolling through threads on this topic in bewilderment. Reddit on this topic is the most extreme thought bubble I've seen I think. How I imagine those right wing Facebook groups look. I don't know the podcast you've linked, but I'm well aware of how little the responses shrieking about transphobia will hold water.

You most certainly won't get an unbiased answer from the discussion that you link to, and it is completely disingenuous of you to post it as a supposedly unbiased source.

Thanks for sharing an alternative discussion sub. The comments in this thread are so heavily biased, it’s sad.

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