The Cass Review- Interim Report

[rogdmum]

The Cass Review Interim Report has been released. 112 pages long and it’s such a bloody relief to read common sense.

cass.independent-review.uk/publications/interim-report/

There’s so much in it, but emphasis on taking a holistic approach with a great chart on page 57 showing the complex presentations in and complex pathways.

And social transitioning has been recognised as an active intervention!

“Social transition – this may not
be thought of as an intervention or treatment, because it is not something
that happens within health services. However, it is important to view it as an active intervention because it may have significant effects on the child or young person in terms of their psychological functioning. There are different views on the benefits versus the harms of early social transition. Whatever position one takes, it is important to acknowledge that it is not a neutral act, and better information is needed about outcomes.” Pages 62/63

So much in it. So much. And there’s more to come as the review continues to work on the issues.

Wow. Great to hear. Thanks for the share, rogd. Here's to some common sense breaking out.

Have you kept a copy of that?

Just for future reference.

Copy of what? The report is on the Cass Review website (link in first post)

I think she means they might take it down, if the TRAs make a fuss.

Always good to have a copy archived.

Yes, I forsee tantrumming.

I'm so happy to see this:

"important to acknowledge that it is not a neutral act, and better information is needed about outcomes."

Hugely important.

This bit was interesting.

Because the specialist service has evolved rapidly and organically in response to demand, the clinical approach and overall service design has not been subjected to some of the normal quality controls that are typically applied when new or innovative treatments are introduced.

Overall I think this report is really important. Whenever we see a post about a school or SS proposing social transition this needs to be the first piece of evidence we quote to show that it's actually an experimental medical procedure.

I agree there will be much tantrumming. But I’m fairly certain Dr Cass won’t be swayed by it.

Phew.

Because the specialist service has evolved rapidly and organically in response to demand, the clinical approach and overall service design has not been subjected to some of the normal quality controls that are typically applied when new or innovative treatments are introduced.

I wish I could add 'and has been heavily politically steered and stage managed' before 'in response to demand'. The huge amount of uncontested political lobby group interference, access and pressure is a serious part of this, particularly in regard to finding out why normal safeguarding did not effectively stand up to, and what impact this has had on ethics.

1.23. Evidence on the appropriate management of children and young people with gender incongruence and dysphoria is inconclusive both nationally and internationally.

2.18. The disagreement and polarisation is heightened when potentially irreversible treatments are given to children and young people, when the evidence base underlying the treatments is inconclusive, and when there is uncertainty about whether, for any particular child or young person, medical intervention is the best way of resolving gender-related distress.

No evidence. What a surprise!

Thank you so much for the heads-up, @rogdmum.

You've been waiting a long time for this.

That's Crispin Blunt MP put in his place, thank goodness. And Caroline Nokes. This report can be cited over and over again.

And all schools?

Thanks. I've been waiting for this. I think it was due late summer last year. Will have a read.

And they refer to birth-registered sex. Registered not 'assigned'.

Thanks for posting, this is hugely important.

”Paediatric endocrinologists develop a wide range of knowledge within their paediatric training, including safeguarding, child mental health, and adolescent development. Being party to the discussions and deliberations that have led up to the decision for medical intervention supports them in carrying out their legal responsibility for consent to treatment and the prescription of hormones.”

Looks like the paediatric endocrinologists might find themselves in the firing line, when the court cases begin to arrive.

Glad also to see she uses the terms birth-registered females and males, rather than sex assigned at birth, which I seem to remember she used in a previous update. This is at odds with the ONS definition that she gives on p 26. and various reproduced charts and tables.

This is very damning, considering this is related to an intervention that is supposedly intended to improve the situation:

3.46. NHS England has established a Multi-Professional Review Group (MPRG) to review whether the agreed process has been followed for a child to be referred into the endocrinology clinic and to be prescribed treatment. The Review has spoken directly to the MPRG, which has reported its observations of current practice.

3.47. The MPRG has stated that its work has been impeded by delays in the provision of clinical information, the lack of structure in the documentation received, and gaps in the necessary evidence. This means that when reviewing the documents provided it is not always easy to determine if the process for referral for endocrine treatment has been fully or safely followed for a particular child or young person.*

3.48. The MPRG indicates that there does not appear to be a standardised approach to assessment. They are particularly concerned about safeguarding shortfalls within the assessment process. There is also limited evidence of systematic, formal mental health or neurodevelopmental assessments being routinely documented, or of a discipline of formal diagnostic formulation in relation to co-occurring mental health difficulties.

Will read more later! Thanks very much for the link, OP.

What a relief. Thanks for posting. This sounds like a reassuringly child-centred approach, not all about validating adults. Will try to read it this weekend.

Placemarking to read later, but this sounds very sensible from the highlights above.

The reactions to it will, I’m sure, be very enlightening. I would love to be wrong, but I’ve been in the trenches of this game for too long. The militants will be unhappy, but frankly, they’re lost to reason. It’s the middle ground occupied by the “don’t knows”, the “not sures” and the sensible, rational people who want children with complex needs to receive high quality, non politicised health care who will read and absorb what Dr Cass says.

Downloaded and I've web.archive.org 'd the URL in the OP (can't post or it will be hidden ).

Thank you!

The care of this group of children and young people is everyone’s business.

YES

I'm near to tears at the sheer humanity and groundedness of the interim report.

The care of this group of children and young people is everyone’s business. Our initial work indicates that clinicians at all levels feel they have the transferable skills and commitment to support these children and young people, but there needs to be agreement and guidance about the appropriate clinical assessment process that should take place at primary, secondary and tertiary level, underpinned by better data and evidence.