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Please could you invite Hilary Cass?

134 replies

kiterunning · 16/10/2024 08:44

There are so many questions about the follow-up to her report.
It would be great to have a chance to clarify proposed treatment/therapy for children and also to thank her!

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RedCedars · 22/10/2024 09:44

I would love to have her here. It’d be really interesting and so important.

BonfireLady · 22/10/2024 08:54

MissScarletInTheBallroom · 22/10/2024 07:29

Exactly. Male people with gender dysphoria don't have anything in common with female people without gender dysphoria (other than being human, of course). They certainly don't have any kind of shared identity which justifies them sharing the same single sex spaces or competing in the same sporting categories.

This discussion is, of course, somewhat outside the scope of what Dr Cass was commissioned to report on, which is how to treat gender distressed children. But I do think it is nevertheless somewhat implicit in her findings. In her report, Dr Cass acknowledges that for some people, whose dysphoria is extreme and persistent, medically transitioning will be the right option. But she cautions against taking any irreversible steps during childhood, or even steps which we might think to be reversible, such as socially transitioning a child by changing their name and pronouns. Why would you need to caution against this if being a trans adult were completely unproblematic and trans adults could expect to enjoy as fulfilling a life as anyone else?

And there's the rub. People can socially and medically transition but they will never, ever be the opposite sex and they will never, ever be accepted as such. Even if you move exclusively in the kind of circles where everyone uses your preferred pronouns and insists that you are what you say you are, there will always be limits. There will always be people who object to you using public toilets in accordance with what you see as your acquired gender. You will never be able to compete in sport without controversy. Any hospital admission could cause issues. And you will find that straight men and lesbians might be willing to say you are a woman but most of them are not actually willing to date you. And the ones who are willing to date you may not want to have a long term relationship with you because they want children, something you can never give them (unless you have not medically transitioned and are willing to use your body to perform its reproductive capabilities in accordance with your biological sex, something which triggers your dysphoria).

This isn't to say that trans people can't live happy and fulfilling lives, but trans adults face struggles and challenges that the rest of us don't face (and that's before you even address any health problems they may suffer as a result of medically transitioning) and so it's not the ideal outcome if it can be avoided.

I think this is implicit in the Cass review, where Dr Cass essentially green lights medical transition in a small number of adults as a last resort where all other treatment options have failed, but suggests that otherwise it's not a good outcome. She says so very subtly, but the message is there. And it's essentially the same thing Helen Joyce said, much more bluntly, about needing to keep the number of people who have transitioned to an absolute minimum. Dr Cass can, of course, never say this explicitly, even in a Mumsnet Q&A.

This ⬆️⬆️⬆️

MissScarletInTheBallroom · 22/10/2024 07:29

Ereshkigalangcleg · 21/10/2024 20:59

Knowing what sex one is is not the same type of "identity" as thinking you are the opposite sex because you don't feel aligned to the one you are.

I would say I'm surprised by the mental gymnastics on show here, but it's textbook for this ideological movement.

Exactly. Male people with gender dysphoria don't have anything in common with female people without gender dysphoria (other than being human, of course). They certainly don't have any kind of shared identity which justifies them sharing the same single sex spaces or competing in the same sporting categories.

This discussion is, of course, somewhat outside the scope of what Dr Cass was commissioned to report on, which is how to treat gender distressed children. But I do think it is nevertheless somewhat implicit in her findings. In her report, Dr Cass acknowledges that for some people, whose dysphoria is extreme and persistent, medically transitioning will be the right option. But she cautions against taking any irreversible steps during childhood, or even steps which we might think to be reversible, such as socially transitioning a child by changing their name and pronouns. Why would you need to caution against this if being a trans adult were completely unproblematic and trans adults could expect to enjoy as fulfilling a life as anyone else?

And there's the rub. People can socially and medically transition but they will never, ever be the opposite sex and they will never, ever be accepted as such. Even if you move exclusively in the kind of circles where everyone uses your preferred pronouns and insists that you are what you say you are, there will always be limits. There will always be people who object to you using public toilets in accordance with what you see as your acquired gender. You will never be able to compete in sport without controversy. Any hospital admission could cause issues. And you will find that straight men and lesbians might be willing to say you are a woman but most of them are not actually willing to date you. And the ones who are willing to date you may not want to have a long term relationship with you because they want children, something you can never give them (unless you have not medically transitioned and are willing to use your body to perform its reproductive capabilities in accordance with your biological sex, something which triggers your dysphoria).

This isn't to say that trans people can't live happy and fulfilling lives, but trans adults face struggles and challenges that the rest of us don't face (and that's before you even address any health problems they may suffer as a result of medically transitioning) and so it's not the ideal outcome if it can be avoided.

I think this is implicit in the Cass review, where Dr Cass essentially green lights medical transition in a small number of adults as a last resort where all other treatment options have failed, but suggests that otherwise it's not a good outcome. She says so very subtly, but the message is there. And it's essentially the same thing Helen Joyce said, much more bluntly, about needing to keep the number of people who have transitioned to an absolute minimum. Dr Cass can, of course, never say this explicitly, even in a Mumsnet Q&A.

Ereshkigalangcleg · 21/10/2024 20:59

Knowing what sex one is is not the same type of "identity" as thinking you are the opposite sex because you don't feel aligned to the one you are.

I would say I'm surprised by the mental gymnastics on show here, but it's textbook for this ideological movement.

MissScarletInTheBallroom · 21/10/2024 20:24

DadJoke · 21/10/2024 09:24

The issue is that gender identity isn’t a belief in the sense that religion is a belief - it’s in the same category as sexuality and has genetic and environmental components. It’s the gender critical belief that there is no such thing in the face of evidence which is the pseudo religious belief.

Nonsense. If that were true then everyone would have one. In reality, the vast majority of people don't have one. And even if they did, how would it be relevant to anything?

Oblahdeeoblahdoe · 21/10/2024 17:50

Yes please. She was great on Woman's Hour a couple of weeks ago

BonfireLady · 21/10/2024 17:48

VegasVagabond · 21/10/2024 14:35

We have some great questions for Cass:

Does she believe in geneder identity?
If so, what does she believe it is, and what is the evidence for this?
Does she think psychologists who do not belive in gender identity, who may be GC can /should be abe to support children with distress at their perceived gender incongruenece?

Then lots of questions about the study. the new clinins and young adults.

There are many things to ask which remain unlcear from the review or her subsequent responses.

Please invite her MNHQ I thin it could be a very rich discussion.

As brilliant as it would be to fully understand Baroness Cass' personal view on this...

Does she believe in geneder identity?
If so, what does she believe it is, and what is the evidence for this?

... I think it would take up a whole interview/thread because we'd probably get no further than we see above where there is no consensus on who holds the belief and who holds the fact. I never refer to "gender critical belief" for this reason - I find it far more useful to refer to the legal protection that Forstater also achieved in the appeal to not believe that everyone has a gender identity.

Does she think psychologists who do not belive in gender identity, who may be GC can /should be abe to support children with distress at their perceived gender incongruenece?

This ⬆️ would be great though. This is going to be a very real position and it will be helpful to understand how a non-believer can navigate the delivery of neutral therapy to the satisfaction of a believer. A difference in core belief shouldn't matter at all when you look at the recommendations of the Cass Report, but what if a child is demanding affirmation only from the start and refuses to accept any approach that isn't a social transition, for example? Her thoughts on this would be really useful to understand.

VegasVagabond · 21/10/2024 15:45

MrsTerryPratchett · 21/10/2024 15:19

Religiosity is heritable as well. And many people posit that it is had-wired.

Of course if 'gender identity' is genetic we'd need to know what 'gender' is to understand it, and presumably we'd come to some sort of interests/ behaviours associated with a particular sex class type understanding. (The association may be totally socially constructed or not ,that doesn't really matter, it just is a fact we can all observe, that we do always asscoiate some traits with certain sexes in all cultures, although the cultures vary)

I'd agree these traits are likely to have some heritability, as personality and interests have heritability.

We could then maybe agree that for some people their personality traits and interests which are socially incongruent with their sex, causes such dissonance and possibly distress it becomes a central element or defining aspect of how they view themselves: Identity based on gender/ gender identity.

But it is 'gender/ personaloty' whihchis inherited and an identity forms becase of the socila incongruence.

Suggesting it 'exists' without defining it is not possible. and the better we define it the clearer it becomes and the more possibility we can help people unerstand themselves and relieve distress,

MrsTerryPratchett · 21/10/2024 15:19

DadJoke · 21/10/2024 09:24

The issue is that gender identity isn’t a belief in the sense that religion is a belief - it’s in the same category as sexuality and has genetic and environmental components. It’s the gender critical belief that there is no such thing in the face of evidence which is the pseudo religious belief.

Religiosity is heritable as well. And many people posit that it is had-wired.

VegasVagabond · 21/10/2024 14:35

We have some great questions for Cass:

Does she believe in geneder identity?
If so, what does she believe it is, and what is the evidence for this?
Does she think psychologists who do not belive in gender identity, who may be GC can /should be abe to support children with distress at their perceived gender incongruenece?

Then lots of questions about the study. the new clinins and young adults.

There are many things to ask which remain unlcear from the review or her subsequent responses.

Please invite her MNHQ I thin it could be a very rich discussion.

DadJoke · 21/10/2024 14:33

@BonfireLady One clarification:

"Although I can't imagine many believers would want to do so, any more than a Christian would want to debate about god with atheists.... as it would just be a stalemate of believers saying "we know gender identity is real because of a, b, c" and others saying "no, that can be explained by x,y,z" (just as a "god is real" debate would)."

We disagree with who the atheists are, here. "We think that gender identity is real, because there is scientific evidence for it based on well conducted studies" vs " We don't think it can be real because it conflicts with our deeply held protected beliefs, therefore the studies are wrong."

Other than that, we are in agreement.

DadJoke · 21/10/2024 14:18

@BonfireLady thank you for that response - I would love to hear from Cass. However, I have sworn off posting on the FWR forum, and I'll keep my word.

BonfireLady · 21/10/2024 13:46

DadJoke · 21/10/2024 12:19

Claiming that there is something is your brain which dictates your sexuality is the same kind of "belief."

I understand you think it's implausible that we have mental apparatus, determined in part by genes and early environment which affects our relationship to our usual sex group? You are of course entitled to that belief, but it's not what the evidence says. Children have a strong sense of being "like" others of their gender which can't just be explained by social pressure or their genitals. That's what gender identity is - how it manifests is culturally determined.

It seems an odd hill to die on - it doesn't stop you being gender critical to acknowledge what the evidence says. Any, it's clear Cass does not think it's a pseudo-religious belief.

  1. Not everyone believes we all have a gender identity. It's OK that you do and it's ok that I don't. Neither of us needs to persuade the other to shift our position
  2. sexuality/sexual orientation isn't a "belief", it's a recognition of sexual attraction by sex category: from puberty, we're all innately same-sex, opposite-sex or both-sex attracted (unless something has "malfunctioned" e.g. medication side effects)
  3. for completeness, (biological) sex isn't a "belief" either. It's a biological, physically observable reality. Within the binary of male and female, there are male-specific and female-specific physical variations, including DSDs

it's clear Cass does not think it's a pseudo-religious belief.

It certainly seems that way, agreed. That's why I said it was good that someone who believes that we all have a gender identity (Cass) is advocating for evidence-based care. It sounds like you are too. This is great news!

Unfortunately this is a somewhat of a derail from the thread. I've added a link below where it might be a better place to discuss gender identity as "belief vs fact". Although I can't imagine many believers would want to do so, any more than a Christian would want to debate about god with atheists.... as it would just be a stalemate of believers saying "we know gender identity is real because of a, b, c" and others saying "no, that can be explained by x,y,z" (just as a "god is real" debate would).

https://www.mumsnet.com/talk/womens_rights/4717860-gender-theory-seems-completely-illogical-or-is-it-me

Gender theory seems completely illogical? Or is it me? | Mumsnet

I feel like I’m living in some bizarre twilight zone where most people just blindly accept and believe in something which to me appears to be complete...

https://www.mumsnet.com/talk/womens_rights/4717860-gender-theory-seems-completely-illogical-or-is-it-me

Datun · 21/10/2024 12:55

I understand you think it's implausible that we have mental apparatus, determined in part by genes and early environment which affects our relationship to our usual sex group?

Who knows? But affecting your relationship with your sex group doesn't change your sex group.

As I said. You're the sex you are, you can't change that. You can have all the theories in the world about why you might not like it.

But you'll never, ever be able to claim that you're the opposite sex, nor that you know how the opposite sex live.

You don't have the equipment.

SinnerBoy · 21/10/2024 12:36

Claiming that there is something is your brain which dictates your sexuality is the same kind of "belief."

Ah, I see that you've deployed some of your strawman phalanx.

She didn't say that, as you know.

DadJoke · 21/10/2024 12:19

Datun · 21/10/2024 11:09

Claiming that there's something in your brain that dictates your sex is obviously a belief. Your sex is dictated by your reproductive pathway. You can't have both definitions.

There might be something in your brain that says you don't like it, of course.

Edited

Claiming that there is something is your brain which dictates your sexuality is the same kind of "belief."

I understand you think it's implausible that we have mental apparatus, determined in part by genes and early environment which affects our relationship to our usual sex group? You are of course entitled to that belief, but it's not what the evidence says. Children have a strong sense of being "like" others of their gender which can't just be explained by social pressure or their genitals. That's what gender identity is - how it manifests is culturally determined.

It seems an odd hill to die on - it doesn't stop you being gender critical to acknowledge what the evidence says. Any, it's clear Cass does not think it's a pseudo-religious belief.

Jollyjoy · 21/10/2024 11:09

Oooh I’d love to see her on here please, MNHQ.

Datun · 21/10/2024 11:09

Claiming that there's something in your brain that dictates your sex is obviously a belief. Your sex is dictated by your reproductive pathway. You can't have both definitions.

There might be something in your brain that says you don't like it, of course.

lcakethereforeIam · 21/10/2024 11:07

I can't believe (tee hee!) I'm posting this. I know if I get anything at all it'll be the same tired, easily debunked links but...let's see the evidence then!

DadJoke · 21/10/2024 10:59

Harassedevictee · 21/10/2024 09:57

Ridiculous. Of course it is a belief system.

As a Christian who also understands and accepts evolution exists I know the difference between a religion and scientific fact. I also respect not everyone is a Christian and may have different beliefs or no belief.

It’s the same, sex is scientific gender is a social construct.

A social belief requires the transmission of a belief. The expression of gender, sexuality and gender roles are societal but the evidence suggests that unlike, say, religion, sexuality and gender identity have genetic and early environmental components. So being gay or transgender is not “transmissible.” Cass does not treat it as a belief, nor do scientific bodies. Gender critical peoples’ deeply held belief that the science on this issue is false is also legally protected, as long as it can’t be changed by evidence.

Harassedevictee · 21/10/2024 09:57

DadJoke · 21/10/2024 09:24

The issue is that gender identity isn’t a belief in the sense that religion is a belief - it’s in the same category as sexuality and has genetic and environmental components. It’s the gender critical belief that there is no such thing in the face of evidence which is the pseudo religious belief.

Ridiculous. Of course it is a belief system.

As a Christian who also understands and accepts evolution exists I know the difference between a religion and scientific fact. I also respect not everyone is a Christian and may have different beliefs or no belief.

It’s the same, sex is scientific gender is a social construct.

SinnerBoy · 21/10/2024 09:33

DadJoke · Today 09:24

The issue is that gender identity isn’t a belief in the sense that religion is a belief

Yes, it absolutely is a religious / philosophical belief.

- it’s in the same category as sexuality and has genetic and environmental components.

There's bound to be some medico-scientific, probably psychological causes for it, but that's not the same as it being empirically provable.

It’s the gender critical belief that there is no such thing in the face of evidence which is the pseudo religious belief.

That's a complete turning on its head of the facts. In humans and all mammals, there are two distinct sexes, which is scientifically irrefutable. It's nothing at all like pseudo religious belief, it's the exact opposite, backed up by hard science. "Belief" is the realm of the gender identitarians, not the rational sex realists.

DadJoke · 21/10/2024 09:24

The issue is that gender identity isn’t a belief in the sense that religion is a belief - it’s in the same category as sexuality and has genetic and environmental components. It’s the gender critical belief that there is no such thing in the face of evidence which is the pseudo religious belief.

MissScarletInTheBallroom · 20/10/2024 16:44

DadJoke · 20/10/2024 14:06

As she is someone who clearly accepts the scientific validity of gender identity, that transgender people need the best healthcare in the nhs and that puberty blockers are potentially a valid treatment for dysphoria, it would interesting to read an AMA, to contrast with more extreme views here.

I don't think many posters here dispute that trans people feel they have a gender identity. And as identity is personal, if they say they have one, they have one.

What many of us disagree with is the idea that everyone has one, and that this is a valid basis on which to organise society.

Dr Cass wasn't commissioned to weigh in on philosophical arguments like that; only to look at the evidence regarding care for children who identify as transgender.

MrsTerryPratchett · 20/10/2024 16:40

DadJoke · 20/10/2024 14:06

As she is someone who clearly accepts the scientific validity of gender identity, that transgender people need the best healthcare in the nhs and that puberty blockers are potentially a valid treatment for dysphoria, it would interesting to read an AMA, to contrast with more extreme views here.

'Scientific' is doing some heavy lifting here. I don't think GC women believe that no one firmly and honestly holds a gender identity. I certainly think that some people honestly believe they are meant to be the opposite sex.

Where that comes from and what it means for everyone else is the crux. I have worked with people who firmly, honestly believe the CIA are after them, or that they are reincarnated. Or that wine and water turn into blood and flesh. Or that there are ghosts. Or that they are overweight at 6 stone. And there are very good brain structure and chemistry reasons they do believe those things. Or cultural and religious reasons. Or biological reasons. All of which is 'scientific' and valid. And insofar as it's harmless (CIA and weight aren't and ghosts might be) and personal (religion), great.

But 'scientific' and 'true' are not synonyms. Just because someone believes their life is more meaningful and happy living as their idea of what the opposite sex is, doesn't mean everyone else has to live their life as if that's true too. Basically, as in the case of wine and water, belief = good. Spanish Inquisition and conquistadors =/= good.

Sometimes it's therapeutic and kind to work with their reality (like with Alzheimer's patients) but sometimes it isn't (using off-label drugs and experimental surgery on children).

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