The Cass Review- Interim Report

Cass writes with powerful clarity in that BMJ piece.

Review of gender identity services for children and young people
BMJ 2022; 376 doi: doi.org/10.1136/bmj.o629 (Published 10 March 2022)
Cite this as: BMJ 2022;376:o629

My interim report sets out my initial findings and advice. Here I set out my more specific reflections for clinical colleagues.7

Children and young people with gender dysphoria must receive the same standards of care as every other child or young person accessing NHS services

Primary and secondary care clinicians have reported to the Review that they are nervous about seeing children and young people with gender-related distress because of lack of evidence and guidance about appropriate management, and the toxicity of the societal debates.

Some clinicians also reported feeling unable to undertake the process of assessment and differential diagnosis that would be the norm in their clinical practice because they perceived that there is an expectation of an unquestioning affirmative approach. They felt that this was at odds with a more open and holistic evaluation of the factors underpinning the young person’s presentation, and consideration of the full range of possible support and treatment options.

As a result, a majority refer directly to GIDS, where the waiting list now exceeds 2 1/2 years. This means that these patients are not receiving the same level of care and support as other similarly distressed young people, despite being at high risk of mental health and safeguarding issues.

I'm inclining more to my previous interpretation of "not neutral" as above (of course I would).

(Though I do have a theory why that might be...)

C+P of 2 of the fox batterer's tweets from that very long thread.

If you are a young trans woman, absent puberty blockers, your voice will drop and you will develop an adam's apple and this will make it very, very difficult for you to 'pass' as what you feel to be your gender in later life.

And, in a society that is transphobic, you know that the changes that are happening to you will impede your whole life and existence. Put bluntly, they will mean a lifetime of people discriminating against you and sneering at you.

He's a little ray of sunshine, isn't he?

I'm not sure why someone with his privileges of power and influence doesn't use them to fight alongside feminists to change attitudes to 'gender', rather than encouraging young people to take strong drugs to change their healthy bodies.

Thank you for posting this here. I just hope that all those within the system who have been raising safeguarding concerns for years will know their fight is finally exposing the whole scandal. And that those who are still in thrall to the ideology take a serious look at themselves and the damage they have done.

Some clinicians also reported feeling unable to undertake the process of assessment and differential diagnosis that would be the norm in their clinical practice because they perceived that there is an expectation of an unquestioning affirmative approach.

Let's hope that puts paid to the nonsense that 'curing children of gender dysphoria' is conversion therapy.

The initial responses by trans activists were mixed, with positives coming from the idea that having many more gender clinics was being proposed. However, the consensus is shifting to "it's a betrayal of trans kids, Cass is secretly gender critical".

Cass has published an Opinion piece in the BMJ:

www.bmj.com/content/376/bmj.o629

I'm not on Twitter, and provided I don't click on anything I can access it?

His tweets are all there, he has not deleted them, and I can access them from my twitter account, maybe you are blocked?

So, more scaremongering /No Debate from Kimonoboy, then.

Something scared him into protecting his tweets though.... I'd love to know what.

Sorry, Helleofabore, my rubbish slow typing means I crossposted with your much better analysis..

[quote Awkwardy]The Cunning Little Vixenkiller has a different take...

twitter.com/JolyonMaugham/status/1501884753309483010?s=20&t=XCQA2DceuQ-K6hP2EjgWqg[/quote]
Central concern seems to be who makes the decisions, the transchild/woman (again, no mention of natal females or ROGD in his analysis) or the medical professional. Absolutely ignores the interim Report's points about other diagnoses and social pressure which may impact/influence/destroy the patient's capacity to make the decisions.

So, more scaremongering /No Debate from Kimonoboy, then.

Counselling, social or psychological interventions – these may be offered before, instead of, or alongside physical interventions. Again, they should be viewed as active interventions which require robust evaluation in their own right.. p 63

As usual, people like Maugham focus on the males. He, along with others ignore these sections:

5.9. As previously indicated, the epidemiology of gender dysphoria is changing, with an increase in the numbers of birth-registered females presenting in early teens. In addition, the majority of children and young people presenting to GIDS have other complex mental health issues and/or neurodiversity. There is also an over-representation of looked after children.

5.10. There are several implications arising from the change in epidemiology:
● Firstly, the speed of change in the numbers presenting means that services have not kept pace with demand.
● Secondly, the cohort that the original Dutch Approach was based on is different from the current more complex NHS cohort, and also from the current case-mix internationally, and therefore it is difficult to extrapolate from older literature to this current group.
● Thirdly, different subgroups may have quite different needs and outcomes, and these must be built into any service design, so that it works for all children and young people.

5.11. At present we have the least information for the largest group of patients – birth-registered females first presenting in early teen years. Since the rapid increase in this group began around 2015, they will not reach late 20s for another 5+ years, which would be the best time to assess longer-term wellbeing.

page 58.

It is always about the males. Always.

[quote Awkwardy]The Cunning Little Vixenkiller has a different take...

twitter.com/JolyonMaugham/status/1501884753309483010?s=20&t=XCQA2DceuQ-K6hP2EjgWqg[/quote]
What he seems to be missing with his talk of 'trans children', is that the report would indicate that there is actually no such thing. That it's a definition grasped by children with a multitude of other issues.

Although when she discusses the fluidity of gender amongst youngsters, that does muddy the waters a bit.

And yes, as a previous poster says, that fluidity is incredibly superficial and looks as though it just involves hair dye and clothing.

The fox killer is wondering about all these parents and children left high and dry without puberty cancelling drugs. As soon as gender ideology stops getting taught in schools and off social media, that number is going to drop drastically. And those troubled children will be allowed to access the right kind of treatment for their individual conditions.

To me there's always this glaring gap when people talk about treatment for trans children, because they never bloody ask what's caused it.

Nothing shows it up more than that. If hordes of children were suddenly suffering from something that needed urgent, irreversible treatment, one of the very first things you would be asking is why they've got it.

Not, as he does, just going hell for leather about how to treat it.

I was hoping that Hilary Cass would acquire information about the dark side of this issue. The pressures at play, and the adults involved.

Her talking about children being given lines to get drugs, it would indicate that she is.

Yes what Empressaurus said. Its all very "I know better than experts", and suggests that Cass has kicked the main recommendation down the road, ie whether young people know whats best for them, or medical experts do.

He had a long thread about how if a 'young trans woman' wanted blockers they'd get them one way or the other. I didn't read all of it but something about it being easier if they had rich parents who could take them abroad.

The link works for me if I am not signed in to Twitter and don't click anything regarding cookies etc.

[quote Awkwardy]The Cunning Little Vixenkiller has a different take...

twitter.com/JolyonMaugham/status/1501884753309483010?s=20&t=XCQA2DceuQ-K6hP2EjgWqg[/quote]
I just see that he protected his tweets. Dying with curiosity here, what did he say?

I'd say that we are more than averagely engaged readers of this report so I'd hope that the differences in interpretation are an indication to the report writers that this section needs to be clearer.

Since young people may not reach a settled gender expression until their mid-20s, it is too early to assess the longer-term outcomes of this group.
ScotGov - self ID at 16 with no way to legally detrans (as ever)

Thanks ROGD

The Cunning Little Vixenkiller has a different take...

twitter.com/JolyonMaugham/status/1501884753309483010?s=20&t=XCQA2DceuQ-K6hP2EjgWqg

4.5 We have heard that some young people learn through peers and social media what they should and should not say to therapy staff in order to access hormone treatment; for example, that they are advised not to admit to previous abuse or trauma, or uncertainty about their sexual orientation.

So, these children and young people are being told by others to deny their trauma to obtain a diagnosis that might not be right for them?

And activists cannot see the issue with that?

For those at the beginning of the thread concerned about the Dr Cass being put under pressure to change the report, I had the same thought and went to check it had been archived. It had; here's the link web.archive.org/web/20220310104606/cass.independent-review.uk/publications/interim-report/