The Cass Review- Interim Report

Mermaids didn't even think any kind of psychotherapy was necessary before treatment

The 'best practice' they link to doesn't see this as a requirement either

Some quotes from that document

Autonomy in the context of transgender healthcare involves transgender people being able to able to make informed choices for themselves regarding gender affirming care and being free from experiencing harmful pathologisation and other barriers to accessing this care.

While many trans people access psychotherapy for support with living in their affirmed gender, psychotherapy is not a requirement of accessing gender affirming care.

Include mental health issues as part of a holistic psychosocial assessment, for example discussion of anxiety, depression, risk of self-harm, while being clear that having mental health issues is not a barrier to accessing gender affirming services

Puberty blockers are considered to be fully reversible and allow the adolescent time prior to making a decision on starting hormone therapy.

There are also handy consent forms in the Appendix

Go back to the 2019 hit. It's there.

The article can be found in archive.org, just paste this into its search.

www.yorkshireeveningpost.co.uk/news/health/from-jack-to-jackie-why-i-had-sex-change-at-16-1-4018711

(I think Mumsnet blocks actual archive links?)

The post by @OldCrone in that thread on the 24th of March at 22.23 is eye-opening. The article can't be found if you click on the link, but OldCrone has copied and posted some of it.

Little fucking wonder that there is no evidence base for operating on children who play with the wrong toys.

I haven't read the full report, do they reference what's happened in Sweden?

Can't see anything directly - it actually doesn't seem to refer to recent policy changes elsewhere. International stuff is limited to the evidence base for the treatment.

I guess it's trying to stand on its own working from primary sources, rather than reference other similar reviews.

Mermaids are shitting themselves because they know how much influence they exerted on the Tavistock and various clinicians.

Yes, Polly Carmichael herself said so, didn't she.

Mermaids didn't even think any kind of psychotherapy was necessary before treatment!

Susie Green 🧜‍♀️
@green_susie100
Marci Bowers saying surgery should be allowed based on competency NOT age of majority. Psychological assessment should not be needed for surgery as this is not required for cisgender surgeries of ANY type. Removal of the sterilisation clause is key 💜 @Mermaids_Gender #WPATH2018

www.mumsnet.com/Talk/womens_rights/a3541977-Another-Mermaid-statement-about-Good-Morning-Britain-and-Caroline-Farrow?msgid=85831267#85831267

In fact, that entire thread is absolutely gobsmacking. I'd forgotten quite how involved in all this mermaids were/are.

www.standard.co.uk/news/london/tavistock-centre-gender-clinic-young-people-children-nhs-report-b987475.html

I haven't read the full report, do they reference what's happened in Sweden?

PMK

Mermaids are shitting themselves because they know how much influence they exerted on the Tavistock and various clinicians.

They also know how much they've added to the trend in the media, as mentioned in the report.

There's many pages on previous mermaid's websites that I really hope are archived. I remember certain things written, I don't know how to then.

It is interesting if they are linking to NZ. Did they then include this from the RANZCP?

www.ranzcp.org/news-policy/policy-and-advocacy/position-statements/gender-dysphoria

The Royal Australian and New Zealand College of Psychiatrists recently updated their guidance last year. I wonder if Mermaids paid attention.

Last year, they warned that there is NOT ENOUGH evidence to recommend affirming only treatments or indeed any particular treatment plan. They said that underlying health issues should be treated at the same time. And warn that medicalisation of children and teens should be very carefully considered and thoroughly explored considering the ‘paucity’ of evidence at this time.

The Cass report confirms that 6 months on there is still no evidence to support affirmative only options, particularly for females.

If Mermaids were relying on NZ for their foundation, they obviously ignored the clinician body’s recommendation. Talk about cherry picking to find something to grasp onto.

They also chose the BPS guidelines for Psychologists working with adults (18+) so not at all relevant to the cohort the Cass Review is looking at.

Mermaids choose the guidelines from NZ, population 5 million, a document written in Māori & NZ English?

which simply means supporting a young person’s understanding of who they are while taking an exploratory approach.

What are they defining as an exploratory approach?

Because I seem to remember Susie Green saying that you 'cannot make a child trans, and cannot make a trans child not trans.'

No room for any kind of exploration in that statement.

Did anyone click the link 'best practice'?

It takes you to these New Zealand Guidelines!

Yes, I did. And it left me somewhat in admiration of Mermaid's chutzpah in declaring something is best practice because they've decided it ought to be, on the basis of no evidentiary or clinical standing that they've shared with the public.

Mermaids are not trying to let their patients down gently, they’re trying to delicately extricate themselves from any potential legal fallout.

Yes they do it every time there’s some kind of review/enquiry. When the Education dept said that no child was born in the wrong body, Mermaids did a complete reverse ferret. It would be funny to watch if it wasn’t children's lives they are experimenting with.

Mermaids are not trying to let their patients down gently, they’re trying to delicately extricate themselves from any potential legal fallout.

This is an interim report. Almost by definition, you can't expect it to contain conclusions.

I believe this is presenting the evidence they've gathered and giving parties a chance to point out anything they've got wrong or missed before they proceed to the completed report, which I would expect to have firmer views and recommendations.

On best practice... the Cass Review only says "this term exists and is used in some locations". There's no opinion given about it. There's information in the report such as:

"From the point of entry to GIDS there appears to be predominantly an affirmative, non-exploratory approach, often driven by child and parent expectations and the extent of social transition that has developed due to the delay in service provision"

But no view expressed about it.

The organisations that have espoused social transitioning and ideas of having an "innate gender identity" etc aren't going to stop. What will their training deliver? Who would pay for it? They need "best practice" to be accepted as such.

I don't think this is a reverse ferret. They've slightly softened their position by saying good care must be provided but then they go right back to where they were. And none of what they point to, is produced by them so it'll be "not me, guv".

We know that Mermaids have form for executing the reverse ferret. Remember how you could be born in the wrong body but then it turned out that’s not what they meant to say? Except by that point, the concept of being born in the wrong body had been well and truly cemented in the minds of many kids, families, schools……so, damage done.

Regarding the lack of access to timely care, I think one problem is that the demand for gender services has absolutely erupted in recent years but where were the specialist clinics and professionals suddenly supposed to emerge from at the same rate? From an epidemiological point of view, these services don’t just emerge from nowhere, the need for them has to be tracked and planned for. But it’s hard to do that when the population they’re trying to serve has just appeared en masse as if from nowhere. It’s hardly a normal pattern in most areas of public health.

It takes you to these New Zealand Guidelines!

researchcommons.waikato.ac.nz/bitstream/handle/10289/12160/Guidelines%20for%20Gender%20Affirming%20Health%20low%20res.pdf

Artichoke

Which is why I think the approach outlined in Cass is right: more services, more widely distributed, more easily accessible, but not necessarily giving the service users what they think they need - instead, actually giving them what they need.

I just hope this is what occurs.

That.

Plus the frequent lack of any urgent, purposeful action to address the situation for a kid in distress, which makes anything within the power of the child and family to do themselves so much more attractive.

If you look at narratives like the fox basher's, it's all to do with now now now, action, fast, change, do something. That's very attractive when the actual services are swamped, slow, ineffective and in practical terms offering very little. And inevitably gatekeeping and channelling happens in swamped services; there will be the temptation there to funnel certain kids straight to another service without unpicking more complex needs.

There's the other problem in that narratives that are about respond immediately to the intense distress and do something, anything, to alleviate it is not a professional or therapeutic approach. Helping someone to be able to tolerate distress and uncomfortable feelings is a huge part of helping, but it has to come fast enough and purposefully enough that the person doesn't just feel abandoned and grabs for any other pain relieving solution.

But yes. Mental health services for kids are abysmal and have played a very large part in all of this coming about.

How do wait times for Tavistock compare to wait times for CAMHS?

A major concern is that if there is a diagnosis of Autism CAMHS will wash their hands of the YP, even if the issue isn't related to the autism diagnosis or is something that needs specialist input. The danger therefore is that a significant cohort of children will still effectively be ignored by CAMHS.