Cass review - out on Wednesday

Just watching Hannah Barnes on Newsnight. Victoria Derbyshire with her. Articulate and on point. Well done.

No sign of the usual pics of tomorrow's front pages on the BBC news app. Hmm, I wonder why.

I was feeling tired but having seen those front pages I feel very awake!

So many people are going to be so very pissed off tomorrow!

Here’s another

Those front pages! Brilliant

Typical of the Guardian, you can’t find that article on the front page of the website without digging for it.

Barnes, not Barney!!

The Guardian front page

The Mail front page

Hannah Barney's about to come on Newsnight (about 5 mins)

Only a photo at the moment, but the times front page is below

KJK on YT discussing the Cass Review. She has a copy.

I'd be interested to hear your thoughts after it's published. Both my kids pre-school setting and after school setting have had trans/NB staff and have told my kids it's possible to change sex and I would like to be able to respectfully challenge this - and stop them from discussing it with young children who are clearly too young and will believe whatever a 'teacher' figure tells them.

Hannah Barnes has just tweeted a picture of the BBC saying it's good to be back. Hopefully she will be on several programmes tomorrow

Interesting discussion of Cass tomorrow on reddit (Reddit TrangenderUK comment) including a link to a leaked version which appears to have been closed down since some of the commenters commented on it.

Much as expected, plus recommendation for no medical treatment until age 25.

https://www.theguardian.com/society/2024/apr/09/cass-review-nhs-children-gender-dysphoria

“This new approach advised that as well as thinking about gender identity when meeting patients, clinicians should consider adverse experiences, sexual orientation, mental health, and wellbeing at school.”

Lol, holistic care is hardly a new approach is it?

We can’t be far off a case of a teacher being sued for transitioning a kid in school without parental knowldege. Tory are not psychologists or doctors so they can’t rule out eg autism so they should not be doing any social transition

Am going back to this because it happened to us, during lockdown and I had to fight very hard to get it pushed back. But the upheaval and additional distress caused by a lawsuit would have just added so much grimness at a really difficult time anyway, and the last thing you want to do is make things worse for your child when you are already doing something they don't want you to do. So can't ever really see this happening. Perhaps unfortunately.

Lots of useful food for thought there @Brainworm

On the subject of the "lobby groups", I agree entirely. It's great that groups like Sex Matters etc press for change and raising awareness but ultimately, the actual changes need to come from within the NHS, DfE etc.

Again, this points to the significance of the CAN-SG conference. It's part of the roadmap towards effecting the changes that are needed in the NHS, where the inputs from the different "lobbying" organisations can be shared and challenged (alongside the evidence) and either consolidated or rejected.

As for autism groups lobbying and being captured by gender identity... I really hope that the nudges like the "up to 25 years old" from the leaked/reported information on the final report will end up circumventing their impact on what happens in the NHS. The input from the autism groups is rather like turkeys voting for Christmas on this subject.

On the subject of the leadership in the NHS, hopefully there will be someone at or near the top who is steering it with integrity. I watched the Marcus Evans interview on Heretics last night and although a lot of what he said on this subject is covered in Time to Think, it was interesting hearing it from his viewpoint, as a former governor of the Tavistock and Portman Trust.

@Brainworm Wonderful post, lucid and perceptive, particularly when explaining the dangers inherent in only listening to people with 'lived experience'.

Corgi, I agree with you that continuing to present as the opposite sex isn't the best solution for the vast majority of these children. When GIDs was set up, it was a designed as a highly specialist service that was considered applicable for a very small number of children. It defies belief that the clinical directors and governors at the Tavi failed to properly oversee and intervene when the service started morphing into something completely different.

GIDs was a cash cow for the T&P Trust, which over time has lost a number of national contracts and, up until recently maintained little financial oversight of income versus expenditure. It is in a very precarious financial situation and the closure of GIDS presents a significant dent in income. I expect the repetitional damage from the GIDS scandal will impact on the number of people wishing to undertaking training courses there (they were once considered a world leader in psychoanalytic and systemic psychotherapy), which was also an income generator - but small fry compared to the national contracts. Whilst these departments had little or no involvement with GIDS (which was a closed shop), I expect they may well be tainted by association.

Since the announcement of the closure of GIDS the Tavi has appointed a new CEO and a new Chair of Trustees. The outgoing post holders left by choosing and there was no hint that it was under any kind of cloud.

I am not sure whether the new leaders will be inculcated into the widespread delusion that permeates the organisation that criticism represents misunderstanding and a lack of willingness to tolerate the complexities of life.

I agree with this. I saw WPUK retweeting an old tweet of theirs on Fraser/Gillick. It didn't grapple with the topic and the article said they were tweeting "as a feminist organisation". Well so what? Unless you're focused on women and children, and/or have a child specialism, or a safeguarding arm (adults and/or children), unless you're going to get into the meat of the topic, why get involved? Here it is, it's strange especially as at the end they zone in on contraception while seemingly trying to talk about GIDS matters.

https://x.com/womansplaceeuk/status/1777615018109882413?s=46&t=WHoOZ3Kv5G6-FyQuvE0LQ

womansplaceuk.org/2020/10/11/wpuk-gillick-competence-fraser-guidelines/

this can't just apply to Mermaids and GIRES, it also needs to apply to Sex Matters and Let Women Speak

I agree with this; the whole thing needs to be thrown back to evidence based health care.

That's very interesting Brainworm, I will bookmark your post. I absolutely agree that clinicians, psychotherapists and counsellors etc should not base their practices on the views of any given special interest group.

I'm not aware that Sex Matters would give an opinion on healthcare per se as that this not their specialism. LWS is a completely different type of thing - not really an organisation, more a movement that organises events to, well, let women speak!

Whatever goes on with healthcare it needs to be broadly consistent with other things that are and aren't paid for by the NHS in terms of physical interventions to treat psychological issues. Eg when is a breast reduction or augmentation allowed for women with severe body image issues versus when are breast implants given to a man who wants to be a woman? Another example would be something like this story: : Quebec man has two fingers amputated to cure body integrity dysphoria | National Post

Brainworm I think we'd all want option 2: To eliminate distress and improve immediate and long term quality of life.

The question is how you go about that. What Hannah Barnes found, and I think Cass will find too, is that in children, much of that distress which manifests itself as gender dysphoria is the manifestation of other problems: neurodiversity, sexual abuse, bullying, depression and so on. If you could tackle those, the dysphoria goes away.

So I think it's immensely unlikely that continuing to present as the opposite sex is going to be the solution for the vast majority of these children.

Whilst it is a bit of an oversimplification, I think there are 3 competing views about what the goal of treatment in a gender clinic should be:

1. To enable patients to desist with their gender identification
2. To eliminate distress and improve immediate of long term quality of life
3. To facilitate medical transition to anyone requesting it to affirm their gender identity

No doubt options 1 and 3 have in mind reducing distress and improving quality of life, but their outcomes involve a gender-related outcome, whereas option 2 doesn't.

I think Cass will present the second option, causing upset to those seeking options 1 and 3.

I think option 2 is the right way forward because there are as many ways out of gender distress and there are ways in. I have encountered people who can and do live their best lives with what they understand as being a gender identity that is incongruent with their sex. They are resilient and comfortable in themselves and their understanding of themselves. They lead happy lives knowing that other people may not and do not see them the same way as they see themselves. I have met more children for whom this isn't the and their gender distress is a symptom of other issues that need addressing and, once addressed, the gender distress has disappeared.

When it comes to healthcare, most on this board will agree that this shouldn't be based on the demands of specialist interest groups, but this can't just apply to Mermaids and GIRES, it also needs to apply to Sex Matters and Let Women Speak (I don't know if they have even given views, but they are two examples of GC groups that came to mind as exemplars).

The lack of confidence is the past model of provision is justified, and its understandable that interested parties will want to have a voice and their voices should heard, but the solution isn't to stop responding to the demands of one interest group and, instead, respond to another.