Hillary Cass at Scottish parliamet - live

@Sloejelly to answer your question, this ⬆️ has been the answer I've had from pretty much every adult I've spoken to.

I've moved on with a "well, we can come back to the belief vs fact another time because what's more important really is the impact of this on distressed children, on women's sports etc.". In other words I've let it go and left it hanging there. A few adults have later come back to me and asked me to talk about my lack of belief and/or my "gender critical belief". Many end up saying that "of course sex is real. It's odd that you are referring to it as a belief" - to which I agree and say it's just the legal position (and then we talk about a few tribunal cases, and how important sex-segregated data can be or how important it is for fairness in sports).
Obviously everyone has different ways of engaging but I've found it to be a useful way to have conversations.
I suspect that most people end up getting to a point where they don't believe they have a gender identity, but I never push for that as the outcome of the conversation - in the same way as I would never push for anyone to deny their faith just because I personally see it as "illogical". It's the enforced belief that's the issue and/or people accepting it as if it's simply fact.

I spoke to a therapist about whether it was a viable conversation to have with children (specifically my own "gender distressed" child), to unpick the difference between belief and fact. Her advice was no, because in teenage years, your truth comes from your tribe and we're programmed to keep looking for our own "tribe" during adolesence. That's obviously what makes children so vulnerable but it's also why challenging anything that the tribe says is going to end up going nowhere.

I haven't heard a definitive definition of gender and its expression that isn't covered by the word "personality". To me they are synonyms.

Yep. I have also had to push back aginst that one. It's infuriating.

Possibly. The reaction from my children in their most ardent ally phase was that I really did have a gender identity, whatever I might think, and that I just hadn't noticed it because it was congruent with my sex.

BonfireLady thank you for your assessment of Cass. Do you think she has met any nonbelievers? What would be her reaction to them/us? That she wouldn’t believe us and think we are denying ‘our truth’?

To add on "trials": observational studies will be useful using whatever is a available, be that retrospective follow-up now that the receiving adult clinics have been ordered to share their data, tracking children in other countries where PBs and cross-sex hormones are used or tracking children who follow the new design of holistic pathway (which hopefully puts 99.99% in to a different route after differential diagnosis to unpick autism, internalised homophobia, trauma following sexual assault etc).
I think two key things will be clear from these studies:

1. it will be difficult to conclude anything as it's not easy to standardise any of it, except the last part in the new clinics 2) it will become apparent that studying data on people who were given irrerversible treatment as children feels ethically uncomfortable very quickly. It's akin to all the data we now have following the Nazi experiments. I remember doing my scuba diving course and being told that a lot of what we know about the impact of pressure on the body comes from those experiments. Obviously it's "great" to have the data, but at what cost?

I finally got chance to listen to the whole hour and RTFT (busy week.. than you for starting this thread Arabella 🙏) which meant that I ended up hearing the vote in parliament before this. It was an interesting way round to experience it.

One of the first things that struck me from the report was that Cass really does believe that everyone has a gender identity. The report refers to it as a truth. Thankfully in 8.23 it gives wiggle room to challenge this by saying we don't know enough about what it means.

Cass' answers in this Q&A underlined that this is her belief. The part that gives me hope, visible both here and in the resultant vote, is that even a believer can see that "gender affirming care" is completely inappropriate.

I'm in agreement with PPs who say that if she'd gone in harder, the whole thing would have been dismissed. If Be Kinders (who haven't really thought that deeply) listen to this Q&A, I think many would do exactly as the politician with the red hair (sorry, I've forgotten her name 🤦‍♀️) and conclude with a grateful "thank you. The power of clear words".

What we really need next is statutory guidance in schools and a huge shift in thinking across all of the teams that support children in education and healthcare. The draft government guidance on Gender Questioning Children states that not everyone believes we have a gender identity. This is key to unpicking all of it.

While I admire the game I suspect Cass is indeed playing, I wonder whether, in time there will come to be regrets over not taking a harder line. If we eventually want to bring these doctors to justice, giving them any kind of wriggle room that allows them to justify continued experimentation on children might be seen, with hindsight, to have been a misstep.

I think she was game-playing to a degree (particularly on the trial stuff - I can't imagine much will pass ethics approval other than something observational like lechiffre55 has mentioned) but is a genuine believer. As per my comments above, I think her contribution has been exactly what's needed at this stage. But yes, I have the same concern that it may not be enough. I hope that's not the case.

Prior to this approach being so public, it wasn't clear to everyone there was no "middle ground" where you could just believe that everyone has a gender identity and that's it. If you believe, the rules were that you have to support all of it (women's sports etc etc) but if it got too difficult to unpick the cognitive dissonance, you could just ignore it and say "it's complicated". Putting children's health under the spotlight like this has really forced the believers to think. It's held up a mirror: to use an analogy, if all believers in God/Allah were required to support suicide pacts/attacks as part of their faith, there would be pushback. Thankfully this isn't being asked of all Christians and Muslims, so believers in these faiths can carry on believing in their respective god. However, people who believe that "we all have a gender identity" are being asked to support something that is similarly unethical and abhorrent: the irrerversible medical experimentation on children and young people. This report gives believers a chance to reverse ferret their support. The big difference is that, unlike religions, the belief itself still forces all children and young people down the radicalised route. Schools are the next big battleground for public focus. Thankfully this has already got large headway and Cass has made it possible to talk about it publicly.

I think it's a very, very difficult tightrope to walk for clinicians.

This patient group (and I include parents as part of the group really, especially for younger children), are extremely motivated to want medication. This isn't unique to gender medicine - there's a whole history of pharmaceutical companies/pressure groups targetting/funding/influencing patient groups in various ways, some you might agree with and some you wouldn't.

I think Cass and her colleagues are probably following a harm reduction path - is binding a great idea? Well it's better than a mastectomy. Are cross-sex hormones a brilliant plan in your 20s? Well, better than at 15.

They're also operating in a health environment where psychological interventions are severely rationed, plus with the added burden that if you're working with a patient group that are highly resistent to talking therapies then you need to wait for them to be more open. It's really tough.

I agree, "gender" may be considered a fluid thing if you listen to people who say they feel "more boy" or "more girl" from one day to the next, but it's based on a highly regressive set of stereotypes that treat sexed bodies as if they were a set of interchangeable parts like an online avatar.

I wonder, optimistically, whether Cass could be the Golden Bridge we are all hoping for - because everyone can agree on the science. She has certainly provided a route for some to back away from their previous beliefs.

No, I don't like her suggestions about TruTrans/good for some children, but I absolutely accept that my desire to shout at the top of my lungs 'THIS IS INSANE. ARE YOU ALL MAD? GET AWAY FROM THOSE CHILDREN BEFORE I SHOOT YOU' probably isn't the most diplomatic approach (I would probably never do this, I'm a reasoned debate person, but inside I'm absolutely steaming).

I thought it was interesting when she said:

'It's a tough time to grow up. But secondly, a much more fluid approach to how young people see gender. They see gender much more flexibly than, say, my generation did.'

I think I would disagree and say that the predominant strain of gender identity ideology is very much about rigid stereotypes and, in recent years, society has become less open minded about some of the sexist stereotypes (around personal appearance for example) applied to girls and women.

Also, Cass mentioned nurses in clinics teaching young girls how to breast bind safely and that concerned me. She described that, along with prescribing the pill to stop menstruation, as much more straightforward interventions than puberty blockers to reduce anxiety.

I’m honestly not trying to nitpick, I want children to have good evidence-based medical treatment and I’m very glad the Cass Report exists but just occasionally Dr Cass says things that give me pause for thought.

Cass referred many times in the interview to gender non-conforming children and that makes me worry that she doesn’t see the idea of gender stereotypes as being the problem. I think she sees them as a symptom indicating treatment is required rather than a cause of the mental health distress, if you know what I mean.

That is a worry. Children being distressed because they are gender non-conforming shows the problem with gender and a society that enforces it, not with the child. If we look to Afghanistan - how many of the women and girls they are distressed by the expectations imposed on them because of their sex? Does she think the answer is testosterone and mastectomies?

Are you new to MN? It’s very common for threads to drift as the conversation evolves. And the topic is still very relevant to Cass, as one of her core findings was that there is scant evidence to support the use of PBs.

you may have grounds for complaint if we end up discussing merchandise or edibles but by this boards standard we are very much on topic.

I’m very glad you enjoyed it and I agree that the interviewer asked very relevant and intelligent questions.

I think that, more than any other interview with Dr Cass that I’ve watched/read, I’ve come away from listening to it with the belief that Dr Cass thinks some people are TruTrans and that for some children the medical route will be the best outcome.

From her answers in this interview she said a few things that seemed to support the idea. I found that concerning because I genuinely believe the medical profession should never mess about with hormones and surgery to 'treat' a mental condition (or satisfy a paraphilia in the case of some adult men).

I’ll be interested to see what others think after listening.

Edited to add: Cass referred many times in the interview to gender non-conforming children and that makes me worry that she doesn’t see the idea of gender stereotypes as being the problem. I think she sees them as a symptom indicating treatment is required rather than a cause of the mental health distress, if you know what I mean.

@Sloejelly
Probably not but possibly if they were seen in NHS clinics for gender dysphoria/incongruence as young children and the records are still available.

They should be keeping good records now and that data should be available to researchers. I was shocked that many of the adult clinics didn't turn over their records for the Cass Review. I can't think of an acceptable reason for that. You'd think that they'd want the researchers to have as much data as possible in order to retrospectively try to learn what worked and what didn't. If something worked, why wouldn't you want others to use that treatment for similar patients? If it didn't, why wouldn't you want others to avoid or at least modify it? (Using those records to learn this and maybe find particular subgroups for which treatment A/B/C was helpful or harmful and in what ways is what I was talking about.) The fact that they didn't willingly turn over the records speaks volumes about their concern for their patients. I was shocked that so many refused to do so.

I was expecting the thread to be limited to what Cass said in the parliament and the responses there.
It's evolved into a discussion of the uses of PBs, which would have warranted its own thread.

I am terribly sorry if my post came across as rude, it certainly wasn't intended that way.

Ah, you mean like the middle aged men, who received no ‘treatments’ as teenagers, who are now transitioning and say ‘if only I had had puberty blockers when I was a child, before I got married had kids and watched them grow up, then I would pass better now’ and taking that data and applying it to the current population attending GIDS services?

AlisonDonut
Gender distress = wanting to be/thinking they are really the opposite sex; not wanting to be the sex they are and being very unhappy.
It is the correct way of describing the predicament of a child - rather than the phrase "trans child".

It's a real mental health issue but it is a symptom. What's gone wrong is that GIDS treated gender distress as if it was a condition in itself or an indication of incongruent "gender identity" (which is made-up nonsense), as opposed to a warning sign of underlying conditions.

@Sloejelly
You could only say that some appeared harmed less than others. You could not tell if they are in a better position, despite the harms they have suffered, than they would have been had they received alternative treatment (eg psychotherapy) or no treatment.

My hypothetical was tracking the whole group so that you might find subgroups who might potentially benefit from a treatment, e.g., in the hypothetical, 100% of that subgroup of autistic boys who had gender dysphoria and incongruence before age 4 continued to have gender dysphoria and incongruence as adults, Assuming it's a large enough group, once you have identified that subgroup, you can try various treatments on those with the characteristics.

I don't understand what harms you mean since you wouldn't have used any particular treatments on them yet. You're looking at the data you presumably will get from the clinics in order to try to find subgroups that you hypothesize might benefit from future treatment, and only at that point trying treatments on them (e.g., cross sex hormones, psychotherapy, both, neither). That is the point I would look to see if a treatment helped or harmed.

In the face of it, I’d agree. We all think here that children have been, and continue to be harmed, and that medical staff should take the most conservative, cautious, do no harm approach. It seems blindingly obvious to us.

however, many other people don’t look at healthy young women having undergone mastectomy and think “harm”, they think “success”, “he’s happy now” “what’s your problem”. We have to accept that’s what some people really think and that our preferred approach is the harmful one. And without properly generated evidence either way the general population are just going to think it’s a shouting match between two bunches of ideologies.

Great post.
Women on FWR have been pointing out for ever (with many being deleted ) of the impact of this social grooming on children. There's so much evidence about how abused children and young people see abuse as the norm once an abuser has successfully eroded their boundaries.

Professor Alexis Jay who led the Rotherham inquiry into the grooming of young girls and the government's Independent Inquiry into Chile Sexual Abuse said parallels have been drawn between what she discovered and the findings of the Cass Review. Nobody has been allowed to intervene with these children and young people - not even their parents - for fear of allegations of transphobia & bigotry.

https://www.holyrood.com/news/view,scot-who-led-rotherham-inquiry-warns-of-parallels-with-cass-review

Stop all medical treatment of children for ‘gender distress’, stop the indoctrination in schools and children’s media, and remind girls that there is nothing about short hair/mechanics/football/leadership/trousers/avengers/physics that stops them being for girls, and remind boys there is nothing about long hair/pink/glitter/dolls/caring that stops them being for boys. But that there are two sexes and it is impossible to change sex.

It is possible to use the word of others to reference what they are saying without agreeing with what is being said.
The mere use of those words does not signify agreement, it is reference to what other are saying.
This jumping up and down at the slightest language infraction feel purile and pointless.
If you want to propose better terms that don't upset your delicate sensibilites then do so but for fuck's sake please stop squaking like a chicken having a fit every bloody post. It's not constructive.

Kids are having issues, I believe those issue to be mental problems, the kids express those problems using language around gender and all sort of made up nonsense that they have been fed. Referencing what they say is not agreeing with it.