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:
- To enable patients to desist with their gender identification
- To eliminate distress and improve immediate of long term quality of life
- 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.