Even though LGB teens are at the centre of this issue, the University of York’s international survey found that only two out of the ten clinics surveyed broached the subject of sexuality/sexual orientation with its patients presenting with gender distress (p. 135). The York synthesis of international guidelines found that the guidelines issued by the World Professional Association of Transgender Health (WPATH), a pro-affirmation lobby group that has had immense – and we would say, malign – influence on practice in this field in the UK and elsewhere, does not include sexual orientation as a “domain” that should be assessed (p. 135, Table 7).
The often-cited clinical consensus on the benefits of the “gender-affirming” approach is misleading. It is based on a circular process in which WPATH quotes the guidelines of other organisations – which were either prepared with WPATH’s help or based on WPATH’s own guidelines.
It is not commonly known that most of those seeking “gender care” are LGB teenagers, and in particular lesbians. The public perception is doubtless influenced by the fact that LGBTQ+ support groups mainly endorse “gender affirming care” (Appendix 9, p. 7), in which a girl who says she is a boy must be affirmed in that belief. LGB Alliance emphatically rejects that view.
Cass rightly observes that in some strictly religious cultures, being transgender is seen as preferable to being same-sex attracted as it is then perceived as a physical rather than a psychological issue (p. 119).
Most children who are unhappy with their sexed bodies later desist. “A study followed 2,772 adolescents from age 11 to 26. Gender non-contentedness (as defined by the question “I wish to be of the opposite sex”) was high in early adolescence, reduced into early 20s, and was associated with a poorer self-concept and mental health throughout development. It was also more often associated with same-sex attraction when compared to those who did not have gender non-contentedness” (p. 122, from Rawee et al. 2024). They do need time to think, but as Cass points out, “There is no evidence that puberty blockers buy time to think” (p. 32).
A survey of detransitioners found that 23% gave homophobia or difficulty accepting themselves as lesbian, gay or bisexual as a reason for transition and subsequent detransition (p. 188). LGB Alliance is pleased that these figures will now finally reach a wider public, but full of sadness and frustration that it has taken so long.
It is extremely worrying that precisely the response recommended by Cass – a holistic approach, involving careful exploration of the underlying issues, is rejected by the secretive but influential Coalition Against Conversion Therapy, chaired by Igi Moon – and by all its many signatories. They regard an exploratory approach as a “conversion practice” and that is what they seek to outlaw with their drive to ban “transgender conversion practices”. LGB Alliance was very pleased to see the recent announcement by the professional organisation UK Council for Psychotherapy (UKCP) that it has withdrawn its signature from the Memorandum of Understanding on Conversion Therapy – and cancelled its membership of the Coalition Against Conversion Therapy – because it rejects the inclusion of minors in the MoU. Hopefully more will soon follow. Cass recommends that clinicians should “seek to understand the child/young person’s emerging sexuality and sexual orientation, consistent with assessments in other adolescent settings, where deemed appropriate to age and context.” (p. 143).
Cass refers to a very worrying situation – in part the result of the efforts by Igi Moon’s group and other “affirmative approach” activist clinicians. That is the reluctance of clinicians to engage in the clinical care of gender-questioning children and young people. They are worried about making the wrong judgment and also express concerns about potential accusations of conversion practice when following an approach that would be considered normal clinical practice [italics ours] when working with other groups of children and young people.
They do make other observations, but thought it important to have the issue that so many young women are thinking they must be trans, and that so many young people seem to be able to think they are trans but not same sex attracted.
ie anti gay and anti lesbian attitudes are still ruining young peoples lives.
They have published their whole statement at https://lgballiance.org.uk/lgb-alliance-response-to-the-final-report-from-the-cass-review/