There's a couple of points in there in particular that make me raise an eyebrow:
“Suicides of patients on treatment were not formally discussed," & lessons not learned.
Transition is all about stopping suicides apparently. So where there have been some, no one has thought 'how can we improve care and stop this repeating'. As long as they are getting care that's everything. Doesn't matter if it's shockingly poor standards of care, or inappropriate care, just as long as they are affirmed and medicalised.
Cass told. In one clinic “regret was treated as a new episode of dysphoria.”
So regret and detransition wasn't in the radar at the same time as the effects of drugs apparently being 'fully reversible'. How can you reverse if it's not acknowledged as a possible outcome?!
“There was a philosophy “that it was up to patients to make their own mistakes."
That's completely devoid of medical liability as a hcp. You can't just abdicate that responsibility legally. If they have been acting in this way it opens up a whole can of worms about possible litigation.
Workloads were described as “unmanageable”, with some holding responsibility for “many risky patients”, and leaving the service as a result. “Medical practitioners who left... described doing so because they were worried that they could not defend their clinical practice.”
What's a 'risky patient '? Is that a reference to unstable mental health? And in what way? Or are they actively dangerous? Or do they threaten staff or make unreasonable demands? What does this section even mean!
Much to unpick on this.