Children 'weaponised' by both sides of transgender debate - Dr Cass | Sunday with Laura Kuenssberg
15th Feb 2026 - BBC News (9.27 mins)
Video Description
Children have been "weaponised" by both sides of a toxic debate about transgender rights, the author of a government review into the treatment of children and young people questioning their gender has said.
Dr Hilary Cass told Sunday with Laura Kuenssberg "people at the extremes" had caused "quite a lot of distress for young people". She also suggested "unrealistic images and expectations on social media" had misled children, and that if some young people had "taken more time" they might not have pursued medical treatments.
Her 2024 review found gender medicine had been operating on "shaky foundations" when it came to evidence for medical treatment.
The review was commissioned after concerns about the treatment of growing numbers of children and young people with worries about their gender, particularly at the Tavistock Clinic in London.
Transcript
CASS: I think it should be rare um and particularly rare in prepubertal children. And I think the guidance does a good job in explaining that you have to be particularly careful about young children because if they socially transition too early um we think they can get locked onto a trajectory that may not have been the correct natural trajectory for them. So super caution with the very young children.
KUENSSBERG: So for kids at primary school, you would say are on the side of caution in in every case because if not, it could set them on a path that they might not otherwise have followed.
CASS: Yes. Back in the day, oh, in the 1970s when they first started having clinics for children with gender dysphoria and gender in congruence. They were mostly prepubertal boys who felt that they were girls and left to their own devices because we didn't have hormone treatments and internet and all the rest. then most of them grew out of it and became gay men. So you the the risk of getting a child very fixed in a certain way of being too early is that you are not allowing them to develop and and work it out.
KUENSSBERG: How do you assess how many children and young people have distress that might be resolved as they grow up compared to the number of children and young people for whom this is going to be a lifelong issue?
CASS: When the clinic started there were about 50 children a year in the UK and then by the time I started my review it had shot up to three and a half thousand a year and we tried very hard to find out from the TAVIStock what happened to the ones that didn't go on a medical pathway and they just didn't follow them up. We didn't have that data. So that's one chunk of children who don't go on a medical pathway and then there's all the ones that you know parents and teachers will tell you about who go through two or three years of gender questioning and then desist. So I think it's probably a really tiny number and as I said even amongst the traditional the traditional cohort of the the birth registered boys um who presented prepubertally most of them grew up to be gay men. So it's probably quite a tiny number who are going to grow up, but I can't give you figures.
KUENSSBERG: What do you think is behind that change, that huge ballooning of the numbers of kids and young people who feel this kind of distress?
CASS: I think it's complex. Um there's never going to be simple answers to this, but there's a whole series of different pressures on young people now. Plus, there's a different kind of cultural context where people are in some ways less locked into gender stereotypes, so they can feel more flexible about their about how they identify. And that's healthy. Um, but I think what has kind of misled children is the belief that if you are not a typical girl, if you like, you know, playing with trucks or, you know, boys who like dressing up, that that means or or that you have um same-sex attraction, that means that you're you're trans. And actually, it's not like that. That those are all normal variations. And I think children were being and young people were being given a narrative that it's not okay to be anything but absolutely typical of the other girls on Instagram.
KUENSSBERG: It's interesting you say misled, and you mentioned Instagram and social media. Do you think then there's a generation that have been misled by social media?
CASS: I think they I think they have had unrealistic images and expectations on social media. even, you know, a lack of realism about what transition would really mean and how hard it would be. Because for those young people who are going to grow up and never be comfortable in their body, um, a medical transition is the only way they're going to be able to live their life successfully and comfortably. But if that's not the path that you were intended to be on, it's a it's a huge cost to go through, you know, quite um quite intensive medical treatments and sometimes quite brutal surgeries um when actually if you'd taken more time that might not have been your pathway.
KUENSSBERG: There are though young people and some families who feel that you've made it harder for get for them to get the treatment that they desperately want that they desperately need.
CASS: Well, I think the the the new centres will be making sure that every single young person has individualised treatment and there are more centres. There are waiting lists but that that was the case before I did my review and we are seeing the waiting list going down. So I think the biggest hurdle at the moment is that they are still working through this this big backlog.
KUENSSBERG: When it comes though to the trial. So there is a plan at the moment. The intention is that there will be a trial of around 200 under 18s um being put on puberty blockers. There are clinicians in your field who feel that is the wrong thing to do. And in your report also you say for under 18s they shouldn't be given anything that's irrevocable that might be a kind of sliding doors moment for them in their life and then they can't go back the way. So how do you justify it?
CASS: Well, so we don't have any evidence at the moment that puberty blockers are irreversible. There's been a growing belief that that that's the case. There's no evidence at the moment that they cause irreversible changes. But these children who are on this trial will be about the most closely monitored you could imagine. People will be very carefully looking at all aspects their cognitive development their psychological development their bone development and any hint that there are any significant long-term risk they would come off they would come off the trial. So, so it's ex it's a very careful trial, but what's much more worrying is that it's the children outside the trial who are getting these drugs from unregulated and dangerous sources with no monitoring um and possibly, you know, for the wrong reasons.
KUENSSBERG: For you, is it vital it happens?
CASS: I yeah, I think it's really really important because otherwise if we never answer this question, we're we're going to have ongoing um uh charlatans just handing out inappropriate drugs.
KUENSSBERG: It has been, as you said, a very fraught debate both amongst medical professionals and politicians. Do you think kids were let down by all the all the shouting from the adults?
CASS: Yeah, absolutely. and and were also caught up in all the issues about single sex spaces and sports and and safe safe areas for women which were actually not to do with the children but they were somehow part of a a football within it and and so you know that's that's that's a real shame that children have been weaponized
KUENSSBERG: Weaponized?
CASS: Yeah I think so by some people by people at the extremes the vast number of people in the middle are silent. Um, but the it's the people at the extremes who really have, I think, caused quite a lot of distress for young people. You know, even as there's been, you know, rhetoric in the press. It's frightening for young people.
KUENSSBERG: What do you mean by people at the extremes? Do you mean campaign groups or activists? Who do you mean?
CASS: So I think the people who have been activists on behalf of trans rights have actually in some ways been so strident that it's made it more difficult for trans people themselves who are just try quietly trying to live under the radar. Um and um and equally people who have taken a view that no one should ever transition have have similarly made it difficult and in a way I'm not really interested in the semantics of you know a trans women and that. There are a tiny number of people who will never be comfortable in their in their with their biological sex with the gender associated with their biological sex. And for them, a medical pathway is the only way they're going to live their life comfortably. And we don't understand why that is. But we have to try and help those people thrive as much as the young people who are going to grow out of this.
KUENSSBERG: You yourself came in for quite a lot of criticism by people on the extremes of both sides. At one point, you said you weren't even using public transport. Is that better now? How's it been? What kind of toll has it taken on you?
CASS: Well, that was just in the brief period immediately after the report came out. Um there's a there's a lot of noise on social media that you can just switch off as you know. And um the thing that really counterbalances it for me is that so many clinicians that I see when I go and talk at clinical conferences just come up to me and say, "Oh, thank you. so I can now just do the job I've been trained to do without being fearful of being called transphobic" or "Your report wasn't rocket science. It just makes good sense". And those comments from real people far outweigh the noise on social media.
KUENSSBERG: Dr. Cass, thanks so much indeed for coming and speak to us and having a calm and clear conversation about a very sensitive issue. Thanks so much.
CASS: Thank you.