Hilary Cass Shocked to Find Youth Gender Medicine Debate Politicized and Ignoring Evidence
“There are no new research findings and the MHRA hasn’t presented any new evidence,” Cass told the Observer, in response to the shut down of the clinical trial she proposed.
by Evan Urquhart
The inexperienced pediatrician brought in by a conservative government to end medical care for young trans people in the UK expressed her shock and dismay that youth gender medicine decisions have been politicized and divorced from the evidence, according to reporting by the Observer on Sunday, February 22.
Hilary Cass, whose review of the evidence in youth gender medicine recommended clinical trials, was responding to a recent decision by the medical regulator, MHRA, to pause those trials citing safety concerns about puberty blocker use. While the body raised concerns about bone and brain health, the drugs remain available to treat the psychological and social adjustment problems of children with early puberty, a condition that can cause distress but rarely includes any purely medical risks.
“There are no new research findings and the MHRA hasn’t presented any new evidence,” Cass told the Observer. “It feels to me like they are responding to political pressure rather than to science.”
Of particular concern to Cass seems to have been the plan to restart the trial with only youth over 14 eligible to participate. Though Cass has no experience treating trans patients, she correctly pointed out to the Observer that children over 14 are too old to benefit from puberty blockers. The drugs work by pausing puberty in the earliest phases, preventing permanent, changes from natal puberty that can be harmful to trans children’s mental health. Giving the drugs too late to meaningfully pause puberty would render the findings of the trial moot.
Puberty blockers being given too late to be useful was one of the Cass Review’s lesser-noticed criticisms of youth gender medicine in the UK. The standards of care for youth gender dysphoria recommend puberty blockers for children with persistent gender dysphoria in the earliest phases of puberty, but hormone therapy would be the recommended treatment for patients who are first seen as older teens.
These statements to the Observer aren’t the only recent utterances of Baroness Cass, who was given a peerage for her role in ending treatment for trans youth in the UK. In an interview for the BBC she speculated that the number of trans children who are genuinely trans is a “really tiny number.”
As evidence, Cass cited the increase in youth presenting at gender clinics in the UK, which she says went from 50 to 3500 patients per year. Taking a very conservative estimate of 0.5 percent as the prevalence of gender dysphoria in the adult population, about 70,000 minors under 18 in the UK would be expected to grow into trans adults.
Buried in the appendixes of the Cass Review is the information that Cass found fewer than 10 examples of detransition in 3306 patient records reviewed. The Review also found that, despite reports of children being rushed into medical transition in the UK, less than a third of patients under 18 who were seen by a gender clinic were referred to endocrinology for further treatment. It recommended further limiting care out of concern that too many children might grow up to be trans.
Evan Urquhart is the founder of Assigned Media.