The final Cass Review landed last week and no one in gender critical spaces has been able to talk about anything else since then. After an extensive review of all the available literature, the team of clinical experts from York University found “a lack of high-quality evidence” that pediatric transition is safe or improves mental health. They also “recommend an extremely cautious clinical approach and a strong clinical rationale for providing hormones before the age of 18,” a sentence that will probably put the British National Health Service out of the pediatric transition business altogether.
Reactions to the Cass Review ran the gamut. At one end of the opinion spectrum, transgender activists who needed the ‘trans kids’ to justify their demands on society reacted with utter denialism, feigning indignation that Dr. Cass and the York University team had not accepted all their favorite low- and middling-quality studies at face value. These same activists were horrified to see Stonewall meekly accepting the results rather than fight against the rules of scientific rigor on their behalf. Now they are desperately trying to undermine belated efforts to gather data for review.
Perhaps the biggest shift has been at the middle. Wes Streeting, shadow health secretary for the Labour Party, has been steadfastly pro-trans, but he was “pretty angry” when he learned that six of the seven adult NHS trusts had “refused to cooperate” with the Cass Review, withholding data on more than 9,000 children who had entered adult services. “I want to send a clear message to them that under a Labour government there’ll be accountability for that, you’re not going to get away with it. And I want to work constructively with the Government to try to get this right,” Streeting told the Telegraph.
As one might expect, on the gender critical end of the spectrum, most people welcomed the Cass Review, though many had some reservations on first reading. For example, Dr. Cass uses “inaccurate, unscientific and confusing” terms like “assigned male/female at birth,” Sex Matters said. Cass also gives far too much creedence to the so-called minority stress model. There have been a few very good critiques, such as this one, which took issue with aspects of the report beyond its evidentiary conclusions.
My only answer to this critique is that Dr. Cass has exhibited the same oversights that her entire profession always seems to make.
So there is plenty of room for positive criticism, and plenty of positive criticsm to be had. That’s a good thing, because not allowing any criticism at all is how we got here in the first place. As Kemi Badenoch said in The Times yesterday, if “those who warned that gender services in the NHS had been hijacked by ideologues been listened to instead of gagged, children would not have been harmed and the Cass review would not have been required.”
But then there is a tranche of ‘gender critical TERF’ who is not happy at all with the Cass Review, for whom mere criticism is insufficient, because apparently the whole thing is a conspiracy against them.
Dear reader, did you know that according to the Tide Ultra-GC™ crowd, the term “detransitioner” is “captured language” because it presupposes that there was ever a medical “transition” in the first place? Really!
See, that’s how we know the Cass Review is just a sinister plot to make us use the enemy’s words.
The Cass Review says a lot about the lack of scientific rigor in the so-called evidence base for pediatric transition, the six NHS trusts refusing to share data, and the need to put every child undergoing experimental treatment in some sort of experimental program with data tracking. Perhaps you thought that Dr. Cass was highlighting ethical lapses in medicine, or that she was making it impossible for those lapses to repeat. But you were wrong, reader, because what Dr. Cass really wants are guinea pigs.
And why is Dr. Cass taking part in this conspiracy? Why, for money, of course. And also to get her jollies from making life harder for women, somehow.
They are drawing all the connections on the bulletin board with tacks and string and Post-It notes, Always Sunny in Philadelphia-style.
Truly, these are the greatest minds our movement has ever produced. We should be grateful that we have such brilliant people on our team, since they will be very helpful in organizing the gender critical movement again once they have finished setting it on fire and tearing it entirely down to the ground.
That’s what they’re best at, really. As though they were born to the task.
There are three basic explanations for ‘transness’ in the literature: exposure to hormones in utero, brain structure, and some other biological mechanism. The Cass Review rejects all of them. Still, these Tide Ultra-GC™ people are so incredibly astute that they can see the hidden “tru-trans” ideology underneath the veneer.
When Dr. Cass criticizes the lack of evidence-based guidelines, it is because she wants there to be guidelines, whereas the real TERFs want no guidelines to exist at all, for anyone, ever.
At points in the Cass Review, the author leaves room for doubt, admitting the possibility that some children might benefit from transition, “whereas others may resolve their distress in other ways. Some may transition and then de/retransition and/or experience regret. The NHS needs to care for all those seeking support.” Everyone has a right to evidence-based care, according to medical ethics.
This is how scientists talk, but of course activists are not scientists. Susie Green, the former CEO of Mermaids, transformed the GIDS clinic at Tavistock into her personal army. That is what scientific medicine looks like when activists take it over. Dr. Hilary Cass is not anybody’s personal army. Her job was to remain objective, which is the opposite of activism.
The people currently sneering at the Cass Review for not going far enough, for not doing what they want, or for saying things they would not say at all, are all just that, activists. They tweet. They hold especially intense opinions. But they do not have any larger responsibility than to hold those opinions, whereas Dr. Hilary Cass had the weight of the world on her shoulders.
In their own minds, perhaps they are the true heroes because they feel the issue more deeply than the rest of us mortals. Contrarily, the people who do the boring work of patching up lives and agencies and societies are all deemed “grifters” because they compromise on terminology, or charge for a networking conference ticket, or refuse to run Phil Illy out of town for wearing a blue dress. They are holding out for a better revolution that is perfectly to their own liking. They are not here to win the fight, they just want to be the winners, and will always be jealous of anyone who accomplishes more than they do.