The British Medical Association (BMA) has announced an evaluation of the Cass Review, partly because of concerns around the banning of puberty blockers for youngsters.

In a press release on Wednesday (31 July), the trade union, which represents more than 190,000 doctors, called for a pause in the implementation of the Cass Review’s recommendations while it carried out an evaluation of its findings.

“The BMA has been critical of proposals to ban the prescribing of puberty blockers to children and young people with gender dysphoria, calling instead for more research to help form a solid evidence base for children’s care,” the statement said.

Cass, published in April, made upwards of 32 recommendations to restructure the way in which trans youngsters receive care in England.

It was commissioned by NHS England in 2020, and headed by paediatric expert Dr Hilary Cass, in response to the sharp rise in referrals to what was then England’s only youth gender clinic, at North London’s Tavistock Centre.

The fully published report was criticised for some of its recommendations, which included calling for “extreme caution” in prescribing puberty blockers to under-18s. Activists and medical experts also questioned the decision to regard well-established research as being of “poor quality.”

BMA council chairman professor Philip Banfield said it was “vitally important” that the report was scrutinised.

“This is a highly specialised area of healthcare for children and young adults with complex needs and, as doctors, we want to be sure they get the most appropriate care and the support they need,” he added.

A “task and finish” group, appointed and established by Banfield, will reportedly pay particular attention to the report’s methodology, which justified the recommendations made. Until their work is finished, the BMA is urging an immediate halt to the implementation of the recommendations in Cass.

“[The group] will work with patients to ensure the evaluation invokes the old adage in medicine of ‘no decision about me without me’,” Banfield said.

“It is time that we truly listen to this group of important, valued and, unfortunately often-victimised, people and, together, build a system in which they are finally provided with the care they deserve.”

The former chief executive of trans charity Mermaids, Susie Green, called the announcement a “huge relief,” adding that it is a “moment of sanity and humanity in the midst of a witch-hunt designed to erase trans identities”.

Cass Report described as ‘deeply flawed’ by medical organisations

The Cass Report has been criticised by several established institutions, including the World Professional Association of Trans Healthcare (WPATH) and Yale Law School, as well as several healthcare professionals who labelled the report “poor quality.”

WPATH highlighted the report’s “selective and inconsistent” use of evidence to justify its recommendations and said the it deprived young trans people “of the high-quality care they deserve” and “causes immense distress and harm to both young patients and their families”.

In addition, a group of more than 20 clinicians and academics carried out an appraisal, concluding that the report was “deeply flawed“.

Led by Dr Chris Noone, an LGBTQ+ healthcare research expert, the appraisal said: “Our critical analysis reveals significant methodological problems… that undermine the validity of the Cass Report’s recommendations.

“In light of this, and the report’s poor understanding of transgender identities and experiences, it is vital that academics, healthcare practitioners, policymakers and the public, question the integrity and validity of the recommendations.”

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