Cass review should be used as a ‘watershed moment’ for NHS gender services, Streeting says

Wes Streeting has said he wants the Cass review to be a turning point in healthcare for young people questioning their gender identity, but understands why some trans people may feel “scared”.

The shadow health minister said children and young people, but trans people in general, have been “completely failed” by the healthcare available, adding: “We need to get this right for them”.

Streeting said the Cass review, which recommended sweeping changes to the way the NHS treats under-18s who are uncertain about their gender identity or experience gender dysphoria, created an opportunity to move beyond “some of the toxicity” around the issue towards a “more thoughtful, careful and deliberate approach.

“I have been doing my utmost, especially in the wake of the Cass review, not to throw stones at the Tory party and to see if we can try to build a more positive consensus,” he said. “But that will depend on whether the Conservative party becomes more like David Cameron and less like Suella Braverman.”

However, Streeting indicated that Labor shares responsibility for the tone of the debate, saying there is “plenty of blame” for a situation where the clock was turned back on years of progress on LGBTQ+ issues.

He said the country needs a “more thoughtful and inclusive” conversation about trans rights, and regretted some of the language he has used on the subject in the past.

Streeting said his own “wake-up call” was against women in the Labor Party who were LGBTQ+ allies and stood up against transphobia but were reluctant to raise concerns about women’s sex-based rights: “They said told me that they felt silenced. That cannot be a good thing and it has led to a more toxic debate and conversation.”

But he added: “I understand why trans people are scared right now. There is a deeply toxic political backdrop in our country, which has seen a rise in trans hate crime and made the task of the Cass review more challenging.

“Trans activists have questioned the motivation (of the report) and are concerned about whether or not this will be a turning point that will make things better or worse.

“It should be a turning point that makes things better for transgender people and for young people who are questioning their gender identity.”

Streeting said he could understand why there was “a degree of skepticism” among transgender people as they had “failed so many times before”. There should be a more robust evidence base, shorter wait times, adequate mental health care and holistic care, he said.

A Labor government would force all seven adult gender dysphoria clinics to hand over data that six of them refused to share with researchers who helped draw up best practice guidelines for the Cass review.

“It is critical data for understanding the journey people take along the gender identity journey and it is critical for informing our understanding of the evidence base we need to ensure transgender people receive good health care,” Streeting said .

In the meantime, the clinics should publicly explain their decision to withhold data, he said. “We simply can’t have this free for all if people are deciding when or not to take part in an NHS England assessment. That is not acceptable, especially when it comes to a topic as important as this.”