Cass review ‘absolutely’ not unfair, author tells Scottish Parliament

The Cass review “absolutely” did not set an unreasonably high bar for evidence, the author said, as she raised “significant misinformation” about its assessment of health care for gender-questioning young people in England and Wales.

Dr. Giving evidence to the Scottish Parliament’s health committee on Tuesday morning, Hilary Cass said she believed Scotland could benefit from the more holistic approach recommended in her research, commissioned by NHS England.

She also expressed frustration at the misinformation circulating about the review of evidence on the impact of medical interventions such as puberty blockers and cross-sex hormones on young people, which was carried out by the University of York as part of its review.

“There has been the question, ‘Have we raised the bar for this systematic review?’ and we absolutely did not do that,” she told MSPs. “These young people should be given the same standard of evidence as any other young person.”

Last month the review found “weak evidence” for the use of puberty blockers and cross-sex hormones to treat young people experiencing gender incongruence and said this vulnerable cohort had been “let down” by the “toxicity” of the debate around their gender incongruence. concern.

She told the Holyrood committee: “To be clear, there was an incorrect piece on the information circulating that 98% of those articles (focusing on the effects of puberty blockers and cross-sex hormones) were left out and that only randomized, controlled studies had been conducted. included.

“Both things are wrong. There were no randomized controlled trials (and) 58% of the 102 articles were included in the analysis because they were of high or moderate quality.”

Following the publication of her review, the only clinic in Scotland offering treatment for gender-questioning young people, Sandyford in Glasgow, stopped prescribing puberty blockers and cross-sex hormones. The Scottish Government is under increasing pressure to fully adopt the recommendations, having set up a multi-disciplinary team of doctors to consider how they could be applied to NHS Scotland.

Cass, who suggested that Scotland could become a regional centre, sharing research and data across Britain, used the session to address other misconceptions arising from the magazine’s publication.

“The trans community is concerned that we look at detransition to say we shouldn’t provide gender-affirming care,” she said, adding that it was important to understand “what the factors are that lead (individuals) to detransition, were there any earlier signs that this might not have been a successful path for them?”

Cass said she would like to explain any less-than-successful medical outcome to inform anyone considering the same procedure, but added, “That doesn’t mean they can’t do it.”

She told the committee she had “very serious concerns” about private provision, adding that self-medication by young people “happens a lot more than we would like”.

Earlier this week, the Guardian raised concerns that a growing number of under-18s could be going online to access cross-sex hormones.

“It puts people at significant risk if they don’t have the level of assessment that we describe,” she said.

She also said the Scottish Government faced a ‘major challenge’ with its proposal to ban conversion practices. Cass said that while the practice was “completely unacceptable”, lawmakers must ensure it does not deter doctors from having “appropriate exploratory conversations” or make them “potentially even more apprehensive about working in this area”.