In our view, Freddy McConnell’s op-ed (Hilary Cass’s proposals are largely based on common sense. She must reject anti-trans bias with equal clarity, April 11) implies that support for the Clinical Advisory Network on Sex and Gender (CAN- SG) fundamentally undermines the identity and rights of transgender people, and that physicians who question the innate model of gender identity – such as CAN-SG members – do not have the best interests of patients in mind and are “denying” the existence of transgender people .
We reject these claims. In fact, it is the suppression of research and debate in this area that undermines an understanding of gender identity and the right to effective, safe medical treatment.
The Cass report says: “There is broad agreement that gender incongruence is the result of a complex interplay between biological, psychological and social factors,” and this varies over time and between individuals. This is a fundamentally different model than that of an innate gender identity that needs to be affirmed. Developing better models to understand aspects of human distress is normal medicine and science, and does not deny anyone’s existence or rights.
Many doctors have been silenced by these types of toxic, hyperbolic responses. The CAN-SG Conference on Harm Avoidance in Gender Medicine went ahead on March 23 despite attempts at cancellation and masked demonstrators with smoke bombs trying to force entry.
Despite the aggression, courageous clinicians, including CAN-SG members, have for some time raised concerns about the risks and challenged the inadequate assessment, low-quality research and poor data collection that the Cass report now highlights. Victoria Atkins, the Secretary of State for Health and Social Care, said in Parliament that she expected “medical professionals will act in accordance with these recommendations”, and this was echoed by Wes Streeting, her Labor shadow. CAN-SG members call on colleagues to follow our example.
Dr. Stella Kingett
Dr. Louise Irvine
Co-chairs, CAN-SG
Freddy McConnell hits the nail on the head. Hilary Cass conducted a pediatrician review of clinical care for trans children and youth; her report is balanced and full of common sense. But by not explicitly acknowledging the reality of childhood gender dysphoria, she has made it too easy for transphobes to reuse it as evidence that childhood gender dysphoria is an ideological invention.
I’m almost 60 and I was a gender dysphoric child. There was no social transition in the early 1970s; I spent my childhood being bullied like a sissy, desperately struggling – and failing – to fit in. There was no internet; As far as I knew, I was the only child in the world who was like that. Ultimately, in my teenage years, I learned how to “pass” as a “normal” man. The influencers weren’t vloggers, they were society, which forced me to squeeze myself into a mold I didn’t fit into or gain approval. Self-acceptance only came after decades of mental anguish.
I know what it feels like to live in a world that denies the reality of childhood gender dysphoria. It would be a colossal failure if an overhaul of clinical care for young people were hijacked in the service of hate.
Karen Smith
Sheffield
As the mother of a transgender daughter waiting for her first appointment after four years (and counting) on the NHS waiting list, I write to thank Freddy McConnell for his article. It’s unfortunately a rarity to hear a trans person’s voice through the cacophony.
Amnesty International UK and Liberty have noticed that the Cass review is already being weaponized by anti-trans groups, despite the review itself clearly stating how damaging the toxicity of debates can be to transgender youth, their families and friends.
In this context, I would ask that gender-critical politicians and activists consider the impact of their words, as families like ours try to come to terms with the very real implications of the review on our lives. And respectfully remind them that some women cannot claim to speak for all women.
Name and address provided
I am concerned that in your editorial (April 11) you seem to use terms such as ‘gender dysphoria’, ‘trans identity’ and ‘transgender’ as if they are the same. The Cass report does not focus on ‘trans children’, but on children who express a symptom where their biological sex and their expressed gender identity do not align.
I was involved in the design, data collection and analysis of what Hannah Barnes described in her book Time to Think as the one and only audit of the Gender Identity Development Service. We found that about 20% of the first 124 children referred to the service had a strong non-attached identity, a figure also found by Professor Emerita Susan Bradley, the psychiatrist who set up Canada’s first clinic for such children , during her very long experience in this field. Of that 20%, it cannot be assumed that their chosen path will be one of adopting a full trans identity in adulthood. Let us all be very careful in the language we use.
David Vrijman
London