British Medical Association Calls Cass Review "Unsubstantiated," Passes Resolution Against Implementation

The British Medical Association, the professional organization representing doctors in the United Kingdom, has called for a public critique of the review and to bar its implementation.

British Medical Association - Archibald Tuttle - Wikimedia Commons

The largest doctors' union in the United Kingdom, the British Medical Association (BMA), voted in favor of a resolution to publicly critique the Cass Review used to crack down on gender affirming care for trans youth in the United Kingdom, calling its recommendations unsubstantiated. The organization also voted to oppose the implementation of the review's recommendations. This move comes after a court ruled that the government can ban the use of puberty blockers on an emergency basis, citing the review in its decision.

The British Medical Association (BMA) is an independent union representing 151,000 doctors in the United Kingdom. The group negotiates on behalf of all doctors in the UK and lobbies for best practices in medicine to the UK Parliament. The organization states that it “regularly represents the views of doctors and their patients in Parliament” and is also responsible for briefing other medical workers and members of parliament.

The resolution, voted on in July, is substantial. It states that gender identity services in the United Kingdom are “inadequate”—a claim well supported by extreme wait times of five years or more, which have been linked to suicides among some trans patients. It asserts that the Cass Review engaged in “unexplained study deviations” and “ambiguous eligibility criteria” while excluding evidence supporting transgender care. The resolution references a recent review published by the Integrity Project, currently hosted at Yale University, which condemns the Cass Review for its poor methodology and interpretation of research. Lastly, it establishes that the BMA will publicly critique the Cass Review, oppose its implementations, and lobby for continuity of care.

See the full resolution here:

‘This meeting recognises that the provision of gender identity services in the United Kingdom is inadequate, and that transgender people should be treated with compassion and respect for their bodily autonomy. Following the publication of the Cass Review on Gender Identity Services for children and young people, this meeting is concerned about its impact on transgender healthcare provision because of its unsubstantiated recommendations driven by unexplained study protocol deviations, ambiguous eligibility criteria, and exclusion of trans-affirming evidence. Therefore, this meeting calls on the BMA to: 

i. Publicly critique the Cass Review;  
ii. Lobby and work with other relevant organisations and stakeholders to oppose the implementation of the recommendations made by the Cass Review;  
iii. Lobby the Government and NHS in all four nations to ensure continuity in provision of transgender healthcare for patients younger than 18 years old;  
iv. Lobby the Government and NHS in all four nations to ensure continuity in provision of transgender healthcare for patients aged 18 or older;  
v. Publicly state support for transgender people, particularly transgender youth, and provision of prompt access to gender identity services and treatment at all ages;
vi. Condemn the increasing political transphobia which is ostracising transgender people and discriminating against them by blocking their access to healthcare’

The resolution comes after a court decision in the United Kingdom cited the Cass Review to rule that the government may ban puberty blockers via an emergency measure. In that decision, a judge stated that puberty blockers could cause “substantial, albeit unqualified” risks to young patients, using the Cass Review to justify the ban. This finding is not supported by science and has been found untrue in court hearings in the United States. For instance, in the Arkansas decision overturning a trans care ban, a judge ruled that “the adverse health effects of gender-affirming care are rare” and the risks are “comparable with many other medical treatments” routinely offered to youth.

The organization will now produce a fuller critique of the Cass Review through a “task and finish” group, which it expects to complete “towards the end of the year.” This critique will pay particular attention to the methodological flaws in the review. In the meantime, the organization is expected to lobby strongly against the review's implementation in the United Kingdom. Its opposition could have international repercussions, including in the United States, where politicians have cited the Cass Review to claim that doctors now oppose transgender youth care.

“The task and finish group will make recommendations to improve the healthcare system that has, for too long, failed transgender patients. It will work with patients to ensure the evaluation invokes the old adage in medicine of ‘no decision about me without me’. 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.”