The review, released Wednesday, calls for restrictions on trans care, social transition, and transgender adults up to the age of 25 from entering adult trans health treatment in England.
I can't believe bigots like Dr. Cass are in positions of power over the groups they hate. How does society allow this? It's soul-crushing. This is more than enough ammunition for bad-faith actors to ban healthcare for trans people, even adults. What can we even do against such hate? :(
We will fight it, with love in our hearts for those impacted and those misled by such liars as Cass and Ladapo. We will show our resilience, support each other, and take joy in as many things as we can to not let them defeat us. We will mourn the harm, and curse the bad ideas causing it with the scorn they deserve. And people like Erin will shine a light upon the shady places where such hatred grows fast, burning it with the truth and authenticity that is its nemesis. Please stay strong, take care of yourself, and reach out to your supports. Together we will vanquish this. The haters have severely overplayed their hand, and while it does not lessen the damage they are doing now, their incuriousness and cruelty will yet bring them low.
She dismissed studies for not being blinded. Any idiot knows you can’t blind this kind of healthcare. Cass’s report is ABSOLUTELY hate motivated, and spits in the face of science. I’m a scientist. It’s extremely clear to anyone who knows science that Cass’s report ignores all of the studies that don’t support her hate, it’s as simple as that.
Hello - physician here. I can share a study I helped write that was dismissed as "low quality" despite being longitudinal and prospective (pretty much the best you can get without a randomized controlled trial, which those in the field consider unethical given that therapy/counseling was the standard for years and did not provide sufficient relief from gender dysphoria). It was also published in Pediatrics, a highly vetted peer reviewed journal and probably the highest impact in the field. I read through portions of the report pertaining to these areas in detail. The report very clearly cherry picked evidence to fit its predetermined conclusions. As many have said, this report was political and not at all scientific.
Sure, Dr Cass is biased and yes, Erin is also biased. These biases are not equivalent. Erin is biased in favour of trans youth receiving high-quality treatment in order to improve their life outcomes in a manner supported both by personal testimony of trans people and by the best evidence available. Dr Cass is biased in favour of avoiding giving trans youth any treatment as much as is possible, just in case they might turn out not to be trans, which is a vanishingly small outcome and contradicted by the best testimony and evidence available.
The above is why the Cass report had to use a frankly bizarre set of standards to exclude the vast majority of that evidence, while still allowing in evidence of a miserably low quality where it supports her priors (e.g. her inclusion of results from Kenneth Zucker, a man who psychologically tortured non-gender-conforming children for his research, the clear majority of whom were not trans by their own or by any senwible clinical definition).
Those bizarre standards include refusing to class any study that does not use randomized control trials as "high quality", which in the context of trans healthcare would be monstrous malpractice, requiring lying to a group of children telling them they are getting care when they are not. If you want to talk bias, how about a person complaining about there being too much low quality evidence after *personally deciding to set the evidence standard at a level that is impossible to meet*.
So it's not a case of "disliking" the Cass report, anymore than I "dislike" hearing about Israel bombing Gaza. I'm morally outraged, in both cases, and I used that analogy because I think it takes a great deal of bias to *not* feel that way in either case.
I'm taking the time to write this out in the hope that you will understand how tone-deaf, misguided and unhelpful your response above was.
No amount of compassion counts when ultimately that compassion is used as an excuse to do harm. The Cass report will cause great harm. It has already begun. People are allowed to have an emotional response to that.
If you want to see a more fulsome scientific dissection, you might need to wait a little longer. I'm sure you can manage that, as you don't appear to have much emotional investment.
"I have not read Dr. Cass's / UK report on clinical care for transgender patients, but I am asking you to present evidence with regard to the reports that Dr. Cass rejected." You're trolling.
Hi Brian - respectfully, why? You're asking me to make a significant time investment into filtering data for you on a topic that you don't seem to have any prior interest or investment in. I'd like to understand the rationale behind your request so I can make an informed decision. This is, after all, information that you can find for yourself just as easily as I can find it for you, so I'm curious as to why you want me to invest my time first.
Incidentally, your request does seem oddly specific - by "hormone therapy" do you mean cross-sex hormones or are you including puberty blockers here? The latter aren't really hormone therapy, and the former generally aren't prescribed to children under 16, so I need to understand if this is a misunderstanding about terms or a request for something that doesn't exist.
The mysterious Brian "Pope": "Basically, I am asking for you to give me "best evidence" to support providing minor with hormone therapy before the age of 16. Do you think you can do that for me. I am not familiar with very many transgender medical studies involving hormone therapy for minors." He needs to go read the report - which he admits he hasn't done - and then do his own damn research. This is trolling.
They were right, you're trolling. You're calling a journalist's work unsubstantiated or false while admitting you haven't read the report properly yourself. Erin's not the only person to note how many studies they excluded. It is not ethically possible to perform double-blind studies involving hormone therapy on minors and there is no reason to consider it the best methodology when the guidelines Cass was supposed to be using explicitly state that, in the absence of those studies but the presence of overwhelming positive data (those ignored studies) *strong recommendations can still be made*.
So trans people under 25 are now considered as adolescents for the purposes of gender-affirming care? What nonsense. Could there be a more blatant form of discrimination. This is straight out of the mouths of organisations like SEGM and Stella O’Malley, who have been pushing to prevent people under 25 from transitioning for years. It’s no surprise to see the Catholic Medical Association involved, since similar Christian orgs have been funding SEGM et al for years as well. There is nothing scientific about this review. It is ideological and intellectually bereft, based on cisgenderism and transphobia alone.
"Protect the children!" is only ever a way to test the waters for more and more government intrusion into what should be entirely private matters. Now, we're seeing it proven again- having achieved some success in taking away trans kids' care, now the bigots are taking the approach of re-defining young adults as children so they can steal their healthcare, too. If they get 25, then 30 will be next, and if they get that far, total bans are sure to follow.
I'm willing to bet this will become a lead-in to attempts to raise the voting age, as well, if it succeeds- both over there on TERF Island and back here in the Divided States. Conservatives know they're losing the youth vote, and losing it badly; if they can find a way to purge everyone under 25 from the rolls to stave off their own irrelevance for another generation, they'll do it without a second thought.
To revise this, it's less a "column" than a reaction, published online under the head of, "The Point: Conversations and insights about the moment." (I refuse to link to it.) I won't be surprised if she follows it up with a longer piece.
The skew with which Dr. Cass and the committee approached this seems like fairly obvious confirmation bias. The implications of multiple sections of the report are framed by, as Erin notes, ignoring a considerable amount of research, providing specious critiques, and drawing conclusions without sufficient evidence.
Overall, like many of the reports of this nature, it will only serve to add to the “misinformation,” which the report itself notes, are rampant.
One cannot say that each individual must be treated as an individual, while simultaneously invalidating the positive impact of gender-affirming care which is shown in the data.
Well. Confirmation bias is not usually the term used for willful and deliberate misrepresentation of facts and data to promote a consciously malicious agenda. I could think of a few other words.
Disinformation is the technical term (deliberately misleading information with a purpose) versus misinformation (misleading information wrongly made). Though I suppose this would be state sanctioned and sponsored disinformation, so white propaganda may fit (propaganda from a direct government source, versus grey or black propaganda which obscures the source).
My own definition of a "lie" is "a statement made with the intent to deceive." So for me, disinformation would be "a lie for an organized purpose," since disinformation is part of a campaign. Misinformation, on the other hand, may or not be a lie depending on if the speaker believes it or not.
That might be a fun topic! I could start with Pernicious Lies, as I don’t believe there’s a shred of positive or ethical intention in any of these attack projects.
I have to give the Grauniad the tiniest shred of credit for publishing one (1) article that was written by a journalist who spoke to one (1) parent of a trans child and one (1) trans journalist, both of whom correctly construed this as a top-down attack on trans healthcare from elites that will negatively effect trans youth. The rest of their output appears to be as expected though, so on the whole, bollocks to them.
Startling how different the takes on this topic look when they come from an actual expert. But hey, why worry about that when we can get lots of celebratory thunk-pieces from hand-wringing centrist bigots.
The Tories don't need to care about public opinion, because a large majority of voters in favor of trans rights are going to vote Labour anyway, or maybe Lib Dem.
Labour does need to care. Young people are Labour's future base, and they're vastly more socially liberal than the current generation of politicians. If the trans community can put up enough visible resistance to outweigh the propaganda from prominent TERFs, Mumsnet, and the like, then Labour will eventually come round.
It's going to be terrible until that happens, though.
They want to be able to cherry pick the studies that support or do the least to oppose their agenda. Apparently only three studies out of over a hundred were considered useful to cass. I just can't fathom the bias and lack of integrity of so many supposedly scholarly researchers. You've got to be seriously disordered to be able to blind yourself to the reality right in front of you. No conscious for thee.
It’s funny, they actually have it backwards, for me, dysphoria caused depression and anxiety while I was growing up. I’m happy that I’m finally able to start unraveling the mess this caused with my mental wellbeing. As for being influenced, it must have been all of that internet use I had back in the 1980’s that made me this way. 🙄
This is just another “professional” agency that takes bits and pieces of information, that doesn’t represent the entire picture or is completely wrong, and uses it to push people who are already struggling with life even further down. This won’t stop transgender people from existing, it will just force people to perform unsafe DIY transitioning.
The UK has in many respects been a disaster for trans people, especially trans youth. The mount of transphobia there is staggering. While the US is far from perfect, I actually think I prefer to be here - by a considerable margin.
As a pediatrician, I am intrigued that an adult aged 21 years in Florida (18-21 nationwide and in most of Europe) can consent to tubal ligation or vasectomy, but not to hormonal treatment? What???
Florida's government is conducting a campaign of harassment and elimination against trans people. Every law they pass has been done with the intent of making it impractical or impossible to exist as a trans person in that state, whether or not the wording states as muvh in the law.
The "don't say gay" law doesn't mention library books for high schoolers but ended up being used to pull books from libraries entirely. That's not an accident - the people who write, pass and enforce these things aren't idiots, and you can tell they're lying when they say these "side effects" were unintentional because they don't then repeal their shitty laws.
Thank you for this takedown. I spent a lot of time today wading through the review articles and was very overwhelmed. From my daughter when discussing their throwing out all the studies. “Why haven't we had people jump out of planes, half with parachute and the other with a backpack full of rocks, how can we know parachutes work without a double blind study where neither the jump instructor nor the jumpers know who has a parachute and who has a backpack full of rocks.”
Likewise I don't think there are enough high quality studies proving that the earth is round so we should assume that it's flat until such studies meeting our very rigorous standards are available or someone turns up to pay for such studies and they eventually prove conclusively that the earth is round.
Cass should not be referred to as a Dr. She's retired from practice, she's a political operative and this is a political document not a serious medical document. These assholes revel in misgendering and dead naming. They deserve no courtesy. Their preferences in that respect should be ignored.
Trash like Mr. Hilary Cass and Miss Patrick Hunter are deeply troubled individuals. What motivates such dogs to insert themselves into the deeply private and personal medical decisions of people, including adults? Projection? Their own fears and anxieties associated with sexual orientation and gender roles? And how do you police social transition? Does Mr. Cass plan to stand at the entrance of Macy's women's department and make sure only certain people can browse and buy? It's fucking madness. No one cares about any of this and it's only an "issue" because of dogs like Cass and Hunter stirring up manufactured outrage.
And after the Vatican - the world's largest pedophile ring - weighed in yesterday on gender and IVF, cis women should realize that these are all coordinated attacks to protect the privileged positions of white men.
My daughter wouldn't be here without gender affirming care. Thank you as always, Erin.
a lot of us wouldn't be, and they know this
Absolutely. ❤️❤️❤️ you're right, they do know. Some are sadly ignorant but these people know exactly what they're doing. It's infuriating.
I can't believe bigots like Dr. Cass are in positions of power over the groups they hate. How does society allow this? It's soul-crushing. This is more than enough ammunition for bad-faith actors to ban healthcare for trans people, even adults. What can we even do against such hate? :(
We will fight it, with love in our hearts for those impacted and those misled by such liars as Cass and Ladapo. We will show our resilience, support each other, and take joy in as many things as we can to not let them defeat us. We will mourn the harm, and curse the bad ideas causing it with the scorn they deserve. And people like Erin will shine a light upon the shady places where such hatred grows fast, burning it with the truth and authenticity that is its nemesis. Please stay strong, take care of yourself, and reach out to your supports. Together we will vanquish this. The haters have severely overplayed their hand, and while it does not lessen the damage they are doing now, their incuriousness and cruelty will yet bring them low.
She dismissed studies for not being blinded. Any idiot knows you can’t blind this kind of healthcare. Cass’s report is ABSOLUTELY hate motivated, and spits in the face of science. I’m a scientist. It’s extremely clear to anyone who knows science that Cass’s report ignores all of the studies that don’t support her hate, it’s as simple as that.
Hello - physician here. I can share a study I helped write that was dismissed as "low quality" despite being longitudinal and prospective (pretty much the best you can get without a randomized controlled trial, which those in the field consider unethical given that therapy/counseling was the standard for years and did not provide sufficient relief from gender dysphoria). It was also published in Pediatrics, a highly vetted peer reviewed journal and probably the highest impact in the field. I read through portions of the report pertaining to these areas in detail. The report very clearly cherry picked evidence to fit its predetermined conclusions. As many have said, this report was political and not at all scientific.
https://pubmed.ncbi.nlm.nih.gov/32220906/
Sure, Dr Cass is biased and yes, Erin is also biased. These biases are not equivalent. Erin is biased in favour of trans youth receiving high-quality treatment in order to improve their life outcomes in a manner supported both by personal testimony of trans people and by the best evidence available. Dr Cass is biased in favour of avoiding giving trans youth any treatment as much as is possible, just in case they might turn out not to be trans, which is a vanishingly small outcome and contradicted by the best testimony and evidence available.
The above is why the Cass report had to use a frankly bizarre set of standards to exclude the vast majority of that evidence, while still allowing in evidence of a miserably low quality where it supports her priors (e.g. her inclusion of results from Kenneth Zucker, a man who psychologically tortured non-gender-conforming children for his research, the clear majority of whom were not trans by their own or by any senwible clinical definition).
Those bizarre standards include refusing to class any study that does not use randomized control trials as "high quality", which in the context of trans healthcare would be monstrous malpractice, requiring lying to a group of children telling them they are getting care when they are not. If you want to talk bias, how about a person complaining about there being too much low quality evidence after *personally deciding to set the evidence standard at a level that is impossible to meet*.
So it's not a case of "disliking" the Cass report, anymore than I "dislike" hearing about Israel bombing Gaza. I'm morally outraged, in both cases, and I used that analogy because I think it takes a great deal of bias to *not* feel that way in either case.
I'm taking the time to write this out in the hope that you will understand how tone-deaf, misguided and unhelpful your response above was.
No amount of compassion counts when ultimately that compassion is used as an excuse to do harm. The Cass report will cause great harm. It has already begun. People are allowed to have an emotional response to that.
If you want to see a more fulsome scientific dissection, you might need to wait a little longer. I'm sure you can manage that, as you don't appear to have much emotional investment.
"I have not read Dr. Cass's / UK report on clinical care for transgender patients, but I am asking you to present evidence with regard to the reports that Dr. Cass rejected." You're trolling.
I thought the same thing.
Hi Brian - respectfully, why? You're asking me to make a significant time investment into filtering data for you on a topic that you don't seem to have any prior interest or investment in. I'd like to understand the rationale behind your request so I can make an informed decision. This is, after all, information that you can find for yourself just as easily as I can find it for you, so I'm curious as to why you want me to invest my time first.
Incidentally, your request does seem oddly specific - by "hormone therapy" do you mean cross-sex hormones or are you including puberty blockers here? The latter aren't really hormone therapy, and the former generally aren't prescribed to children under 16, so I need to understand if this is a misunderstanding about terms or a request for something that doesn't exist.
The mysterious Brian "Pope": "Basically, I am asking for you to give me "best evidence" to support providing minor with hormone therapy before the age of 16. Do you think you can do that for me. I am not familiar with very many transgender medical studies involving hormone therapy for minors." He needs to go read the report - which he admits he hasn't done - and then do his own damn research. This is trolling.
They were right, you're trolling. You're calling a journalist's work unsubstantiated or false while admitting you haven't read the report properly yourself. Erin's not the only person to note how many studies they excluded. It is not ethically possible to perform double-blind studies involving hormone therapy on minors and there is no reason to consider it the best methodology when the guidelines Cass was supposed to be using explicitly state that, in the absence of those studies but the presence of overwhelming positive data (those ignored studies) *strong recommendations can still be made*.
So trans people under 25 are now considered as adolescents for the purposes of gender-affirming care? What nonsense. Could there be a more blatant form of discrimination. This is straight out of the mouths of organisations like SEGM and Stella O’Malley, who have been pushing to prevent people under 25 from transitioning for years. It’s no surprise to see the Catholic Medical Association involved, since similar Christian orgs have been funding SEGM et al for years as well. There is nothing scientific about this review. It is ideological and intellectually bereft, based on cisgenderism and transphobia alone.
"Protect the children!" is only ever a way to test the waters for more and more government intrusion into what should be entirely private matters. Now, we're seeing it proven again- having achieved some success in taking away trans kids' care, now the bigots are taking the approach of re-defining young adults as children so they can steal their healthcare, too. If they get 25, then 30 will be next, and if they get that far, total bans are sure to follow.
I'm willing to bet this will become a lead-in to attempts to raise the voting age, as well, if it succeeds- both over there on TERF Island and back here in the Divided States. Conservatives know they're losing the youth vote, and losing it badly; if they can find a way to purge everyone under 25 from the rolls to stave off their own irrelevance for another generation, they'll do it without a second thought.
The New York Times just published a Pamela Paul column in which she cites the UK study as proof for her disinformation claims.
Of course she/they did!
To revise this, it's less a "column" than a reaction, published online under the head of, "The Point: Conversations and insights about the moment." (I refuse to link to it.) I won't be surprised if she follows it up with a longer piece.
Thanks for the info! I'm out of Angel Soft. So I should get to the newstand.
The skew with which Dr. Cass and the committee approached this seems like fairly obvious confirmation bias. The implications of multiple sections of the report are framed by, as Erin notes, ignoring a considerable amount of research, providing specious critiques, and drawing conclusions without sufficient evidence.
Overall, like many of the reports of this nature, it will only serve to add to the “misinformation,” which the report itself notes, are rampant.
One cannot say that each individual must be treated as an individual, while simultaneously invalidating the positive impact of gender-affirming care which is shown in the data.
Well. Confirmation bias is not usually the term used for willful and deliberate misrepresentation of facts and data to promote a consciously malicious agenda. I could think of a few other words.
Agreed but what should it be called ideally
Disinformation is the technical term (deliberately misleading information with a purpose) versus misinformation (misleading information wrongly made). Though I suppose this would be state sanctioned and sponsored disinformation, so white propaganda may fit (propaganda from a direct government source, versus grey or black propaganda which obscures the source).
My own definition of a "lie" is "a statement made with the intent to deceive." So for me, disinformation would be "a lie for an organized purpose," since disinformation is part of a campaign. Misinformation, on the other hand, may or not be a lie depending on if the speaker believes it or not.
That might be a fun topic! I could start with Pernicious Lies, as I don’t believe there’s a shred of positive or ethical intention in any of these attack projects.
I saw reporting on this from the Guardian last night. Not surprisingly, their piece didn't mention any of the issues with Cass and potential bias.
I have to give the Grauniad the tiniest shred of credit for publishing one (1) article that was written by a journalist who spoke to one (1) parent of a trans child and one (1) trans journalist, both of whom correctly construed this as a top-down attack on trans healthcare from elites that will negatively effect trans youth. The rest of their output appears to be as expected though, so on the whole, bollocks to them.
Startling how different the takes on this topic look when they come from an actual expert. But hey, why worry about that when we can get lots of celebratory thunk-pieces from hand-wringing centrist bigots.
The Tories don't need to care about public opinion, because a large majority of voters in favor of trans rights are going to vote Labour anyway, or maybe Lib Dem.
Labour does need to care. Young people are Labour's future base, and they're vastly more socially liberal than the current generation of politicians. If the trans community can put up enough visible resistance to outweigh the propaganda from prominent TERFs, Mumsnet, and the like, then Labour will eventually come round.
It's going to be terrible until that happens, though.
Will vanish?? I’d say that as far as youth 17-25 are concerned, with five year-plus waitlists for care, they believe it already has.
They want to be able to cherry pick the studies that support or do the least to oppose their agenda. Apparently only three studies out of over a hundred were considered useful to cass. I just can't fathom the bias and lack of integrity of so many supposedly scholarly researchers. You've got to be seriously disordered to be able to blind yourself to the reality right in front of you. No conscious for thee.
Thank you for bringing this out in to the open.
It’s funny, they actually have it backwards, for me, dysphoria caused depression and anxiety while I was growing up. I’m happy that I’m finally able to start unraveling the mess this caused with my mental wellbeing. As for being influenced, it must have been all of that internet use I had back in the 1980’s that made me this way. 🙄
This is just another “professional” agency that takes bits and pieces of information, that doesn’t represent the entire picture or is completely wrong, and uses it to push people who are already struggling with life even further down. This won’t stop transgender people from existing, it will just force people to perform unsafe DIY transitioning.
The UK has in many respects been a disaster for trans people, especially trans youth. The mount of transphobia there is staggering. While the US is far from perfect, I actually think I prefer to be here - by a considerable margin.
As a pediatrician, I am intrigued that an adult aged 21 years in Florida (18-21 nationwide and in most of Europe) can consent to tubal ligation or vasectomy, but not to hormonal treatment? What???
Thank you
It's advisable not to mistake the wording of a law for the totality of its impact.
https://apnews.com/article/florida-transgender-health-care-adults-e7ae55eec634923e6593a4c0685969b2
Florida's government is conducting a campaign of harassment and elimination against trans people. Every law they pass has been done with the intent of making it impractical or impossible to exist as a trans person in that state, whether or not the wording states as muvh in the law.
The "don't say gay" law doesn't mention library books for high schoolers but ended up being used to pull books from libraries entirely. That's not an accident - the people who write, pass and enforce these things aren't idiots, and you can tell they're lying when they say these "side effects" were unintentional because they don't then repeal their shitty laws.
Thank you for this takedown. I spent a lot of time today wading through the review articles and was very overwhelmed. From my daughter when discussing their throwing out all the studies. “Why haven't we had people jump out of planes, half with parachute and the other with a backpack full of rocks, how can we know parachutes work without a double blind study where neither the jump instructor nor the jumpers know who has a parachute and who has a backpack full of rocks.”
Likewise I don't think there are enough high quality studies proving that the earth is round so we should assume that it's flat until such studies meeting our very rigorous standards are available or someone turns up to pay for such studies and they eventually prove conclusively that the earth is round.
I'm not going to lie, living in the UK gets scarier every day.
I sometimes don't know what to do anymore.
Stay strong! You got this. Big ol mama hugs to you from Texas ~ ❤️
Cass should not be referred to as a Dr. She's retired from practice, she's a political operative and this is a political document not a serious medical document. These assholes revel in misgendering and dead naming. They deserve no courtesy. Their preferences in that respect should be ignored.
Trash like Mr. Hilary Cass and Miss Patrick Hunter are deeply troubled individuals. What motivates such dogs to insert themselves into the deeply private and personal medical decisions of people, including adults? Projection? Their own fears and anxieties associated with sexual orientation and gender roles? And how do you police social transition? Does Mr. Cass plan to stand at the entrance of Macy's women's department and make sure only certain people can browse and buy? It's fucking madness. No one cares about any of this and it's only an "issue" because of dogs like Cass and Hunter stirring up manufactured outrage.
And after the Vatican - the world's largest pedophile ring - weighed in yesterday on gender and IVF, cis women should realize that these are all coordinated attacks to protect the privileged positions of white men.
They could save themselves a lot of trouble by just asking us.
Of course, but they want no opposing views in order to push their agendas about us.