New Journal Report: Cass Review “Echoes Fallacies Promoted By Anti-Trans Disinformation”

While American lawyers pushed the anti-trans Cass Review this week, Australia’s top scholars rebuked it.

Gender GP

Far-right lawyers once again latched on to the Cass Review this week—an anti-trans report widely criticized as ideology-driven and unscientific—during oral arguments for Chiles v. Salazar, a Supreme Court case in which a Colorado therapist is challenging a state law banning conversion therapy.

“The Cass report,” an attorney from the Alliance Defending Freedom told the justices on Tuesday, “tells us [transitioning] comes with a lot of harm and devastation.”

But that same day, on the other side of the globe, The Medical Journal of Australia (MJA)—one of the most important in its field—eviscerated that very same report in a scathing article, representing experts in transgender health care in every state and territory of Australia, as well as doctors from all of the major pediatric hospital gender clinics in the country.

The Australian report, titled “Cass Review does not guide care for trans young people,” is the latest in a swelling body of literature debunking some of the most harmful myths propagated by the project—one laced with politically-charged and frankly shoddy pseudoscience. Nonetheless, the Cass Review has been weaponized worldwide in campaigns against trans-affirming health care and trans life itself.

Spearheaded by Dr. Hilary Cass (who has no background in treating gender dysphoria), the Cass Review was commissioned by conservative officials within the United Kingdom government under the auspices of needing “more evidence” to support gender-affirming care for trans people, even though cis people’s access to it remains uncontested. As a result, countless trans youth lost access to their care. Erin in the Morning has extensively covered the project’s ideological and methodological flaws—choices that were made by the author(s), arguably to skew the results in favor of a pre-determined outcome.

Here is what the MJA paper found.

The Cass Review holds trans people’s health care to exceptionalized and arbitrary standards—not the established best practices for medicine.

Opponents to gender affirming care often couch their transphobia by holding gender affirming care for trans people (and only trans people) to near-unattainable levels of scrutiny.

“It is difficult to name another field in which regulators impose such a benchmark,” the paper says. “Much health care in other areas of medicine is guided by evidence of similar or lesser strength.”

Puberty blockers and hormone replacement therapy have been effectively banned in the U.K. for most youth, with the exception of use in a clinical trial. In addition to the ethical issues that compulsory research participation broaches, such studies take years. And with every month that passes, more and more trans youth will begin to experience the sometimes irreversible impacts of the onset of a puberty that does not match their gender identity.

The Cass Review selectively cites evidence, anecdotes, and statistics in a way that skews the history and reality of trans people’s care.

For example, the authors point out that the Cass Review erroneously suggested that there has been some sort of unexplained boom in people who are trans masculine. In reality, they have simply become more recognized. But be it by accident or by design, this rhetorical maneuver is often used to stoke conspiratorial flames about transness being a social contagion infecting legions of young (cis) girls.

And that’s not the only logical, factual, or methodological quirk. Studies purportedly showing high rates of transition regret, which are actually low, were exaggerated, outdated, or cherrypicked; rates of regret for those who forcibly underwent puberty were not rigorously considered.

“The Cass Review’s internal contradictions are striking,” the Australian paper retorts. “It acknowledged that some trans young people benefit from puberty suppression, but its recommendations have made this currently inaccessible to all. It found no evidence that psychological treatments improve gender dysphoria, yet recommended expanding their provision. It found that NHS provision of [gender affirming care for trans people] was already very restricted, and that young people were distressed by lack of access to treatment, yet it recommended increased barriers to oestrogen and testosterone for any trans adolescents aged under 18 years.”

The Cass Review was politically charged with predetermined outcomes—it was never going to meaningfully evaluate standards of trans care.

The ideological underpinnings of the Cass Review are undeniable. A child’s gender identity is “incorrectly framed as a clinical problem,” the MJA paper says. “Disturbingly, the Review speculatively conceptualised the continuation of trans identity into adulthood as a potential harm of social transition. It ignored the profound distress, family conflict and school refusal that often occur when a trans child’s insistently expressed identity is not respected.”

If being trans is painted as a harm in and of itself, then there’s a manufactured incentive to suppress a child’s gender transition. If the Cass Review truly desired to accurately help transgender people, it would have actively sought out subject area experts and substantially incorporated feedback from members of the community and those who have worked with them. But they didn’t. Instead, they relied on professionals who largely endorsed the idea that “there is no such thing as a transgender child” to begin with.

“Trans people are not a moral, philosophical or social issue,” the MJA article says. “They are people. The statement ‘some people are transgender’ is a demographic fact, not an ideological position.”

The paper can be found in full here.