The recent report borrows from DeSantis bans on transgender care in Florida and appears designed to provide political justification for further attacks on transgender care.
Thank you Erin. I am partway through reading it myself. It is a certainty that their claims are unjustifiable to anyone not yet partisan in the matter -- that they arrive at the claim gender affirming care per WPATH standards of care are weakly supported by data, only by their ignoring 93%~99% of the data in a way which would never be tolerated to be done for other areas of medical care.
This has to be regarded as the deliberate attempt to inflict grotesque child abuse on some children for no reason but the moral vanity of politics -- forcing some girls to have beards and deep voices, and forcing some boys to have breasts and periods.
These "gender critical" people are monsters, and nothing other.
The Atlantic rushed to press with an article blatantly in support of the Cass report. I could tell within the first paragraph of the article that the Cass report was nothing more than a smear job. Citing things like there actually are some side effects from puberty blockers to support banning them. There are side effects from aspirin too. Yet the side effects from aspirin are not monitored by physicians like is required for puberty blockers. It is frustrating that publications latch onto reports with zero depth of research or even critical thinking. It serves to legitimize crackpot science and further demonize transgender people. We are here. We have always been here. We will always be here regardless of agenda "science" or fascist politics. We are a fact not a lifestyle choice. I sure as hell didn't choose to be transgender. Yet I embrace who I am and my brothers and sisters like me who are all humans and deserve human rights. Needless to say, I no longer subscribe to the Atlantic.
The Cass Review felt like a setup when it was released and the deeper people delve into it, that's exactly what it is being shown to be. Unfortunately, the sad reality is that England appears eager to act on it. Trans care was already woefully inadequate over there and this is only going to make things worse. I still think the truth will ultimately win out, but in the short term, trans people are screwed in England and it's heartbreaking.
This report will go down in infamy as one of the worst scandals ever in academic medicine, certainly since Andrew Wakefield's vaccine-autism paper, and especially heinous as it targets a vulnerable and marginalized population. Scant consolation to those affected by it, though.
I'd also add to your excellent summary that Dr. Cass does not have any subject matter expertise in trans-related healthcare. Would anyone suggest that one with no experience whatsoever in oncology should be commissioned to write a review of the oncology literature that will impact clinical care?
I spent time reading the report and especially section 6. It was not hard to deconstruct their fallacies and clear bias. I was very underwhelmed with the extremely limited viewpoints that were presented. My favorite is them talking about randomized controlled trials when cohort studies are the next best thing on the evidence pyramid and claiming it wasn't enough.
Here are a couple of my thoughts on section 6:
Section 6.4 – biological sex is not determined by sex chromosomes. Chromosomes are nothing more than storage or carrier structures of the underlying genetics. Biologic sex is determined by a massive and complex array of genetics and epigenetics. There is no overall general consensus of the definition of biologic sex. Most definitions center around reproductive ability which is not fully determined or realized until well into puberty. Sex assigned at birth is based on appearance of external anatomy. Chromosomes are not frequently used to determine sex assigned at birth unless there is a need to perform an analysis. Section 6.4 massively underrepresents the significance of and variation of results from the gestational period in human sex development~
Section 6.7 – under represents biology and inflates social factors to being identical representations. For example, for sexual orientation, there is no one social factor or “trigger” that has been identified as a cause of homosexuality. Gender incongruence has been represented across societies, history, culture, religions, and languages. There is no one single or collective social cause or trigger of gender incongruence.
Section 6.19- a study from 1966? And no other references to modern studies? The research is there and better than an article from 1966.
Section 6.21-24 – indicate a strong nature component and cites DSD. Should also add DSD is very much underdiagnosed.
Section 6.29 - is not the recommendations by the World Health Organization which recommend avoiding surgeries unless needed for metabolic function. interestingly, at what age should an individual with DSD make the decision to have a surgery? 12? 16? 18? 25?
Section 6.39 – by age 15, adolescents make similar decisions to hypothetical situations as an adult. The rest of the statement is a logical fallacy, adults make poor decisions as well.
The toy argument was terrible and not based on a complete analysis of the research and misrepresented the conclusions in those articles.
I can go on and on, but these hit some of the highlights.
It's so back to basics, we want people to be treated as they are. Accounting for trans people is part of our responsibility in the modern world. I'll be God damned if that's not an important standard to hold our society to. Letting people not be beaten up to where they overdose on their meds, and have to leave us. I demand a world that validates people.
" influenced into being trans by being friends with other trans people"
I will say this. Over the last 15 years nearly every single one of my friends has come out as trans one by one by one. And these aren't simple Egg cracking moments. These were deeply held feelings that had lasted for years long before anyone came out.
Its kind of ridiculous to me how we all just seem to manage to find each other. I have heard of this happening to other groups of people.
Its not a social contagion. We just relate to each other very well even outside of the trans context. It might look like a social contagion but its anything but that.
Other things about this actual report. I knew it was going to be bad when they dismissed something like 95% of the papers cited as "insufficiently rigorous". Like they just can't beleive we would be happy.
I was listening to a streamer the other day talking about this and similar reports (i think he was going through the citations in the Cass report). In one of these studies they were looking at the regret rates of people who had gotten bottom surgery in the 1970s and noted that none of them regretted the surgery, but they found no improvement to mental health and relationships of these people. Its like no crap, they were still living in a highly transphobic society. This is a very important point in these studies. a) because overwhelmingly, positive results are documented even in the face of all of this adversity and b) often when negative results are found it is most likely that the cause is their treatment by society and/or religion coming into play.
Lady MacBeth expresses this wish in MacBeth, Act 1, Scene 5: "Come, you spirits That tend on mortal thoughts, unsex me here, ..."
Based on the reasoning in the Zucker study, Lady MacBeth is expressing a transitory wish to be a different gender, therefore she is a transgender person who desists. Utter freaking nonsense. If you count every girl who ever looked with envy at the boys when she was being condescended to or belittled or sexually harassed and wished for a moment she didn't have to deal with all that, then you'd probably label half the female population as desisting transgender people.
Oh yeah “wrongly gendered toys” are the real issue. Better not let any children play with them. I mean if Johnny touches that Barbie he’s gonna go fruity 🥴
David Brooks opinion piece today frames the Cass report as “courageous.” It’s so frustrating to read. And all the comments full of ill informed praise. I was glad to see one comment making the same points you made in your article. Thank you for all your work to bring accurate information to light.
Because the Conservatives (of which I'm including Starmer's Labour party) and gender criticals want trans kids dead. That's their ultimate goal. :(
Both Starmer and Sunak would love to bring back Section 28. And I'm absolutely annoyed that SNP went along with it and stopped prescribing puberty blockers in NHS Scotland.
I read some of the comments on the Washington post article and it's really sad that at least half the commenters thought the Cass study was unbiased, careful research.
Thank you Erin. I am partway through reading it myself. It is a certainty that their claims are unjustifiable to anyone not yet partisan in the matter -- that they arrive at the claim gender affirming care per WPATH standards of care are weakly supported by data, only by their ignoring 93%~99% of the data in a way which would never be tolerated to be done for other areas of medical care.
This has to be regarded as the deliberate attempt to inflict grotesque child abuse on some children for no reason but the moral vanity of politics -- forcing some girls to have beards and deep voices, and forcing some boys to have breasts and periods.
These "gender critical" people are monsters, and nothing other.
The Atlantic rushed to press with an article blatantly in support of the Cass report. I could tell within the first paragraph of the article that the Cass report was nothing more than a smear job. Citing things like there actually are some side effects from puberty blockers to support banning them. There are side effects from aspirin too. Yet the side effects from aspirin are not monitored by physicians like is required for puberty blockers. It is frustrating that publications latch onto reports with zero depth of research or even critical thinking. It serves to legitimize crackpot science and further demonize transgender people. We are here. We have always been here. We will always be here regardless of agenda "science" or fascist politics. We are a fact not a lifestyle choice. I sure as hell didn't choose to be transgender. Yet I embrace who I am and my brothers and sisters like me who are all humans and deserve human rights. Needless to say, I no longer subscribe to the Atlantic.
The Cass Review felt like a setup when it was released and the deeper people delve into it, that's exactly what it is being shown to be. Unfortunately, the sad reality is that England appears eager to act on it. Trans care was already woefully inadequate over there and this is only going to make things worse. I still think the truth will ultimately win out, but in the short term, trans people are screwed in England and it's heartbreaking.
This report will go down in infamy as one of the worst scandals ever in academic medicine, certainly since Andrew Wakefield's vaccine-autism paper, and especially heinous as it targets a vulnerable and marginalized population. Scant consolation to those affected by it, though.
I'd also add to your excellent summary that Dr. Cass does not have any subject matter expertise in trans-related healthcare. Would anyone suggest that one with no experience whatsoever in oncology should be commissioned to write a review of the oncology literature that will impact clinical care?
I spent time reading the report and especially section 6. It was not hard to deconstruct their fallacies and clear bias. I was very underwhelmed with the extremely limited viewpoints that were presented. My favorite is them talking about randomized controlled trials when cohort studies are the next best thing on the evidence pyramid and claiming it wasn't enough.
Here are a couple of my thoughts on section 6:
Section 6.4 – biological sex is not determined by sex chromosomes. Chromosomes are nothing more than storage or carrier structures of the underlying genetics. Biologic sex is determined by a massive and complex array of genetics and epigenetics. There is no overall general consensus of the definition of biologic sex. Most definitions center around reproductive ability which is not fully determined or realized until well into puberty. Sex assigned at birth is based on appearance of external anatomy. Chromosomes are not frequently used to determine sex assigned at birth unless there is a need to perform an analysis. Section 6.4 massively underrepresents the significance of and variation of results from the gestational period in human sex development~
Section 6.7 – under represents biology and inflates social factors to being identical representations. For example, for sexual orientation, there is no one social factor or “trigger” that has been identified as a cause of homosexuality. Gender incongruence has been represented across societies, history, culture, religions, and languages. There is no one single or collective social cause or trigger of gender incongruence.
Section 6.19- a study from 1966? And no other references to modern studies? The research is there and better than an article from 1966.
Section 6.21-24 – indicate a strong nature component and cites DSD. Should also add DSD is very much underdiagnosed.
Section 6.29 - is not the recommendations by the World Health Organization which recommend avoiding surgeries unless needed for metabolic function. interestingly, at what age should an individual with DSD make the decision to have a surgery? 12? 16? 18? 25?
Section 6.39 – by age 15, adolescents make similar decisions to hypothetical situations as an adult. The rest of the statement is a logical fallacy, adults make poor decisions as well.
The toy argument was terrible and not based on a complete analysis of the research and misrepresented the conclusions in those articles.
I can go on and on, but these hit some of the highlights.
It's so back to basics, we want people to be treated as they are. Accounting for trans people is part of our responsibility in the modern world. I'll be God damned if that's not an important standard to hold our society to. Letting people not be beaten up to where they overdose on their meds, and have to leave us. I demand a world that validates people.
" influenced into being trans by being friends with other trans people"
I will say this. Over the last 15 years nearly every single one of my friends has come out as trans one by one by one. And these aren't simple Egg cracking moments. These were deeply held feelings that had lasted for years long before anyone came out.
Its kind of ridiculous to me how we all just seem to manage to find each other. I have heard of this happening to other groups of people.
Its not a social contagion. We just relate to each other very well even outside of the trans context. It might look like a social contagion but its anything but that.
Other things about this actual report. I knew it was going to be bad when they dismissed something like 95% of the papers cited as "insufficiently rigorous". Like they just can't beleive we would be happy.
I was listening to a streamer the other day talking about this and similar reports (i think he was going through the citations in the Cass report). In one of these studies they were looking at the regret rates of people who had gotten bottom surgery in the 1970s and noted that none of them regretted the surgery, but they found no improvement to mental health and relationships of these people. Its like no crap, they were still living in a highly transphobic society. This is a very important point in these studies. a) because overwhelmingly, positive results are documented even in the face of all of this adversity and b) often when negative results are found it is most likely that the cause is their treatment by society and/or religion coming into play.
Lady MacBeth expresses this wish in MacBeth, Act 1, Scene 5: "Come, you spirits That tend on mortal thoughts, unsex me here, ..."
Based on the reasoning in the Zucker study, Lady MacBeth is expressing a transitory wish to be a different gender, therefore she is a transgender person who desists. Utter freaking nonsense. If you count every girl who ever looked with envy at the boys when she was being condescended to or belittled or sexually harassed and wished for a moment she didn't have to deal with all that, then you'd probably label half the female population as desisting transgender people.
Oh yeah “wrongly gendered toys” are the real issue. Better not let any children play with them. I mean if Johnny touches that Barbie he’s gonna go fruity 🥴
Like I said, we're on the cusp of another Lavender Scare like the 1950s.
Good work as always. Quick fix: "Cass uses this to essential claim that" probably was supposed to be "essentially".
David Brooks opinion piece today frames the Cass report as “courageous.” It’s so frustrating to read. And all the comments full of ill informed praise. I was glad to see one comment making the same points you made in your article. Thank you for all your work to bring accurate information to light.
Because the Conservatives (of which I'm including Starmer's Labour party) and gender criticals want trans kids dead. That's their ultimate goal. :(
Both Starmer and Sunak would love to bring back Section 28. And I'm absolutely annoyed that SNP went along with it and stopped prescribing puberty blockers in NHS Scotland.
I shared a link to this as a comment to an opinion piece in today's Washington Post -
“A new report roils the debate on youth gender care”
You can go read and comment about how bad it is here - https://www.washingtonpost.com/opinions/2024/04/18/cass-review-young-people-gender-transition/
Liked and restacked.
Also, I think this is less of an "opinion" and more of common sense and facts!
I read some of the comments on the Washington post article and it's really sad that at least half the commenters thought the Cass study was unbiased, careful research.