The Andrew Lewer Column: Cass report uncovers scandal on NHS gender identity services

The recent publication of the Cass review, on NHS gender identity services for children, has sent shock waves across the country and confirmed what some of us suspected: NHS gender identity services have been ideologically driven more by cult groups like Stonewall and Mermaids and less by clinical evidence. As a result, they have failed our most vulnerable children and did them great harm.
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Even though we seem to have so many of them, this really is a national scandal of epic proportions. Thankfully many more people seem have been finally snapped out of their delusions on this issue. There is no more sitting on the fence. This report has given gender identity service practices, a powerful and painful push into the real world. We need to ask, how could so many in senior positions have let this happen in the first place?

Psychologists as a profession were at the forefront promoting an ideology that was almost impossible to challenge and, as the Cass review found, largely failed to carry out proper assessments of troubled young people, failing in their most basic duty to keep proper records. Beyond that were the activist organisations like Mermaid and Stonewall who created the ideological framework. They operated within the healthcare setting and their views were taken as gospel truth.

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Any deviation, any questioning of gender transitioning was met by a wall of hostility. Even now, the Chair of this report, Consultant Paediatrician and former President of the College of Paediatrics and Child Health, Dr Hilary Cass says she cannot take public transport for fear of abuse from trans activists. For other medical professionals, it was career ending. Those whistleblowers have now been vindicated. In her report she stated: “There are few other areas of healthcare where professionals are so afraid to openly discuss their views, where people are vilified on social media, and where name-calling echoes the worst bullying behaviour. This must stop.”

The Cass Review – named after its head, Dr Hilary Cass – was released last weekThe Cass Review – named after its head, Dr Hilary Cass – was released last week
The Cass Review – named after its head, Dr Hilary Cass – was released last week

These clinics have made life changing interventions upon on vulnerable children and young people with little proper high-quality evidence behind them. Those decisions included wearing breast binders, the taking of puberty blockers and up to the removal of breasts and genitals. Referrals to specialist child and adolescent gender identity health services increased from 210 per year for 2011-12 to over 5,000 per year for 2021-22. We know that there is an over-representation of girls and those with autism. One third of all children referred to Gender Identity services have Autism Spectrum Disorder. This data should have been ringing deafening alarm bells, but they did not.

The scope of the Cass report was limited to bodies within the NHS, yet the issues are much wider. By the time children come for their assessment, schools have been making key decisions outside their area of competency, determining the "gender" of the child and allowing changes in dress and changing their pronouns on the child’s say so, sometimes without informing parents or even against their expressed wishes. School policies, informed more from activist groups than any evidenced medical intervention are storing up problems.

I foresee a growing wave of litigations aimed both at school bodies and the NHS, now that the evidence of ideological driven error emerges. It is not an exagerration to describe it as we will see this period of our history as a child abuse.

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I have been vocal on the issue of gender reassignment for quite some time now. Last year in Parliament I spoke out about NHS policies badly letting women down in hospital when women who wish, when being intimately examined, to have this performed by a female medical professional are being forced to have a man examine them simply because he self-identifies as a woman. This is wrong. Thankfully, the tide is turning on these issues. They could not be turning soon enough.

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