Thousands of vulnerable children questioning their gender identity have been let down by the NHS, according to a landmark report by Dr Hilary Cass, a leading consultant paediatrician. The report criticises the use of unproven treatments and the 'toxicity' of the transgender debate, which has hindered care.
Dr Cass, who was commissioned by NHS England in 2020 to investigate the Tavistock and Portman NHS trust's gender identity development service (Gids), found that puberty blockers and cross-sex hormones were prescribed despite 'remarkably weak evidence' of benefit and potential harm. The service treated around 9,000 children and young people between 2009 and 2020.
The report has already led to the closure of Gids and a ban on puberty blockers for under-18s, replaced by a 'holistic' model focusing on psychological support. Dr Cass stressed that for most young people, a medical pathway is not the best approach, and those who do need medical intervention should also receive mental health support.
Dr Cass highlighted the polarised public debate, saying professionals are 'afraid to openly discuss their views' and face vilification on social media. She urged an end to 'name-calling' that echoes bullying behaviour. The report recommends screening for neurodevelopmental conditions and mental health assessments for all gender-questioning young people.
Shadow health secretary Wes Streeting called the report a 'watershed moment', emphasising that children's healthcare must be evidence-led and free from culture wars. Professor Sallie Baxendale of University College London said the report 'laid bare' the lack of evidence for previous treatments.
