Trans bans

It is not often that an almost 400-page report is greeted with such a reception, sparking colourful and widespread debate. But the Cass Review, an independent report into the UK's gender identity services for under-18s, has achieved just this.

Led by paediatricianA doctor who works with children. Dr Hilary Cass, the report claims that young people are being "let down" by the lack of substantial evidence on medical interventionsThe act or fact of taking action about something in order to have an effect on its outcome. related to gender identity.

"The reality is we have no good evidence on the long-term outcomes of interventions to manage gender-related distress," Dr Cass writes, expressing concern that gender clinics have been too hasty to prescribe "treatments" which have not been assessed for their long-term safety.¹

There has been a sharp rise in young people accessing gender identity services in recent years. In 2009, the gender identity development service of the NHS saw fewer than 50 children in a year. By 2021-2022, this had increased to more than 5,000.²

This has led to huge backlogsPlural of backlog, meaning an accumulation of unfinished work.. For trans people, the wait for a first appointment at a gender identity clinic can be five years or more, despite a target of 18 weeks.³

Young trans woman Ellie Gomersall says that the report's criticism of prescribing puberty blockers for trans youth fills her with "fear", as she recalls going through male puberty.

"Knowing I was a girl, the irreversible change of my body caused me much distress," she states.⁴

The UK has been at the centre of a raging debate over transgender issues, much of it politically charged.

Recent surveys show that 94% of trans people are happier after medically transitioning.⁵ Some say that we should listen to these positive experiences, rather than letting political disagreements prevent trans people accessing potentially life-saving healthcare.

But others express concern that the controversialCausing a lot of angry public discussion and disagreement. debate means that some medical staff are now scared to speak up with their concerns over gender-related treatments.

Should politics stay out of medicine?

Yes: Policymakers should have nothing to do with medical decision-making. This should be done purely on evidence-based research, which shows that transitioning makes the vast majority of transgender people happier.

No: Politics has its place in medicine. Trans healthcare is a central concern for many people.

Or... Expressing concern about the rapid rise in gender-related treatments in the past decade is not "political". Nor is making reasonable statements about the fact that we are not aware of the long-term effects of some treatments.