The Cass Review

The UK National Health Service commissioned this review in 2020 amid growing concerns about the ‘affirmation model’ of treatment for trans-identifying children. It is the largest systematic review of evidence to date on gender-transition medicine. Dr Hilary Cass has now released her final report, known globally as the Cass Review.

There is no evidentiary basis for medical gender-affirmation therapies in children.

Claims that gender affirmation treatment prevents suicide were found to be without credible evidence base.  

Available research on puberty suppression and cross-sex hormone treatment is of such poor quality that no foundation exists for clinical decisions and informed consent. 

Clinicians are unable to determine which children and young people will have an enduring trans identity. 

The long-term impact of puberty suppression and cross-sex hormones on cognitive and psychosexual development is unknown. 

An unusual number of children who believe they are trans are neurodiverse, have psychiatric disorders or mental health issues. 

Initial research indicates that children presenting at gender clinics have experienced higher-than-usual levels of maternal / paternal mental illness, exposure to domestic violence, emotional abuse and combined neglect or abuse. 

A review of the first 124 cases at the NHS Gender Identity Development Service found over 25% had spent some time in care, and nearly 50% were living with only one parent. 

73% of patients discharged between April 2018 and December 2022 were natal sex female.  Demands immediate suspension of use of puberty blockers and cross-sex hormones for Australian children.