CASS REVIEW: SNP placate Greens, placing ideology over clinical science
Patrick Harvie refuses to accept the Cass Review as valid despite being a Minister in a government publicly accepting it. Dysfunction, politics and obfuscation abound
*Note: article edited at 17.52 April 23rd to include the full 5 minute interview*
The Cass Review raises serious questions about SNP-Green gender policy, and the welfare of young people demands we insist our political leaders wrestle with the report seriously.
For those who don’t know, the Cass Review is a 400 page, independent review into gender identity services for children and young people. Dr Hillary Cass, a paediatrician with decades of experience, makes 32 recommendations in a report which is evidence led involving clinicians and those with real lived experiences. In short, a serious document written by and for serious people.
Reading through Dr Cass four year long review, the conclusions are clear that the clinical evidence base for allowing young children to change gender is insufficient, in particular regarding puberty/hormone blockers.
“6. When the Review started, the evidence base, particularly in relation to the use of puberty blockers and masculinising/feminising hormones, had already been shown to be weak. There was, and remains, a lot of misinformation easily accessible online, with opposing sides of the debate pointing to research to justify a position, regardless of the quality of the studies.”1
Furthermore, the evidence regarding how to optimally treat young people in this area is also deemed weak
“There remains diversity of opinion as to how best to treat these children and young people. The evidence is weak and clinicians have told us they are unable to determine with any certainty which children and young people will go on to have an enduring trans identity.”2
The review into NHS gender identity services having found concerns that evidence for allowing children to change gender was built on weak foundations, also noted that children socially transitioning at younger ages were more likely to proceed with medical pathway regardless
“76. The systematic review showed no clear evidence that social transition in childhood has any positive or negative mental health outcomes, and relatively weak evidence for any effect in adolescence. However, those who had socially transitioned at an earlier age and/or prior to being seen in clinic were more likely to proceed to a medical pathway.”3
This then raises questions about Scottish Government policies to date. It has been dishing out taxpayer funding for organisations such as ‘LGBT Youth Scotland’, which is encouraging asking kids as young as four in schools if they are gay, lesbian or transgender.
LGBT Youth Scotland’s SNP-government funded campaign features as part of a wider push in schools, where kids are signed up to serve to promote Scottish Government funded ideological policy vis-à-vis gender; young people asking four year olds if they are trans, non-binary, gay (with higher marks for the schools if bathrooms are ‘gender neutral’).
This comes despite the Cass Review warning that clinical foundations for young people transitioning gender is weak. It comes despite the medical evidence for allowing children to transition gender is constructed on weak foundations.
Dr Hilary Cass in the view helpfully reminds everyone of what ought to be obvious, that “Young people’s sense of identity is not always fixed and may evolve over time” and “whilst some young people may feel an urgency to transition, young adults looking back at their younger selves would often advise slowing down”
Sadly, slowing down is not what the SNP-Green coalition has been doing in Scotland, as the £450,000 of ScotGov money allocated to LGBT Youth Scotland to undertake their campaign in Scottish schools illustrates. I have written before about the insidious and opaque manner in which gender policy is advanced in Holyrood, where clear evidence of policy capture by special interests abounds.
Thursday (18th) saw me invited on to the news to make some of these points in a five minute slot. I attempted to choose my wording carefully, avoiding unhelpful emotive language (whether or not I succeeded I leave for others to judge)
Demonising Hillary Cass
Depressingly the response to the Cass Review has not been measured, considered and thoughtful from the loudest proponents of youth gender transitioning. Dr Cass has been compelled to undertake BBC interviews to defend her professionalism, qualifications and conclusions (from people who show little indication of being familiar with any of it).
“Adults who deliberately spread misinformation about this topic are putting young people at risk, and in my view that is unforgivable.”
Enter one Patrick Harvie, Minister for Zero Carbon Buildings, Active Travel and Tenants' Rights. Mr Harvie is one of those adults spreading misinformation online (and on television), in what seems to be a rear-guard action to defend his ideological possession from scientific realities.
The Scottish Government minister refused to accept the Cass Review was a valid scientific document, which is more than passing strange given Mr Harvie is so eager to attack those ‘climate deniers’ who ‘put ideology and profit over climate science’. But in regards to young people transitioning, Mr Harvie says the clinical science be damned.
All of which stands in striking contrast with the SNP public health minister Jenni Minto, who says “the Scottish Government welcomed the report. I have been reading it and recognise that Dr Cass is an eminent paediatric physician.”
So, the Scottish Government “welcomed the report” but says “no comment” when a Scottish Government minister does the opposite? Doesn’t collective cabinet responsibility exist anymore in this increasingly dysfunctional administration?
Naturally this incongruous disparity was noticed by Dame Jackie Baillie MSP, asking if the SNP led governmet response thus far to Cass was really just a “sop to the Greens to keep the Bute House Agreement alive”.
Almost as if to prove Dame Baillie’s point, Green MSP Gillian Mackay has suggested we all just ignore the Cass Review (Patrick insists it isn’t scientifically valid mind), pointing out we follow the Scottish Trans organisation’s suggestion to set-up of a Scottish research study (Cass is too ‘English’ I suppose?). Because that’s what Scots need, yet another view - but this time ‘Scottish’ - and let’s just punt the 32 Cass recommendations into the long grass. Humza’s future as First Minister means the Scottish Greens need placating, the Bute House Agreement must not fall (or so, in all likelihood, will hapless Humza after the looming SNP General Election disaster)
Ultimately what matters here are the young people - individuals with individual needs, feelings and personal circumstances - to be front and centre. They have an entitlement to treatment which is not founded on a weak clinical basis, where longer term implications are as yet not properly known.
Dr Cass puts it best (emphasis added is my own)
“We're certainly not saying that no-one is going to benefit from these treatments, and I myself have spoken to young people who definitely do appear to have benefited.
But what we need to understand is what's happening to the majority of people who've been through these treatments, and we just don't have that data.
I certainly wouldn't want to embark on a treatment where somebody couldn't tell me with any accuracy what percentage chance there was of it being successful, and what the possibilities were of harms or side effects.”
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Cass Review, page 20, https://cass.independent-review.uk/home/publications/final-report/
ibid, page 22
ibid, page 31