THE Cass Review “obscures key findings, misrepresents its own data, and is rife with misapplications of the scientific method”, according to a review by academics from Yale Law School and the Yale School of Medicine.
A team of international scientists from Yale, led by Professor Anne Alstott and Dr Meredithe McNamara, have savaged the landmark report into transgender healthcare for young people provided by the NHS in England.
The review, which was published by Dr Hilary Cass earlier this year, made a series of recommendations about what should change in the provision of transgender healthcare for under-18s.
It led to the NHS in Scotland pausing the prescription of puberty blockers and hormone treatments to new patients under-18 after Cass claimed there was “remarkably weak” evidence on medical interventions.
However, the report has now been harshly criticised by academics at the renowned American university.
According to McNamara, the review “levies unsupported assertions about gender identity, gender dysphoria, standard practices, and safety of gender-affirming medical treatments” and “repeats claims that have been disproved by sound evidence.”
The Cass Review is also accused of containing “serious methodological flaws, including the omission of key findings in the extant body of literature.”
“It is vital that the national and international medical community, policymakers, and the media understand what the Cass Review is and what it is not,” Alstott said.
“The review will likely be cited by states attempting to ban gender-affirming care, but, in fact, it is does not recommend a ban on medical care for transgender youth.”
“The Cass Review is an important document for those considering how to remedy the shortage of health services for transgender young people in the UK,” said McNamara.
“It is not an authoritative guideline or standard of care, nor is it an accurate restatement of the available medical evidence on the treatment of gender dysphoria."
The report was co-authored by eight legal scholars and scientists with expertise in adolescent medicine, paediatric endocrinology, child and adolescent psychiatry, and epidemiology, according to Yale.
A spokesperson for the Scottish Government said:
“The Cass Review is a comprehensive and valid scientific document. In line with NHS England – for whom the report was commissioned – we are considering all the recommendations. The Chief Medical Officer will update the Scottish Parliament on the multidisciplinary team’s consideration of the Cass Review, shortly.
“The decision by NHS Greater Glasgow and Clyde and NHS Lothian to pause new prescriptions for puberty hormone suppressants and cross-sex hormones for those aged under 18 years was a decision made by the Health Boards on clinical advice. That position has not changed.”
Scottish Greens MSP Maggie Chapman said: "We stand with the young people who, through no fault of their own, have had their lives turned into a toxic political football as part of the desperate Tory culture war.
"It is their wellbeing and right to healthcare that we must focus on, rather than the cynical political games and demonisation we have seen so much of, particularly in the aftermath of the report.
“Trans people know their own minds. We should listen to them and put them at the heart of policymaking, rather than forcing them to be bystanders while their rights and lives are debated in the most callous ways.
"We must see action to tackle the unacceptable waiting times trans people face for even the most basic consultations. There is clearly a lot of work to do if we are to build a truly supportive, responsive and caring system.
She added: "Rishi Sunak and Keir Starmer are in the press every day trying to outdo each other in a bid to see who can punish trans people the most for being who they are. We cannot let that happen.
"We need all parties to stand together to deliver the Gender Recognition Reform that our parliament voted for, a full ban on all conversion practices, and the life-affirming and life-saving healthcare they deserve.”
The damning assessment throws into doubt the accuracy of Cass’s review and the policy decisions which have been taken in its wake, including the ban on puberty blockers and hormone therapy for under-18s in Scotland.
It comes after two transgender academics in Scotland warned that “politicisation” of the report’s findings should not be allowed to guide decision-making.
