THE doctors’ union has called for the implementation of the Cass Review to be paused while it carries out a “critique” of the report’s implementation.
The report, 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.
Now, the British Medical Association (BMA) has said it is going to carry out an evaluation of the review’s recommendations into a healthcare system which it said has “failed transgender patients”.
The evaluation will likely take the rest of the year to complete.
The union said transgender and gender-diverse patients “should continue to receive specialist healthcare, regardless of their age” and repeated criticism of the ban on puberty blockers, calling instead for “more research to help form a solid evidence base for children’s care”.
Members of the BMA's council recently voted in favour of a motion which asked the association to “publicly critique the Cass Review”, due to what it called “unsubstantiated recommendations driven by unexplained study protocol deviations, ambiguous eligibility criteria, and exclusion of trans-affirming evidence”.
Of the “task and finish” group established by the union, the BMA’s chairman of council, Professor Philip Banfield, said: “It is vitally important we take time and care to get this work right.
“This is a highly specialised area of healthcare for children and young adults with complex needs, and as doctors we want to be sure they get the most appropriate care and the support they need.
“The task and finish group will make recommendations to improve the healthcare system that has, for too long, failed transgender patients.
“It will work with patients to ensure the evaluation invokes the old adage in medicine of ‘no decision about me without me’.
“It is time that we truly listen to this group of important, valued, and unfortunately often victimised people and, together, build a system in which they are finally provided with the care they deserve.”
A spokesperson for the NHS in England said the organisation had “full confidence” in the Cass Review and that it was committed to taking forward its recommendations.
The spokesperson added: “Dr Cass spent four years gathering evidence for the most comprehensive report of its kind, and her expertise and advice has been invaluable in supporting the NHS to create a fundamentally better and safer service for children and young people.
“NHS England has full confidence in her report and we are committed to taking forward its recommendations.
“We will shortly be publishing our plan to implement the report’s recommendations and findings, which includes setting out scope for further research, so children and young people can receive the best-possible care.”
The BMA said the critique will be shared with its UK council at its January 2025 meeting.
A Department of Health and Social Care spokesperson said: “The Cass Review is a robust report backed by clinicians and firmly grounded in evidence.
“NHS England will be implementing Dr Cass’s recommendations so that children and young people get the safe, holistic care and support they need.
“We do not support a delay to vital improvements from the NHS to gender services.”
NHS Scotland has been contacted for comment.
