Children 'Weaponised' in Transgender Rights Debate, Says Government Review Author
Children have been "weaponised" by both sides of a contentious debate surrounding transgender rights, according to Dr Hilary Cass, author of a government review into the treatment of children and young people questioning their gender identity.
In an interview with Sunday with Laura Kuenssberg, Dr Cass stated that "people at the extremes" of the debate have caused "quite a lot of distress for young people." She also highlighted the role of "unrealistic images and expectations on social media" in misleading children, suggesting that some young people might have avoided pursuing medical treatments had they "taken more time."
Dr Cass's 2024 review concluded that gender medicine has been operating on "shaky foundations" regarding the evidence supporting medical treatments for gender dysphoria in youth.
During the interview, Dr Cass emphasized a "lack of realism about what transition would really mean and how hard it would be," referencing "quite intensive medical treatments" and "sometimes quite brutal surgeries."
"There are a tiny number of people who will never be comfortable with their biological sex, with the gender associated with their biological sex. And for them, a medical pathway is the only way they're going to live their life comfortably. And we don't understand why that is, but we have to try and help those people thrive as much as the young people who are going to grow out of this."
The review was commissioned amid growing concerns about the increasing number of children and young people experiencing gender-related distress, particularly at the Tavistock Clinic in London.
When asked about the proportion of children whose distress about their gender persists into adulthood, Dr Cass said it was impossible to provide an exact figure but estimated it to be a "really tiny number."
She provided historical context, noting that when the Tavistock Clinic began, approximately 50 children per year were referred in the UK, which had risen to 3,500 annually by the time of her review.
Dr Cass explained efforts to track outcomes for children who did not pursue medical pathways were unsuccessful, as the clinic did not follow up on these cases or maintain relevant data.
She added that many children undergo two to three years of gender questioning before ultimately desisting.
Regarding whether children have been let down by an adult-led debate, Dr Cass responded affirmatively, stating that children "were also caught up in all the issues about single-sex spaces and sports and safe areas for women which were actually not to do with the children but they were somehow part of a football within it."
"That's a real shame that children have been weaponised."
Dr Cass observed that the majority of people occupying moderate positions in the debate have remained silent, while "people at the extremes" and media rhetoric have been "frightening for young people."
She further commented on the impact of activism, noting that some trans rights activists have been "so strident that it's made it more difficult for trans people themselves who are just trying to live under the radar," while those opposing any form of transition have "similarly made it difficult."
Dr Cass praised recent government guidance for schools in England, published earlier in the week, and stressed the importance of caution regarding very young children beginning the transitioning process.
"If they socially transition too early we think they can get locked onto a trajectory that may not have been the correct natural trajectory for them."
When questioned about the rise in children and young people experiencing gender dysphoria, Dr Cass described the causes as "complex," citing a different cultural context where individuals are "less locked into gender stereotypes."
"I think what has kind of misled children is the belief that if you are not a typical girl, if you like playing with trucks, or boys who like dressing up or that you have same-sex attraction that means that you're trans and actually it's not like that but those are all normal variations," she said. "I think children and young people were being given a narrative that it's not okay to be anything but absolutely typical of the other girls on Instagram."
Reiterating her earlier point, Dr Cass stated that for those who will never be comfortable with the gender associated with their biological sex, "a medical pathway is the only way they're going to live their life comfortably."
"And we don't understand why that is, but we have to try and help those people thrive as much as the young people who are going to grow out of this," she said.
Dr Cass also emphasized the importance of proceeding with a controversial clinical trial of puberty blockers for under-16s, warning that without it, "we're going to have ongoing charlatans just handing out inappropriate drugs," and noted concerns about the private sale of such drugs, particularly online.
Puberty blockers, which suppress hormones responsible for puberty, are often prescribed to children questioning their gender to halt physical changes such as breast development or facial hair growth.
Following the Cass review’s safety concerns, puberty blockers were banned for under-18s, but a clinical trial to assess their safety was announced last year.
The trial has faced ethical questions from campaigners, while the charity Stonewall stated it is "vitally important" that all LGBTQ+ individuals have access to high-quality, evidence-based, and timely healthcare.
Dr Cass denied accusations that she had prevented young people and families from receiving necessary help, stating that new centres will ensure "individualised treatment."
"The biggest hurdle at the moment is they are still working through the big backlog," she said.
