Memo to the CBC and the government: the medicalized transition bubble has burst
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Pock, pock, pock. That’s the sound of champagne bottles being opened throughout the West by people who care about children’s mental and physical health. They are celebrating the 338-page final report and recommendations to England’s National Health Service (NHS) by pediatrician Dr. Hilary Cass and her team, the product of a four-year investigation into the efficacy of social and medical transitioning of children diagnosed with gender dysphoria in England’s gender identity clinics and services.
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Accompanied by thorough reviews of the scientific evidence to support its recommendations, the Cass Review delivers what gender-extremism critics hoped for: the conclusion that gender-affirmative medical practice is built on “remarkably weak evidence.”
The NHS swiftly acknowledged the report’s importance and its intention to comply with the recommendations. “Your final report will not just shape the future of health care in this country for children and young people experiencing gender distress but will be of major international importance and significance,” wrote John Stewart and James Palmer, two directors of NHS England, in a letter to Dr. Cass.
Cass deplored the fact that ideology was guiding treatment, “rather than care being directed by normal principles of pediatrics and mental health.” Her findings included a troubling fear of dissent among medical professionals. They were “afraid,” she said, “to do the things that they would normally do in any other consultation with a young person, and that can’t be right.” She called for NHS gender services to return to a more “holistic assessment” of those referred — that is, a return to responsible therapeutic norms.
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The finding that most puberty-blocked children go onto cross-sex hormones was taken as a rebuttal to the popular activist bromide that puberty blockers only effect a reversible “pause.” Specifically, Cass calls for a halt to puberty blockers and powerful hormones for those under 18. “For most young people, a medical pathway will not be the best way to manage their gender-related distress,” she writes. Even social transitioning in youth can have negative consequences. The report recommends that social transitioning in pre-pubertal children should be done under the supervision of a health-care professional, who should “help families to recognize normal developmental variation in gender role behaviour and expression.”
The response in the United Kingdom has been enthusiastic. Prime Minister Rishi Sunak approved the report’s recommendation for exercising “extreme caution” with the use of puberty blockers in youth, stating, “We care above all about the well-being of children.” The British Labour party says that if it wins the upcoming general election, it will fully implement the Cass report’s recommendations in England. (The devolved governments in Scotland and Wales will do their own reviews of the report.) Kamran Abbasi, the editor-in-chief of the British Medical Journal, wrote that, “The Cass review is an opportunity to pause, recalibrate and place evidence informed care at the heart of gender medicine.”
Britain will now become the fifth European country to acknowledge and act on the recognition that the rapid-affirmation, meds-profligate, co-morbidity-indifferent model of treatment for distressed children has been a dreadful mistake. England’s rapid-affirmation model is headed for the dustbin of history where it belongs. This report is so forensically thorough, disinterested and irrefutable that it is just a matter of time until all the jurisdictions that fell down the anti-science gender rabbit hole follow suit.
Even … Canada? (Insert sound of columnist sighing here.)
A CBC article, published in its health section on Monday, which features dissent from the Cass report’s findings, will likely encourage the government to double down on its extreme affirmation-supportive position. Titled, What Canadian Doctors Say About New U.K. Review Questioning Puberty Blockers for Transgender Youth, the article uncritically showcases argumentation that is so weak, partial or circular, it is unworthy of publication by any respectable media outlet, let alone a taxpayer-funded one.
For example, in response to the criticism that puberty blockers are given to children “off-label,” one interviewed doctor (who treats trans patients) explains that 75 per cent of all drugs are given to children off-label. What he doesn’t say is that with other drugs, it is a question of dosage, not, as in the case of Lupron, for a completely different indication.
The article also cites the World Professional Association of Transgender Health (WPATH) as a reliable source of bona fide science, failing to note the recent scandal that exposed its shameful privileging of ideology over ethical responsibility. WPATH guidelines are, according to Montreal endocrinologist Dr. Roy Eappen, opinion rather than science-based, and therefore “the lowest grade of evidence.” He also disparaged the article for the reporter’s failure to consult a proper expert on evidence-based medicine.
The article is so amateurish, it attracted mockery and derision on social media. In one notable example, Jesse Singal, a chevroned journalist in the child-transition wars, posted a thread on Twitter that begins: “The Cass Review explains, in detail, why we need to trust systematic reviews over both doctors’ anecdotal evidence and low-quality standards published by professional associations. The CBC responds by publishing an article that cites professional associations and is dominated by doctors’ anecdotal accounts. Science journalism seems screwed at the moment.”
Memo to the CBC and the government: The medicalized transition bubble has burst. The affirmation-model Titanic has hit the iceberg. You have a choice — jump into a lifeboat named “We were wrong,” or strike up the band with “Nearer my ideology to thee,” and go down with the ship. Tick-tock, tick-tock, tick-tock.
National Post
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Twitter.com/BarbaraRKay
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