Vindicated: British Medical Association Drops Opposition to Cass Review

In 2020 Britain’s National Health Service commissioned an investigation into the medical research supporting gender affirming care for children. Dr. Hilary Cass spent four years gathering evidence as part of what became known as the Cass Review. Her findings were published in April 2024 and they concluded that the medical research behind many aspects of gender affirming for kids was weak.

The former president of the Royal College of Paediatrics and Child Health said there was no evidence the drugs “buy time to think” or “reduce suicide risk”…

Dr Cass stated there was “concern that [puberty blockers] may change the trajectory of psychosexual and gender identity development” with most patients going on to take cross-sex hormones as a result.

She said the NHS should exert “extreme caution” in giving out cross-sex hormones to under-18s as the research carried out by her review concludes there is “a lack of high-quality research” on their effectiveness.

There was an immediate backlash to the Cass Review on both sides of the Atlantic. The British Medical Association contradicted the review’s conclusions and basically stuck with gender affirming care. They also attempted to undermine the reliability of the Cass Review and said they would be carrying out their own evaluation of it.

The British Medical Association has called for children to be given puberty blockers to help them change gender and vowed to oppose the implementation of the Cass review.

Leaders of the doctors’ union have voted in favour of a motion calling for “prompt access” to gender-affirming medical interventions for under-18s, including sex hormones that block puberty…

The BMA announced on Wednesday that it would carry out an evaluation of the Cass review, raising concerns about “weaknesses in the methodologies used in the review”. The union said that, in the meantime, the implementations of the Cass review should be paused.

This announcement created its own backlash inside the BMA, with hundreds of doctors signing a letter opposing the group’s opposition.

More than 1,400 doctors, 900 of whom are BMA members, have signed an open letter calling for the BMA to drop its opposition to Cass. Some have resigned from the union after being members for up to 50 years, with others describing the BMA’s leadership as“abysmal”, “increasingly bonkers” and “ideologically captured”.

The BMA’s governing council voted to reject the Cass review in a private meeting in July but the union’s membership base of 195,000 doctors was not consulted.

Following the criticism, the BMA council held a further vote last month to say it would approach its critique of the review “neutrally”.

As for Dr. Cass herself, she said the group had no grounds on which to oppose her review.

Dr Hilary Cass has criticised the British Medical Association for its “puzzling” decision to oppose the findings of her review into NHS services for transgender children.

The paediatrician said that the doctors’ union had no evidence to back up its critique of her review, and that the BMA’s stance represented only a “small minority” of the medical profession…

Cass said the BMA’s critique was based on “online sources mainly from the US”, adding: “When thinking about evidence-based care, they haven’t produced any evidence that the review should be stopped.”

Dr. Cass would eventually be proven right. Yesterday, the BMA concluded its own evaluation of the Cass Review and announced that the organization no longer opposed it. The lead author said Dr. Cass had been “vindicated.”

In July 2024, the BMA’s council voted to “oppose the implementation” of the review, which called for an overhaul of NHS gender services and a move away from a “medical pathway” that had led to thousands of children being put on powerful sex hormone drugs.

The BMA said at the time that the recommendations by Dr Hilary Cass, now Baroness Cass, were “unsubstantiated”…

On Wednesday, the BMA published this long-awaited critique of Cass’s work, written by a “task and finish group” of 12 union members.

Professor David Strain, the chair of the BMA’s board of science and the report’s lead author, told The Times that “the baroness has been vindicated in the way she approached the data”.

He praised her methodological approach, and when asked to name a single one of Cass’s 32 recommendations which the BMA opposed he said: “I can’t.”

The BMA is holding on to one disagreement with the fallout from the Cass Review. It says doctors should still be able to prescribe puberty blockers, which were banned by the government, partly because it wants to defend the autonomy of doctors. In any case, this is a clear win for Dr. Cass and the Cass Review. 

Only one US medical association has supported the finding of the Cass Review. The American Society of Plastic Surgeons (ASPS) questioned some elements of gender affirming care in February of this year. At the same time, the American Medical Association also questioned support for gender surgery for minors but then later walked it back and claimed the NY Times had misquoted them or something. They even demanded a correction. The NY Times essentially accused them of lying.

The Times has received no requests to correct, clarify or update our articles from the A.M.A. After the board chair’s comments, Times reporters also confirmed with the A.M.A. spokesperson that the statements reflected in our previous reporting remain accurate in reflecting the association’s stated positions. The board chair’s claims are not based in fact, and are in contradiction to both the association’s own statements provided to The Times.

Unfortunately, politics (not medicine) is still in control at most of the US medical associations.

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