by Martin Hanson
Three recent publications have shed light, rather than heat, on the vexed issue of transgender.
The most recent was the April 10 publication of the final report of the Independent Review of Gender Identity Services for Children and Young People by Dr Hilary Cass, a retired consultant paediatrician and former president of the Royal College of Paediatrics and Child Health in the UK.
Though the 388-page document is restrained in its language, its conclusions are clear. It is severely critical of the UK National Health Service in its dealing with youngsters with gender dysphoria (GD) and in particular, the readiness of health authorities to put children on medical treatments based on “wholly inadequate” evidence. Instead of caution when adopting new treatments, Cass says that in the field of gender care for children, “quite the reverse happened”, with thousands of children given unproven medical treatment such as puberty blockers (which delay the physical changes that come with puberty). It warned doctors against allowing anyone younger than 25 to embark on the pharmaceutical pathway to “transition”.
Reaction, both in the UK and internationally, has been generally positive. The British Government has heralded the Cass Review as “a landmark decision” and “in the best interests of children”, and the NHS has concluded there is not enough evidence that puberty blockers are safe or clinically effective for young people.
Comment in the British media has been generally accepting. The Observer headlined it editorially with: “The Observer view on the Cass review: children were catastrophically failed by the medical profession”. And even activist groups such as Mermaids and Stonewall were unwilling to criticise the review.
Reaction in New Zealand has been much more varied.
Genspect NZ spokesperson Jan Rivers welcomed the report: “The final Cass report moves England decisively away from one-size fits all gender medicine production line to psychosocial approaches that address the actual reasons for distress. It is high time NZ’s medical system took note and recognised the considerable harm it has done to New Zealand’s children and young people.”
On the other hand the Ministry of Health has not said whether it is considering following the UK’s move to ban the routine use of puberty blockers for transgender youngsters.
Much more negative reaction came from the Professional Association for Transgender Health Aotearoa (PATHA), according to which “the Cass Review is out of step with high quality care provided in Aotearoa”.
“PATHA is disappointed to see the number of harmful recommendations made by the NHS-commissioned Cass Review . . . This review ignores the consensus of major medical bodies around the world and lacks relevance in an Aotearoa context . . . . It’s shocking to see such a significant inquiry into transgender health completely disregard the voices of transgender experts,” says PATHA president Jennifer Shields. “It would be like reviewing women’s health with no women, or Māori health with no Māori involved.”
And Craig Young, in an opinion column in YOUR EX, New Zealand’s only LGBTQ+ publication, believes that “The Cass Review pathologises trans lives”.
Now for the second publication. The World Professional Association for Transgender Health (WPATH) is a powerful lobby group that has presented itself as the world authority on transgender and gender medicine, and as such, has shaped the policies of hospitals, health authorities and governments, globally.
That was until recently, when internal emails were leaked to journalist Michael Shellenberger, and the group, Environmental Progress. The documents reveal that WPATH’s guidance on gender dysphoria (GD) amounts to medication without question, and is therefore devoid of medical legitimacy. Indeed, in her review, Cass wrote that the WPATH guidelines “which were taken as an industry standard and adopted very widely internationally, were very, very poorly evidence-based”.
The third document, published a few months ago, was the result of a 15-year study by researchers at the University of Groningen in the Netherlands, published in the journal Archives of Sexual Behavior. The study tracked the feelings of 2772 adolescents as they grew from age 11 to their mid-20s. At ages 11, 13, 16, 19, 22, and 25 years they were asked how they felt about their sex and identity.
In early adolescence, 11 percent of the children reported gender non-contentedness, but this decreased to 4 percent by age 26, showing that in children and adolescents, feelings of confusion about gender identity normally pass as they mature into adulthood.
The researchers concluded: “The results of the current study might help adolescents to realise that it is normal to have some doubts about one’s identity and one’s gender identity during this age period and that this is also relatively common . . . As such, policies that prohibit gender transition for minors make a great deal of sense.”
