The Cass Review: Created in bad faith, designed to marginalise, weaponised to hurt
The Cass Review into the care of trans children and young people is out. With prejudice encoded into it from the outset and feverish, pre-planned weaponisation of it once released, it's hard to overstate the amount of despair it is going to cause.
Well, I guess we knew it was coming. But, even after eight or more years of sustained abuse and hatred on the front line of the British Culture Wars, we had no idea it would be this bad.
The Cass Review, a long awaited inquiry into the healthcare for trans children and young people, appeared just over a week ago - 4 years after Sajid Javid, Conservative Health Secretary, set it up. In 2022 Javid went onto television, with his Best Concerned Face, to say that trans children were in fact the victims of "child abuse" and this week he celebrated the arrival of the report as a major defeat for "extreme gender ideology" which had taken over the NHS. He added that he'd seen the state of services for young people in this area as a "huge medical scandal in the making". But not because it was now taking 5 years for these children to get an appointment, with literally thousands on a waiting list for the one clinic he had just closed...but because these children were diagnosed as trans at all. The conspiracy was so deep he added that it had overtaken other European countries too, where equivalent services seem to be still treating trans kids as if they actually existed (and where indeed sinister Woke Conspirators seem to be so totally in control that in some countries they have just deepened their commitment to acceptance and proper care of them).
I won't go into the results of the Cass Review in depth. It's nearly 400 pages long and listing out the institutional, nailed-on, bias and blindness in which it is marinated would take too long* To many in the UK trans community it makes us think of a report written about black or brown people that doesn't include any black or brown voices at all, or perhaps one about women's rights written entirely by men because this one was written by, and for cisgender people. As a matter of policy includes no trans voices (as service users, academics, or anything else) nor even any clinicians with experience in working with trans people in NHS Gender Services. It centres, quotes from and cites well established and politically influential 'Gender Critical' groups, medical practitioners of a particular viewpoint only (some of whom assert that trans people do not even exist), and well known anti-trans voices (some of them with no medical provenance at all), and presents them as neutral. Whilst it berates the failing system of care for trans young people (which has indeed collapsed since the Conservative Party took office) and suggests that a new one should take its place which is responsive and sensitive to its patients' needs (something that no-one can argue with), it goes on to frame the approach of that successor service in terms of the pathologisation of trans kids.
In short, the core idea is that trans children and teenagers (and thus, by extension all trans people, as we were all kids once) aren't actually trans, they are mentally ill. That illness - what it is and how to 'cure' it, is to be the focus is, now. Autism, abuse, personality disorder, bullying, even 'catching it' from social media is getting a lot of attention. Any could be the real reason why trans kids feel the way they do. Not that they are actually trans, it seems.
You don't need to peer very hard between the lines to understand the meaning in this. Being trans isn't a real thing it turns out, despite trans people having existed in the historical record for centuries, and thus being a trans person is to not be a real person. And anyone who feels themselves to be trans really needs to be saved from the awful fate of transition.
Hardly surprising then that the arrival of the report has been greeted with unconfined circle jerking by right wing newspapers, 'Gender Critics' and government ministers. Even the Labour Party has got in on the fun, with the Shadow Health Minister, Wes Streeting now deciding that trans women aren't women after all, and saying it's all "very complicated"
Forgive me for finding all this not very complicated at all. I'd go more for 'fucking terrifying'. You see, I am trans. I transitioned many years ago. It was the best - the only - thing I could do, and despite what the monsters who run the British press and who populate Parliament have tried to do to us in the last decade, it remains something that I would never, ever, go back on. To be accused of being sick after all, to hear that that after all these years I have been acting out some kind of hidden pathology and in fact that I do not exist as I know myself to be, is news that doesn't help me sleep better in this broken country. Further, all this reads right into the TERF/GC trope of trans people - trans women specifically - being deceitful concealers of a shadowy illness that characterises their true identity. Insert your illness here...and they do, usually going for some kind of sexual or violent deviance.
Excuse me while I reach for an appropriate response to your take on my life. "Fuck you?". Yes, that's it.
The research that's been used to come to the conclusion in this report that trans kids are mostly suffering from something else entirely has been highly selective, with swathes of worldwide data discounted for spurious methodological reasons that, if you were charitable (and you really shouldn't be) were the consequence of letting an ingenue team lose on a complex area about which they knew nothing, and if you were not, was quite intentional. There has been no explanation why part of the report (around the appropriate use of puberty blockers) essentially copies the debunked approach to research used by the profoundly anti-trans team assembled by greasy fascist and Florida Governor Ron DeSantis**, and which has been widely attacked as a piece of barefaced political manipulation by many, including Yale Medical School.
Unsurprisingly, the way forward now seems to be the creation of two new clinics for (so-called) trans young people, but their focus is to be on finding the real sickness within. These clinics have in fact been promised since 2022, when an interim Cass Report came out, but - predictably - they have not yet opened (even though the centre at the heart of it at, the Tavistock Centre's Gender Identity Services Clinic, has been shut down). Recruitment is underway, with specialists in the field now not invited to apply. To date, these two new venues have recruited 9 clinicians each, specialists in trauma, Autism, abuse symptoms, depression etc - to replace the 80 specialists who lost their jobs when the Tavistock was shut - and they are expected to deal with a waiting list well over double the size it was when this whole fiasco began.
You've probably not heard about Cass. If you have, what you have heard is likely to be one of two takes on it.
The first is that 'GENDER IDEOLOGY IS ON THE RUN!' (Copyright all the Conservative Party, Right Wing Newspapers in the UK, 'Gender Critical' voices, JK Rowling et al). Now in for the kill! etc.
The second 'THANK GOD THAT'S ALL SORTED BY THE NICE OLD LADY HILARY CASS, WOW WHAT A HORRID LOT OF ARGUMENTS WE CIS LIBERALS ALL HAD AND IT'S ALL OVER NOW. PHEW!' (The Guardian, Independent).
There's a third take, one coming out of the despairing and broken group of people that have become a punchbag for the collective hatred of the right together with the self-regarding, smug, liberal blindness of the centre-left (two groups of politicians and journalists who can normally not give each other the time of day but who have found their deep common ground: they are all cisgender). That group is trans people, especially this week, young trans people and their families.
Forgotten, monstered, lied about and, as Cass gets weaponised to wide applause in the British public discourse, more and more scared.
********
* If you want to read it, it's here.
** If you are new to this, then know that amongst the growing number of Republican dominated states in the US that have been working energetically to erase trans people's basic right to exist, Florida takes the crown. Though in 2024, Oklahoma is really putting in a bid, leading the way amongst the 547 anti-trans bills sitting in state legislatures.
The Cass Review, a long awaited inquiry into the healthcare for trans children and young people, appeared just over a week ago - 4 years after Sajid Javid, Conservative Health Secretary, set it up. In 2022 Javid went onto television, with his Best Concerned Face, to say that trans children were in fact the victims of "child abuse" and this week he celebrated the arrival of the report as a major defeat for "extreme gender ideology" which had taken over the NHS. He added that he'd seen the state of services for young people in this area as a "huge medical scandal in the making". But not because it was now taking 5 years for these children to get an appointment, with literally thousands on a waiting list for the one clinic he had just closed...but because these children were diagnosed as trans at all. The conspiracy was so deep he added that it had overtaken other European countries too, where equivalent services seem to be still treating trans kids as if they actually existed (and where indeed sinister Woke Conspirators seem to be so totally in control that in some countries they have just deepened their commitment to acceptance and proper care of them).
I won't go into the results of the Cass Review in depth. It's nearly 400 pages long and listing out the institutional, nailed-on, bias and blindness in which it is marinated would take too long* To many in the UK trans community it makes us think of a report written about black or brown people that doesn't include any black or brown voices at all, or perhaps one about women's rights written entirely by men because this one was written by, and for cisgender people. As a matter of policy includes no trans voices (as service users, academics, or anything else) nor even any clinicians with experience in working with trans people in NHS Gender Services. It centres, quotes from and cites well established and politically influential 'Gender Critical' groups, medical practitioners of a particular viewpoint only (some of whom assert that trans people do not even exist), and well known anti-trans voices (some of them with no medical provenance at all), and presents them as neutral. Whilst it berates the failing system of care for trans young people (which has indeed collapsed since the Conservative Party took office) and suggests that a new one should take its place which is responsive and sensitive to its patients' needs (something that no-one can argue with), it goes on to frame the approach of that successor service in terms of the pathologisation of trans kids.
In short, the core idea is that trans children and teenagers (and thus, by extension all trans people, as we were all kids once) aren't actually trans, they are mentally ill. That illness - what it is and how to 'cure' it, is to be the focus is, now. Autism, abuse, personality disorder, bullying, even 'catching it' from social media is getting a lot of attention. Any could be the real reason why trans kids feel the way they do. Not that they are actually trans, it seems.
You don't need to peer very hard between the lines to understand the meaning in this. Being trans isn't a real thing it turns out, despite trans people having existed in the historical record for centuries, and thus being a trans person is to not be a real person. And anyone who feels themselves to be trans really needs to be saved from the awful fate of transition.
Hardly surprising then that the arrival of the report has been greeted with unconfined circle jerking by right wing newspapers, 'Gender Critics' and government ministers. Even the Labour Party has got in on the fun, with the Shadow Health Minister, Wes Streeting now deciding that trans women aren't women after all, and saying it's all "very complicated"
Forgive me for finding all this not very complicated at all. I'd go more for 'fucking terrifying'. You see, I am trans. I transitioned many years ago. It was the best - the only - thing I could do, and despite what the monsters who run the British press and who populate Parliament have tried to do to us in the last decade, it remains something that I would never, ever, go back on. To be accused of being sick after all, to hear that that after all these years I have been acting out some kind of hidden pathology and in fact that I do not exist as I know myself to be, is news that doesn't help me sleep better in this broken country. Further, all this reads right into the TERF/GC trope of trans people - trans women specifically - being deceitful concealers of a shadowy illness that characterises their true identity. Insert your illness here...and they do, usually going for some kind of sexual or violent deviance.
Excuse me while I reach for an appropriate response to your take on my life. "Fuck you?". Yes, that's it.
The research that's been used to come to the conclusion in this report that trans kids are mostly suffering from something else entirely has been highly selective, with swathes of worldwide data discounted for spurious methodological reasons that, if you were charitable (and you really shouldn't be) were the consequence of letting an ingenue team lose on a complex area about which they knew nothing, and if you were not, was quite intentional. There has been no explanation why part of the report (around the appropriate use of puberty blockers) essentially copies the debunked approach to research used by the profoundly anti-trans team assembled by greasy fascist and Florida Governor Ron DeSantis**, and which has been widely attacked as a piece of barefaced political manipulation by many, including Yale Medical School.
Unsurprisingly, the way forward now seems to be the creation of two new clinics for (so-called) trans young people, but their focus is to be on finding the real sickness within. These clinics have in fact been promised since 2022, when an interim Cass Report came out, but - predictably - they have not yet opened (even though the centre at the heart of it at, the Tavistock Centre's Gender Identity Services Clinic, has been shut down). Recruitment is underway, with specialists in the field now not invited to apply. To date, these two new venues have recruited 9 clinicians each, specialists in trauma, Autism, abuse symptoms, depression etc - to replace the 80 specialists who lost their jobs when the Tavistock was shut - and they are expected to deal with a waiting list well over double the size it was when this whole fiasco began.
You've probably not heard about Cass. If you have, what you have heard is likely to be one of two takes on it.
The first is that 'GENDER IDEOLOGY IS ON THE RUN!' (Copyright all the Conservative Party, Right Wing Newspapers in the UK, 'Gender Critical' voices, JK Rowling et al). Now in for the kill! etc.
The second 'THANK GOD THAT'S ALL SORTED BY THE NICE OLD LADY HILARY CASS, WOW WHAT A HORRID LOT OF ARGUMENTS WE CIS LIBERALS ALL HAD AND IT'S ALL OVER NOW. PHEW!' (The Guardian, Independent).
There's a third take, one coming out of the despairing and broken group of people that have become a punchbag for the collective hatred of the right together with the self-regarding, smug, liberal blindness of the centre-left (two groups of politicians and journalists who can normally not give each other the time of day but who have found their deep common ground: they are all cisgender). That group is trans people, especially this week, young trans people and their families.
Forgotten, monstered, lied about and, as Cass gets weaponised to wide applause in the British public discourse, more and more scared.
********
* If you want to read it, it's here.
** If you are new to this, then know that amongst the growing number of Republican dominated states in the US that have been working energetically to erase trans people's basic right to exist, Florida takes the crown. Though in 2024, Oklahoma is really putting in a bid, leading the way amongst the 547 anti-trans bills sitting in state legislatures.
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