Evidence is 'shaky' for 'gender affirming care,' says UK report

There's no reliable evidence that puberty blockers, hormones and surgery are the best treatment for children with "gender-related distress," concludes the Cass Report on youth gender medicine in Britain. "For most young people, a medical pathway will not be the best way" to manage their problems, concludes Dr. Hilary Cass, a pediatrician working for the National Health Service.

Five European countries, including Britain, are backing away from hormone treatments for children, reports Azeen Ghorayshi in the New York Times. All cite the "lack of evidence of their benefits and concern about long-term harms."

While the European Academy of Paediatrics issued a statement this year questioning the effectiveness of biomedical treatments, "the American Academy of Pediatrics last summer reaffirmed its endorsement," she reports.

It's time for Americans to set politics aside and rethink "gender-affirming care," writes Helen Lewis in The Atlantic. Raising questions about the best way to deal with gender dysphoria is not "transphobic."

The evidence base for widely used treatments is “shaky,” Cass found, after reviewing research and interviewing doctors, parents and young people.

“There are few other areas of healthcare where professionals are so afraid to openly discuss their views, where people are vilified on social media, and where name-calling echoes the worst bullying behaviour.”

When the University of York research team tried to follow up on 9,000 former patients treated at gender-identity clinics, they were denied access to data, writes Cass, who suspects the lack of cooperation was "ideologically driven." As a result, "we have no good evidence on the long-term outcomes of interventions to manage gender-related distress.”

"We don’t have strong evidence that puberty blockers are merely a pause button, or that their benefits outweigh their downsides, or that they are lifesaving care in the sense that they prevent suicides," writes Lewis.

In addition, "we don’t know why the number of children turning up at gender clinics rose so dramatically during the 2010s, or why the demographics of those children changed from a majority of biological males to a majority of biological females."

Child sex changes primarily target children who'd otherwise grow up to be gay, writes Andrew Sullivan. "Those of us who have expressed concern have been vilified, hounded, canceled and physically attacked for our advocacy. When we argued that children should get counseling and support but wait until they have matured before making irreversible, life-long medical choices they have no way of fully understanding, we were told we were bigots, transphobes and haters."

The Cass Report should be a game changer, Sullivan writes.

. . . the report concludes that puberty blockers are not reversible and not used to “take time” to consider sex reassignment, but rather irreversible precursors for a lifetime of medication. It says that gender incongruence among kids is perfectly normal and that kids should be left alone to explore their own identities; that early social transitioning is not neutral in affecting long-term outcomes; and that there is no evidence that sex reassignment for children increases or reduces suicides.

Gender discontent is not unusual for children, but normally passes away, according to a Dutch study that tracked children from age 11 into their mid-twenties, writes Jo Bartosch in Spiked. While 11 percent of 11-year-olds expressed varying degrees of "gender non-contentedness," only 4 percent of 25-year-olds "often" or "sometimes" felt discontent with their gender.