BMA reverses opposition of Cass Review into gender medicine

Doctors from the British Medical Association say they no longer oppose the Cass review into gender medicine, but believe clinicians should still be allowed to prescribe puberty blockers.

The BMA had previously criticised the report, but now says Dr Hilary Cass was right in her approach.

The doctors' union, which represents medical professionals across the UK, says decisions on medication shouldn’t be made by politicians.

It comes as puberty blockers remain unavailable for trans youth in the UK, with the NHS trial paused earlier this year.

Dr Hilary Cass's review, published in April 2024, highlighted shortcomings in research and evidence concerning medical interventions for children and young people, describing NHS gender medicine as “built on shaky foundations.”

Initially, the BMA had opposed the implementation of the review, but now is calling it 'robust', aligning with broader calls to strengthen the services offered to young people facing gender identity issues and to base treatments on solid scientific foundations.

Their report

Their comprehensive report has critically examined the Independent Review of Gender Identity Services for Children and Young People, chaired by Baroness Dr Hilary Cass.

The findings underscore the limited evidence concerning the benefits and potential risks associated with puberty blockers and gender-affirming hormones for young people, with the report calling for enhanced research, better data collection, and more robust multidisciplinary services to support the medical profession in addressing gender incongruence.

While much of the Cass Review is bolstered by referenced research, the BMA report notes instances where statements oversimplify complex findings or stress potential risks without adequately discussing possible benefits.

Contributors to the Cass Review expressed concerns about their engagement not being sufficiently influential in shaping the Review’s conclusions and reported that their input was received too late in the process.

Professor David Strain, Chair of the Group and the BMA’s Board of Science, highlighted the importance of the collaborative approach

He said: “A strength of this work has been the ability of clinicians with differing perspectives to engage constructively to ensure the concerns of the profession and those with lived experience were explored.

"While interpretations and policy preferences in the group, as in the profession indeed in wider society, have diverged, there has been consistent respect for the underlying data and for the ethical complexity of the decisions involved."

Professor Strain further elaborated on the need for improvement in gender identity services, saying: “This report identifies the need to make significant improvement in the way in which gender identity services for children and young people are provided.

"As in many other treatment areas, it also highlights the ongoing challenge of managing uncertainty for the medical profession when caring for people with gender incongruence in a way that is proportionate, transparent, and patient-centred."

Responding to the move, The LGB alliance, which promotes gay, lesbian, and bisexual rights based on biological sex, said on Facebook: "We’re pleased to see that the BMA has walked back its ideological opposition to the Cass Review.

"Disappointing to see they are still advocating for puberty blockers.

"Most of these children would grow up to be LGB."

Ensuring equal rights

In separate commentary on LGBTQ+ equality in medicine, the BMA reiterated its commitment to ensuring equal rights, asserting that discrimination based on sexual orientation or gender identity has no place in the profession.

The organisation has listed priority areas for action including improving medical curricula concerning LGBTQ+ health needs, enhancing ways to report discrimination, and increasing the visibility of LGBTQ+ role models in education and the workplace.

These efforts aim to foster an inclusive culture that eliminates prejudice and promotes equal opportunities within the medical profession.

You can read the report in full here.

The final Cass Review report can be read here.

There's also more to read about the new announcement over on the British Medical Journal.

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