FOR IMMEDIATE PRESS RELEASE
Advocates for Trans Healthcare provide space for discussion at Royal College of Psychiatrists International Congress in Edinburgh
On Wednesday 19th, advocates for trans healthcare gathered outside the Edinburgh International Conference Centre. Their aim: to provide a space for attendees of the Royal College of Psychiatrists International Congress to talk with real trans people, and family members, who have been negatively impacted by work of some speakers at the Congress.
The demonstration took place outside the EICC from 8:00am – 1:00pm, and a second demonstration took place on Thursday 20th June, from 10:30am – 14:30pm.
“Hear our stories”
A participant at the demonstration who spoke to several attendees of the congress said:
“Every single one of us has a unique experience of being trans, but every single one of us has our experience intertwined with our struggles to obtain the lifesaving care we need. Today we want the psychiatrists attending the conference to hear our stories, and for them to engage in good faith with our community about how politically motivated barriers to trans-affirmative healthcare, reinforced by biased representations of evidence in the likes of the Cass Review, are affecting us.”
Elimination of care and promotion of conversion practices
On Wednesday, Congress featured a keynote from Dr. Hilary Cass, primary researcher and author of the Cass Review. The Cass Review has been criticised for substandard scientific rigour and unethical recommendations by researchers and medical experts from global organisations such as the World Professional Association for Transgender Health. Its implementation has resulted in a near-total elimination of specialist medical treatment for young trans people across the UK. The use of puberty blockers for trans people under the age of 18 was halted across England, Wales and Scotland, and a legal ban on prescribing puberty blockers has since been introduced. However, cis (non-trans) young people are still able to access puberty blockers for conditions such as precocious puberty.
On Thursday, there was a panel presentation from members of CAN-SG and SEGM, which have been accused of promoting pseudoscience and conversion therapy by organisations including Trans Safety Network and the Southern Poverty Law Centre. The Royal College of Psychiatrists is a signatory to the Memorandum of Understanding on Conversion Therapy, which identifies these practices as “unethical and potentially harmful“.
“A political decision”
A parent of a trans adolescent seen by the Sandyford clinic in Glasgow, who would prefer to remain anonymous for reasons of safety, has said:
“It is quite clear that this is a political decision and has nothing to do with patient or clinical safety if cis children will continue to be prescribed blockers.
“Trans young people know who they are”
A sector worker who has supported trans young people for over a decade, who would prefer to remain anonymous for reasons of safety, has said:
“Trans young people know who they are. They fight for years for access to healthcare to support them to feel comfortable as themselves. Puberty blockers and hormones are a small but key part of this support for some. In many cases, the distress that these interventions alleviate is life-saving. I cannot understate the horrific impact that this decision will have on the lives of young people and their families.”
Flawed evidence
The healthcare ban informed by the final report of the Cass Review, published Wednesday 10th April 2024, was met by protests from advocates for trans healthcare, and has necessitated demonstrations such as the one which took place today to provide psychiatrists with an opportunity to speak about the impacts of the review with those most affected by it.
Retired paediatrician Hilary Cass, who had no previous professional expertise in working with trans, gender-nonconforming, or gender-questioning young people, was commissioned by NHS England in 2020 to lead its review into child and adolescent gender services.
The Cass Review argues that there is insufficient “high-quality” evidence to justify the use of endocrine treatments in young trans people. It therefore recommends that hormone blockers be prescribed within the context of a “full programme of research”, including a puberty blocker trial, and that “extreme caution” is required for the provision of hormone therapies for under 18s. It does not recommend a full ban on either treatment.
While the findings and recommendations of the Cass Review have been praised by UK politicians and a handful of medical professionals, they have widely been condemned by international experts in trans healthcare, feminist scholars, and trans communities.1
Critics have highlighted the biased and inconsistent use of evidence within the Cass Review. Cass’ team dismissed the findings of over 100 clinician studies demonstrating the benefits of endocrine treatments for young people, while basing most of its recommendations upon just a handful of studies of similar or lower quality. Many other medications used routinely in paediatric medicine, such as ADHD medication or anti-psychotics, have a similar or lower level of evidence justifying their use.
Among the more bizarre claims within the final report of the Cass Review is the assertion that girls are biologically predisposed to play with dolls (p.100), and the inaccurate argument that the word “trans” has changed substantially in meaning since 2020 (p.187). The report also cites the far-right Youtube channel “Thoughts on Things and Stuff” to evidence the activities of England’s Gender Identity and Development Service (p.70).
The Terms of Reference for the Cass Review intentionally excluded trans healthcare experts and service users from formal oversight of the project. No-one from these key stakeholder groups was employed to work on the project.2
Conversely, a number of professionals involved in the Cass Review, including its reviews of the evidence base on transgender healthcare, have been directly involved either in lobbying efforts against trans healthcare provision, or have actively promoted conversion therapy.3
References
- For examples, see Dr Ruth Pearce’s round-up of commentary and evidence: https://ruthpearce.net/2024/04/16/whats-wrong-with-the-cass-review-a-round-up-of-commentary-and-evidence/. ↩︎
- https://www.tandfonline.com/doi/epdf/10.1080/26895269.2024.2328249 ↩︎
- https://transsafety.network/posts/tsn-statement-on-cass-final-report/ ↩︎
Resisting Transphobia in Edinburgh 