Paediatrician behind bombshell Cass Report was vilified online (2024)

An eminent paediatrician tasked with overhauling care for gender-questioning kids has told how she was vilified while compiling her review.

Dr Hilary Cass faced criticism solely for engaging with all sides of the 'exceptionally toxic' debate.

The topic of trans healthcare has become so vicious that medical professionals are 'afraid to openly discuss their views', wrote the ex-president of the Royal College of Paediatrics and Child Health in her bombshell 388-page report.

In a plea to 'people on all sides', Dr Cass urged those engaging in the 'worst bullying behaviour' to stop, warning the 'stifling of debate' by adults has not only let children down but hampered scientific progress in the area.

Her landmark report published today ruled children given NHS trans treatment have been set on a path of irreversible change despite scant medical evidence.

NHS gender identity services for children and teens have been based on 'remarkably weak evidence', it said as it took aim at powerful puberty blockers and hormones.

In its foreword, Dr Cass said: 'Despite the best intentions of everyone with a stake in this complex issue, the toxicity of the debate is exceptional.

'I have faced criticism for engaging with groups and individuals who take a social justice approach and advocate for gender affirmation, and have equally been criticised for involving groups and individuals who urge more caution.

'The knowledge and expertise of experienced clinicians who have reached different conclusions about the best approach to care are sometimes dismissed and invalidated.

'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. This must stop.

'Polarisation and stifling of debate do nothing to help the young people caught in the middle of a stormy social discourse, and in the long run will also hamper the research that is essential to finding the best way of supporting them to thrive.'

She also accused 'people on all sides of the debate' of misrepresenting studies to support their own viewpoint.

Dr Cass urged clinicians to 'cut through the noise and polarisation'to provide trans-children with the same standard of care as others.

Her review, commissioned four years ago, made 32 recommendations to overhaul NHS trans services to improve the care children receive.

Among them were calls for GPs to resist attempts by private providers to prescribe puberty blockers or hormones, 'particularly if that private provider is acting outside NHSguidance', she said.

The powerful body-altering hormones, which can permanently weaken bones, were banned last monthon the NHS for children.

They are, however, still available, prescribed privately 'off-label' by some medics at non-NHS-based gender clinics.

Dr Cass concluded:'The reality is that we have no good evidence on the long-term outcomes of interventions to manage gender-related distress.'

Prime Minister Rishi Sunak today welcomed her findings and said the lack of knowledge about long-term impact of medical interventions meant people should proceed with 'extreme caution'.

Labour's shadow health secretary Wes Streeting, meanwhile, called on the report to 'provide awatershed moment for the NHS's gender identity services'.

He added: 'Children's healthcare should always be led by evidence and children's welfare, free from culture wars.'

Sallie Baxendale, a professor of clinical neuropsychology at University College London, also said:'Exceptionalism often lies at the heart of medical scandals when services go rogue and start to operate outside the normal parameters of clinical practice.'

Previous research by the world-renowned expert has alarmingly found young girls seemingly lost between seven and 15 IQ points while taking puberty-blockers.

But in February, Professor Baxendale revealed academics had accused herof 'bias' by questioning if puberty blockers were safe.

Today's 388-page review follows Dr Cass' damning interim report, published in 2022, which criticised the country's only child transgender service, at the Tavistock Clinic in London, as 'not a safe or viable long-term option'.

The controversial service eventually closed last month, replaced by two regional hubs in London and Liverpool that opened this month.

Dr Cass herself is no stranger in raising concerns to those in power.

In 2013 it was revealed she leftGreat Ormond Street Hospital after raising concerns about patient safety.

She warned bosses that inadequate staffing, poor morale and a lack of co-operation between departments was putting patients at risk.

After emailing managers an account of her concerns, GOSH used a confidentiality agreement to settle a long-running dispute with her which saw her demoted and led to her departure.

It sparked a national conversation about the use of so-called 'gagging clauses' in the NHS.

Dr Cass, who went to a prestigious London private school for girls before studying medicine at the University of London, herself is a recognised leader in the field of medical care for children, having served as president of theRoyal College of Paediatrics and Child Health from 2012-2015.

On top of that, she was chair of the British Academy of Childhood Disability between 2017 and 2020.

While no longer working clinically, she remains an honorary consultant paediatrician at Evelina London Children's Hospital — part ofGuy's & St Thomas's NHS Foundation Trust.

While at Evelina she worked on the development of paediatric palliative care services for extremely ill children and their families.

Dr Cass, who has previously described her ideal guilty pleasure as eating a Snickers while watching an episode of The Thick Of It, has also published multiple articles on the care of children withneurodisability.

Previous work of hers involves children with autism, cognitive and visual impairment as well as those with multipledisabilities.

The care of children is clearly a subject close Dr Cass's heart, as even after stopping clinical practice she has worked with charities dedicated to helping youngsters with complex medical conditions.

These include being an ex-chair of the children's palliative care charity Together for Short Lives and a trustee for the Noah's Ark Children's Hospice.

Dr Cass, an avid fan of the theatre, has been recognised multiple times for her work, including receiving an OBE for her services to child health in 2015.

She has also been granted honorary fellowships by the Royal College of Nursing and Royal College of General Practitioners.

Dr Cass has form for wading into controversial medical topics, previously speaking in 2013 on her support for doctor assisted suicide, otherwise known as medical euthanasia.

When she retires, she plans a 'gap year for grown ups', according to an interview she did with the British Medical Journalin 2013.

In that same piece, she spoke of her love of 'crispy duck from the local Chinese takeaway'.

Her parents 'always thought that I was argumentative and perverse enough to be a lawyer', Dr Cass also said.