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| Puberty-blocker focus disproportionate, Cass says | Puberty-blocker focus disproportionate, Cass says |
| (32 minutes later) | |
| The focus on puberty blockers in the gender-care debate is disproportionate, the paediatrician who led the NHS review into children’s services, says. | The focus on puberty blockers in the gender-care debate is disproportionate, the paediatrician who led the NHS review into children’s services, says. |
| Dr Hilary Cass said the merits of the treatment used to delay the onset of puberty had been “oversold” and there was “very limited” evidence they were of use. | Dr Hilary Cass said the merits of the treatment used to delay the onset of puberty had been “oversold” and there was “very limited” evidence they were of use. |
| Adults with long-standing trans identity should be offered medical interventions, she told BBC News, but it was right to be careful with children questioning their gender, who were in a “dynamic state of development”. | Adults with long-standing trans identity should be offered medical interventions, she told BBC News, but it was right to be careful with children questioning their gender, who were in a “dynamic state of development”. |
| It follows a ban, earlier this year, on the routine prescription of puberty blockers for children with gender dysphoria. | It follows a ban, earlier this year, on the routine prescription of puberty blockers for children with gender dysphoria. |
| The ban, in response to Dr Cass’s landmark review, led to criticism from the British Medical Association (BMA) and campaigners taking legal action against it. | The ban, in response to Dr Cass’s landmark review, led to criticism from the British Medical Association (BMA) and campaigners taking legal action against it. |
| The BMA, which has since rowed back on its criticisms after a backlash by doctors, had called Dr Cass’s recommendations “unsubstantiated”. | The BMA, which has since rowed back on its criticisms after a backlash by doctors, had called Dr Cass’s recommendations “unsubstantiated”. |
| And one of its senior leaders had claimed banning puberty blockers, external could cause “incredible harm“ to trans people. | And one of its senior leaders had claimed banning puberty blockers, external could cause “incredible harm“ to trans people. |
| Closed down | Closed down |
| The review, commissioned by NHS England and published in April, called for better psychological support, noting young people struggling with their gender had higher rates of mental-health problems and neurodiversity such as autism and ADHD or childhood trauma. | The review, commissioned by NHS England and published in April, called for better psychological support, noting young people struggling with their gender had higher rates of mental-health problems and neurodiversity such as autism and ADHD or childhood trauma. |
| On Wednesday, Dr Cass told BBC Radio 4's Woman's Hour programme: “They [puberty blockers] have been a disproportionate amount of the discussion, because actually the evidence doesn't show benefit for the majority of young people who go on them. | On Wednesday, Dr Cass told BBC Radio 4's Woman's Hour programme: “They [puberty blockers] have been a disproportionate amount of the discussion, because actually the evidence doesn't show benefit for the majority of young people who go on them. |
| "And in some senses, they have been oversold to young people as being the thing that is going to make them feel dramatically better." | "And in some senses, they have been oversold to young people as being the thing that is going to make them feel dramatically better." |
| Puberty blockers were prescribed to children by London’s Tavistock Clinic, which was the only NHS gender service for under-18s but has now been closed down. | Puberty blockers were prescribed to children by London’s Tavistock Clinic, which was the only NHS gender service for under-18s but has now been closed down. |
| There was “very limited” evidence they could help, Dr Cass told Woman's Hour. | There was “very limited” evidence they could help, Dr Cass told Woman's Hour. |
| They could be used for a small number of young people “but we just don’t know who they are”. | They could be used for a small number of young people “but we just don’t know who they are”. |
| “We don’t know if the harms outweigh the benefits in other young people," Dr Cass told the programme. | “We don’t know if the harms outweigh the benefits in other young people," Dr Cass told the programme. |
| “If I was pitching any other drug to give to children with that kind of data, you would say, 'no way.'” | |
| Better evidence was needed, so the NHS was setting up a clinical trial into their use. | Better evidence was needed, so the NHS was setting up a clinical trial into their use. |
| And medical and surgical interventions for children transitioning gender required extra care, because they were in a “dynamic state of development”. | And medical and surgical interventions for children transitioning gender required extra care, because they were in a “dynamic state of development”. |
| 'Wrong pathway' | 'Wrong pathway' |
| “We just don’t know which way they are going to go in adulthood," Dr Cass told Woman's Hour. | “We just don’t know which way they are going to go in adulthood," Dr Cass told Woman's Hour. |
| "If they go down the wrong pathway for them, then the costs in terms of medical intervention are gravely heavy to bear, when some of the effects are irreversible." | |
| But for adults with an “enduring and long-standing trans identity”, the costs of medical intervention were “trivial” compared with “how difficult it would be not to be able to live in your identified gender”. | But for adults with an “enduring and long-standing trans identity”, the costs of medical intervention were “trivial” compared with “how difficult it would be not to be able to live in your identified gender”. |
| “For those people, it is absolutely crucial they get the clinical intervention they need and want," Dr Cass told the programme. | “For those people, it is absolutely crucial they get the clinical intervention they need and want," Dr Cass told the programme. |
| Neutral position | Neutral position |
| She also said the BMA's objections did not “matter”, as NHS England was already pushing ahead with a new network of services emphasising the provision of more holistic care to children and young people. | She also said the BMA's objections did not “matter”, as NHS England was already pushing ahead with a new network of services emphasising the provision of more holistic care to children and young people. |
| Earlier this year, the doctors’ union called for a pause to the implementation of the Cass Review and the ban on puberty blockers to be lifted. | Earlier this year, the doctors’ union called for a pause to the implementation of the Cass Review and the ban on puberty blockers to be lifted. |
| But it later said it was moving to a neutral position after the backlash by doctors. | But it later said it was moving to a neutral position after the backlash by doctors. |
| The BMA is carrying out its own review into gender services for children. | The BMA is carrying out its own review into gender services for children. |
| Dr Cass said she found the union’s position “puzzling” and urged it not to “cherry-pick” the evidence. | Dr Cass said she found the union’s position “puzzling” and urged it not to “cherry-pick” the evidence. |