Dr Hilary Cass has criticised the spread of “disinformation” around her report, including from a Labour MP, as she revealed she had been told not to travel on public transport over safety fears.
In an interview with The Times, the paediatrician behind last week’s landmark review on the treatment of transgender children said that young people were being put “at risk” by the spread of false information.
Following publication of her 388-page report, figures including the Labour MP Dawn Butler repeated claims that Cass had not included 100 transgender studies in it.
Calling the assertion “completely wrong”, Cass said that it was “unforgivable” for people to undermine her report by spreading “straight disinformation”.
The physician, 66, who has spoken about the toxic debate around the issue, also revealed that she had been sent “vile” abusive emails and been given security advice to help keep her safe.
Of her critics, Cass said: “I have been really frustrated by the criticisms, because it is straight disinformation. It is completely inaccurate.
“It started the day before the report came out when an influencer put up a picture of a list of papers that were apparently rejected for not being randomised control trials.
JANE BARLOW/PA
“That list has absolutely nothing to do with either our report or any of the papers.
“If you deliberately try to undermine a report that has looked at the evidence of children’s healthcare, then that’s unforgivable. You are putting children at risk by doing that.”
In the days after the Cass review was published, activists claimed on social media that only two out of 100 studies were included in the report.
Butler told the House of Commons: “There are around 100 studies that have not been included in this Cass report and we need to know why.”
Cass explained that researchers had appraised every single paper, but pulled the results from the ones that were high quality and medium quality, which was 60 out of 103.
Of Butler, she added: “You don’t get up in parliament with an intent to spread misinformation … [but] what I was dismayed about, was the understanding she got [from the report].”
Cass’s NHS review found that an entire field of medicine aimed at enabling children to change gender had been “built on shaky foundations”. She found there was no good evidence to support the global clinical practice of prescribing hormones to under-18s to pause puberty or transition to the opposite sex.
The Gender Identity Development Service (Gids) at the Tavistock and Portman NHS Foundation Trust was ordered to close after her interim report found it “was not a safe or viable long-term option”.
HENRY NICHOLLS/THE AFP
Her final report — the world’s biggest review into the contested field of transgender healthcare — involved trans patients, families, academics and doctors.
Cass said she was pleased that, for the most part, both sides in the debate over the treatment of children with gender dysphoria had not “weaponised” her report. But she has still had to deal with a “pretty aggressive” response from some, particularly those in activist groups. She is also staying away from Twitter/X.
Cass said: “There are some pretty vile emails coming in at the moment. Most of which my team is protecting me from, so I’m not getting to see them.” Some of them contained “words I wouldn’t put in a newspaper”, she said.
She added: “What dismays me is just how childish the debate can become. If I don’t agree with somebody then I’m called transphobic or a Terf [trans-exclusionary radical feminist].”
Cass said the abuse spiked every time the review said something “people don’t like”.
Online discussion hardened following her interim report, in 2022, and the selection of Liz Truss as Tory Party leader and prime minister, she said. “That was when the debate got more aggressive and people got into bunkers, then the online furore heats up.”
But Cass, the former president of the Royal College of Paediatrics and Child Health, is remaining resolute, despite being thrown into the middle of the culture wars.
Asked if the abuse had taken a toll on her, she said: “No … it’s personal, but these people don’t know me.
“I’m much, much more upset and frustrated about all this disinformation than I am about the abuse. The thing that makes me seethe is the misinformation.”
She added: “I’m not going on public transport at the moment, following security advice, which is inconvenient.”
Last week it emerged that NHS adult gender clinics had finally agreed to share missing data on the outcomes of 9,000 patients who were treated as children at the Tavistock clinic.
Secretive’ gender clinics back down over puberty blocker data
Cass revealed that six clinics had thwarted her review by refusing to co-operate with research into the long-term impact of prescribing puberty blockers and sex hormones. She described their failure to share data as “co-ordinated” and “ideologically driven”.
She told The Times that during her review she had held a “really difficult” meeting with the clinics. They accused the review team of taking up their “valuable time”, she claimed.
“They were not particularly friendly to us when we approached”, she added.
Cass also revealed that the Tavistock clinic had refused to co-operate with the review by not handing over data on detransitioners who had been examined by a psychiatrist.
The review team wanted to assess what risk factors in a patient’s history could possibly be linked to detransition. A consultant who had carried out an audit of information from Gids patients had agreed to give it to the Cass team.
But Cass said: “We asked the Tavistock to have it and they wouldn’t give it to us. It was very disappointing.”
Following her report, Kemi Badenoch, the equalities minister, told The Sunday Times that there had been ideological capture of institutions, including the NHS, which needed to be corrected if Cass’s recommendations were to be fully delivered.
Cass responded yesterday by saying that there could plainly be ideological capture about “almost anything and certainly about this”.
In regards to Tavistock, she told The Times she had concluded “there were certainly one or two individuals … who I would describe as activists among the staff.”
However, she added: “I think the majority of staff believed what they were doing was right.”
With long waiting lists for the treatment of children with gender dysphoria, several private clinics have recently emerged to fill the void. Cass said she was concerned about that and claimed young people would not get the level of holistic care NHS clinics provided.
ADRIAN SHERRATT FOR THE TIMES
She singled out GenderGP, a Singapore-based firm founded by Dr Helen Webberley, a British medic, which continues to advertise puberty blocking injections.
Private doctors who give children puberty blockers may be struck off
Cass claimed the care offered by Webberley “certainly doesn’t come anywhere near anything one would recognise as adequate in terms of a proper assessment and exploration”.
She is keeping a low profile following the publication of her report, but is adamant that she wants to help with the implementation of her review’s 32 recommendations.
Meanwhile, NHS England has announced a Cass-style review of adult gender clinics.
“You heard it right here: I am not going to do the adult gender clinic review,” Cass said.
