Dr Hilary Cass has criticised the British Medical Association (BMA) for opposing her review into NHS services for transgender youngsters, saying the leaders of the doctors’ union are a “relatively small minority”.
The 400-page Cass Report, which was published in April, made more than 30 recommendations about the way in which young trans people receive gender-affirming care in England, including to take an “holistic approach” to treatment, and the need for “extreme caution” before prescribing puberty blockers to those under the age of 18.
An emergency ban on private prescriptions for puberty blockers was introduced by the Conservative government the following month. And just days after Labour’s landslide victory in July’s general election, new health secretary Wes Streeting announced it would be made permanent.
The Cass Report has been criticised by clinicians, academics, charities and health bodies which work with trans people, with some expressing “great concern”, and others labelling it “deeply flawed” and claiming it had relied on a “selective and inconsistent use of evidence”.
In July, the BMA, which represents more than 190,000 doctors, voted to “publicly critique” the report, noting the concerns about “weaknesses in the methodologies” which had been raised by members of the medical community and “problems arising from the implementation of some of the recommendations”. The union also expressed concern about the banning of puberty blockers.
The Cass Report faced widespread criticism. (Photo credit should read Wiktor Szymanowicz/Future Publishing via Getty Images)
Cass has now hit back, telling Woman’s Hour on Radio 4 that she found the BMA’s stance “puzzling”, and saying: “They haven’t actually said what it is they object to about my recommendations… do they object to better training? Do they object to better research?
“When thinking about evidence-based care, they haven’t produced any evidence that the review should be stopped.
“There will always be a spectrum of opinion in medicine: that’s the way of the world. But I think the difference between the BMA’s position and mine is that I’ve spoken to hundreds of doctors as well as other clinical staff, both during the course of the review and since.
“The vast majority of those people in national meetings, in one-to-ones and in work groups, are supportive of the approach. So, I feel those who take issue with it are in a relatively small minority within the medical profession.”
In response to the BMA’s decision to review the evidence, hundreds of doctors signed an open letter, calling on the union to abandon its plans, saying the vote on the matter was “opaque and secretive”.
Following another vote last month, the BMA said it would “retain a neutral position” on the review’s recommendations while its evaluation is completed.
Philip Banfield, the chairman of the BMA council, said: “[We are] not aiming to replicate the Cass review. The chair of our ‘task and finish’ group has set out to [the] council how we will listen to those with lived experience, either as patients or as clinicians, consider the link between evidence and recommendation, and compare the recommendations with the actions or strategies that have arisen from them.
“According to the founding principles of the BMA, our evaluation will be evidence-led, starting from a position of neutrality. I cannot predict the outcome of our evaluation. However, I am clear that we will hear different perspectives, always prioritising the needs of transgender children and young people, who deserve the very best care.”
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