Cass-tastrophe: Resist attacks on trans healthcare!

NHS England’s decision earlier this year to prohibit puberty blockers for transgender youth ignited uproar within the queer community, raising serious concerns about the future of trans healthcare. The recent release of the Cass Review’s final report has only exacerbated these fears. The review, characterised by its regressive and harmful approach, constitutes a direct assault on the rights and bodily autonomy of trans youth.

By Keighley Duffy

NHS England’s decision earlier this year to prohibit puberty blockers for transgender youth ignited uproar within the queer community, raising serious concerns about the future of trans healthcare. The recent release of the Cass Review’s final report has only exacerbated these fears. The review, characterised by its regressive and harmful approach, constitutes a direct assault on the rights and bodily autonomy of trans youth.

Dr. Cal Horton identifies four key areas of concern, underscoring the failures of the Cass Review. Firstly, the review demonstrates evident prejudice against the trans community, both within the healthcare system and within the review itself. Despite the pervasive medical discrimination faced by the trans community, the review fails to acknowledge the detrimental impact of anti-trans prejudice on trans youth. Instances of transphobia, such as intentional misgendering of trans children and the invalidation of the identities of trans adults, are rampant throughout the review, further exacerbated by the failure to address the scientifically baseless notion that “there is no such thing as a trans child” held by many healthcare professionals. It seems self-evident that those who deny the existence of trans children lack the credibility to shape the healthcare landscape for trans youth, yet the Cass Review disagrees.

Secondly, Dr. Horton highlights the underlying cisnormative bias within the review, which presupposes that everyone should be cisgender and views transgender identity as aberrant. This bias is evident in the deliberate exclusion of experts in trans healthcare and individuals with lived trans experiences from the review process. Consequently, the focus shifts from improving health outcomes for trans youth to pathologizing gender dysphoria.

Pathologization, the third concern raised by Dr. Horton, persists throughout the Cass Review. Rather than recognizing transgender identity as a valid aspect of one’s identity, the review frames it as an illness in need of diagnosis and “cure,” thereby delegitimizing the identities of trans children.

The final area of concern pertains to the review’s double standard in evaluating evidence and making policy recommendations. The review prioritises randomised control trials (RCTs) as the gold standard for evidence, despite the impracticality and ethical concerns of conducting such trials on gender-affirming medical care for trans youth. Moreover, observational studies demonstrating the positive effects of gender-affirming care are disregarded as “low quality.” Yet, the review fails to apply this standard consistently, instead advocating for treatments either unsupported by evidence or outright contradicted by existing research, such as “exploratory therapy,” which amounts to a thinly veiled form of conversion therapy.In essence, the Cass Review fails to prioritise the needs and well-being of trans youth within a crumbling healthcare system. Rather than aiming to improve health outcomes, the goal of the review appears to be to manufacture consent for limiting trans youth’s access to necessary care.The endorsement of the Cass review by Labour confirms that they pose no real alternative to the Transphobia and divide and rule tactics of the Tory party. We can only rely on a united movement made up of LGBTQ+ and working-class people of all genders to challenge and defeat Trans oppression.

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