US medical orgs ‘out of date,’ says British doctor on ‘weak’ evidence for gender treatments for kids

U.S. medical organizations such as the American Academy of Pediatrics (AAP) and the Endocrine Society are “out of date” on gender medicine for children and adolescents.

So said British pediatrician Dr. Hilary Cass to the New York Times about her final review of studies related to the “gender-affirming care” model of treatment.

Cass and her team concluded that the general provision of puberty blockers and cross-sex hormones to children and adolescents with gender issues is based on “remarkably weak” evidence. 

Her top two concerns as a result of her review, she said, are “just how poor the evidence base is in this area,” and the failure of the “gender-affirming” model to see gender confusion issues in children as part of a “much broader range of challenges that they have, sometimes with their mental health, sometimes with undiagnosed neurodiversity.” 

Cass’ “systematic review” of studies and guidelines pertaining to the medical treatment of children with gender issues ultimately led England’s National Health Service (NHS) to plan a revision of its constitution to define “sex” as “biological sex.” 

Other European nations have followed in restricting medical intervention for children and adolescents with gender issues. 

Under the Biden administration – and fueled by top U.S. Health and Human Services (HHS) official Rachel (born Richard) Levine, who identifies as transgender – the federal government has embraced gender ideology.  

Nevertheless, 24 U.S. states have now halted or restricted the prescription of puberty blockers and cross-sex hormones for minors.  

Establishment U.S. medical groups, however, “have endorsed the treatments as evidence-based and necessary,” the Times reported. 

But U.S. health officials did not respond to the newspaper’s requests for comment on Cass’ report, and the Endocrine Society said the report “does not contain any new research” that would counter its guidelines. 

AAP said it would not comment on Cass’ report and denounced U.S. states that have banned medical gender treatments for minors.  

“Politicians have inserted themselves into the exam room, which is dangerous for both physicians and for families,” AAP President Dr. Ben Hoffman told the Times, which noted as well that when Hoffman was asked about Cass’ remarks after publication of her interview, he reportedly said AAP had reviewed her report and “added it to the evidence base undergoing a systematic review.” 

“Any suggestion the American Academy of Pediatrics is misleading families is false,” he claimed. 

Cass said that while she has “enormous respect” for AAP, “I respectfully disagree with them on holding on to a position that is now demonstrated to be out of date by multiple systematic reviews.” 

The pediatrician added she views AAP as “a fairly left-leaning organization” that “is fearful of making any moves that might jeopardize trans health care right now.” 

“And I wonder whether, if they weren’t feeling under such political duress, they would be able to be more nuanced, to say that multiple truths exist in this space – that there are children who are going to need medical treatment, and that there are other children who are going to resolve their distress in different ways,” she explained. 

Cass said that, in her own country, “both of our main parties have been supportive of the report, which has been great.” 

In response to a question about the perception by trans activists that her final review of the research was “rigged,” Cass said, “We were really clear that this review was not about defining what trans means, negating anybody’s experiences or rolling back health care. 

“There are young people who absolutely benefit from a medical pathway, and we need to make sure that those young people have access – under a research protocol, because we need to improve the research – but not assume that that’s the right pathway for everyone.” 

The Times challenged her as well on the claim that she and her review team are holding the field of transgender medicine for children “to a higher standard than others.” 

Cass responded, referring to the lack of long-term studies on gender medical treatment for children and adolescents: 

“I can’t think of any other situation where we give life-altering treatments and don’t have enough understanding about what’s happening to those young people in adulthood,” she explained. “I’ve spoken to young adults who are clearly thriving – a medical pathway has been the right thing for them.  

“I’ve also spoken to young adults where it was the wrong decision, where they have regret, where they’ve detransitioned. The critical issue is trying to work out how we can best predict who’s going to thrive and who’s not going to do well.”