The UK's new study on gender affirming care misses the mark in so many ways
[block quote] The UK’s new study on gender affirming care misses the mark in so many ways
It’s like the DeSantis administration wrote it.
By Henry Carnell Friday, May 10, 2024
Last month, the UK’s four-year-long review of medical interventions for transgender youth was published. The Cass Review, named after Hilary Cass, a retired pediatrician appointed by the National Health Service to lead the effort, found that “there is not a reliable evidence base” for gender-affirming medicine. As a result, the report concludes, trans minors should generally not be able to access hormone blockers or hormone replacement therapy (HRT) and instead should seek psychotherapy. While the review does not ban trans medical care, it comes concurrently with the NHS heavily restricting puberty blockers for trans youth.
The conclusions of the Cass Review differ from mainstream standards of care in the United States, which recommend medical interventions like blockers and HRT under certain circumstances and are informed by dozens of studies and backed by leading medical associations. The Cass Review won’t have an immediate impact on how gender medicine is practiced in the United States, but both Europe’s “gender critical” movement and the anti-trans movement here in the US cited the report as a win, claiming it is the proof they need to limit medical care for trans youth globally. Notable anti-trans group the Society for Evidence Based Gender Medicine called the report “a historic document the significance of which cannot be overstated,” and argued that “it now appears indisputable that the arc of history has bent in the direction of reversal of gender-affirming care worldwide.”
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Despite all this, Cass’ systematic evidence reviews, used the “somewhat subjective”—as Turban puts it—Newcastle-Ottawa scale rating system to evaluate research on gender-affirming care. (More precisely, the review actually commissioned researchers at the University of York to conduct the ratings, which Cass then discusses at length in her own report). The Newcastle-Ottawa system allows reviewers to rate research on a scale from “low quality” to “high quality.” That sounds fine, except that high quality studies, according to the grading system, are almost always RCTs. This makes the scale inappropriate for use evaluating gender-affirming care. Outside of gender-affirming care, some researchers argue the scale is increasingly inappropriate because it is “outdated” and has “never been published in a peer-reviewed journal.” Cass categorically denies that the review “set a higher bar for evidence than would normally be expected.”
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“It feels like a double standard to say, ‘Oh, there’s no evidence for medical and surgical interventions with regards to gender-affirming care or affirmation,’ but then, ‘Oh, let’s turn around and offer this other therapy that has absolutely no evidence,’” says Streed.
In a follow-up Q&A, Cass said she “believes that no LGBTQ+ group should be subjected to conversion practice.” At the same time, she stands behind her inclusion of exploratory therapies, saying, “young people with gender dysphoria may have a range of complex psychosocial challenges and/or mental health problems impacting on their gender-related distress. Exploration of these issues is essential.”
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Further, experts note the report does not disclose all the people who collaborated on the project and their affiliations. Streed says, for similar reviews, “every author has to have their name on it and say what their conflicts of interests are, where they are getting their funding from. The Cass Report does not offer that information. For me, that is a big red flag.” Some of those connections have become clearer since the report was published. For example, the blog Growing Up Transgender uncovered a 2022 meeting between the US Department of Health and Human Services and the Society for Evidence-Based Gender Medicine, which the Southern Poverty Law Center has dubbed “the hub” of the “anti-LGBT pseudoscience network.” Representing SEGM were Richard Byng and R. Stephens, who were identified in the meeting as part of NHS’ “working group on Gender Dysphoria.”
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More at link:
https://www.lgbtqnation.com/2024/05/the-uks-new-study-on-gender-affirming-care-misses-the-mark-in-so-many-ways/
