14 votes

A brief rundown of some of the flaws of the Cass review

22 comments

  1. [5]
    DanBC
    Link
    Sorry it's on Twitter / X. If you don't like X / Twitter, here's a good article about the problems of demanding gold plated evidence for trans healthcare but not for any other healthcare:...

    Sorry it's on Twitter / X.

    If you don't like X / Twitter, here's a good article about the problems of demanding gold plated evidence for trans healthcare but not for any other healthcare: https://www.erininthemorning.com/p/the-myth-of-low-quality-evidence

    And here's an article talking about problems with Cass review: https://www.tandfonline.com/doi/full/10.1080/26895269.2024.2328249

    We knew it was going to be bad; we didn't think it was going to be this bad; and it's really worrying that the Labour party are fully supporting it. Wes Streeting is a terrible shadow health minister.

    21 votes
    1. TheRtRevKaiser
      Link Parent
      This is another really good summary of how much evidence we do have regarding the safety and efficacy of Gender Affirming Care for trans adolescents. The section labeled "experimental" is...

      This is another really good summary of how much evidence we do have regarding the safety and efficacy of Gender Affirming Care for trans adolescents. The section labeled "experimental" is particularly germane and links to a good literature review.

      9 votes
    2. [2]
      DanBC
      Link Parent
      Some more information about "off label prescribing" https://jane-67706.medium.com/nice-but-naughty-53b9048c8bc In the UK there are about 60million people, and at the moment maybe 100 children on...

      Some more information about "off label prescribing" https://jane-67706.medium.com/nice-but-naughty-53b9048c8bc

      In the UK there are about 60million people, and at the moment maybe 100 children on puberty blockers. It's a tiny number. https://x.com/doublehelix/status/1778354243553902926

      8 votes
      1. DefinitelyNotAFae
        Link Parent
        Got an archive link of that first one? It's members only.

        Got an archive link of that first one? It's members only.

        1 vote
    3. DefinitelyNotAFae
      Link Parent
      I do want to thank you for this thread, I think Erin is one of the best sources on keeping track of legislation on trans issues. Not sure if she normally covers the UK but I'm grateful for it. I'm...

      I do want to thank you for this thread, I think Erin is one of the best sources on keeping track of legislation on trans issues. Not sure if she normally covers the UK but I'm grateful for it. I'm reading through her links

      8 votes
  2. [2]
    TallUntidyGothGF
    (edited )
    Link
    I have been staying mostly out of these discussions because they are just exhausting. But to provide some context on why yesterday's thread was likely deleted: someone pointed out beforehand that...

    I have been staying mostly out of these discussions because they are just exhausting. But to provide some context on why yesterday's thread was likely deleted: someone pointed out beforehand that it felt like a painful continuation of the previous discussion, which I agreed with. It felt to me like a 'here, look at this report, your arguments are wrong!,' with a reset to the beginning point of the previous discussion, even though the content of the review did not invalidate the arguments made in the previous thread - we already knew the substance of the review at this time anyway. It is like being hit with the same stick repeatedly while trying to stay calm and explain again and again why they are not justified in hitting you with a stick. I understand that probably wasn't the intent of the poster.

    Anyway, I saw this article on The Guardian this morning. I don't agree with the Cass review about choices on puberty blockers and I'm not sure how much charity to give it and Cass over its other failings and implications. It really depends on a very blinkered good-faith reading that discounts the context of what it is being used to conceive. For example the consideration of holistic health, mental health, etc, sounds good, and correct, but in reality it would seem that the plan for the new centres has been to implement some form of 'gender exploration therapy,' developed by groups that strongly disagree with affirmative care, and which is therefore essentially conversion or 'desistance' therapy, of which a big component is to attempt to attribute other issues as the sole cause of the gender incongruence.

    In any case, it's worth noting that the bulk of the report does decry failings that the patients and wider community agree strongly with. Quite an indictment of British media (and the NHS I guess) that it's primarily being treated as a vindication of the very worst views.

    14 votes
    1. [2]
      Comment removed by site admin
      Link Parent
      1. TallUntidyGothGF
        Link Parent
        thanks for clarifying, i don't think you bore any ill will. it can be really difficult to discuss these topics in a fair way. i think part of the reaction was probably that your initial framing of...

        thanks for clarifying, i don't think you bore any ill will. it can be really difficult to discuss these topics in a fair way. i think part of the reaction was probably that your initial framing of the report in your comment, noting its recommendations and justifications as something like 'generally correct' (I don't know, and can't look up, the wording!) came across as naive, both to the general societal context of the report, and more specifically to the previous discussion about it here (though it was linked to, and i remember you noted that most people here were against the ban on puberty blockers). this initial framing led to the discussion basically rehashing points that were discussed in detail in the previous discussion.

        to start with, it's stressful to deal with conversations that target you as a subject, that point towards questioning your existence or cast aspersions on a class you are part of. on top of that, it's further stressful to have to repeatedly explain yourself with respect to basic misconceptions or constantly repeated talking points. you feel a duty to have to respond and dispel the misinformation that concerns you, and therefore exhaustion with doing it again and again. although it is not the case here, this kind of thing also forms components of intentional misinformation campaigns; gish gallop, bullshit asymmetry, concern trolling, etc. these are the reasons that even innocent naivety on these subjects can meet with relatively strong reactions from, well, the subjects.

        i don't necessarily think that it should have been deleted, but for my part at least, i can just say that a) it didn't feel like a high quality thread, to see the conversation on the topic being restarted from an earlier, less nuanced point of view, and b) it's frankly scary to see (especially people here) taking the report and reporting around it relatively uncritically and at face value

        8 votes
  3. [6]
    FishFingus
    Link
    There was a topic about this, but it got deleted by a site admin. The UK needs to wake the up about this. The hate groups funding this crap won't stop with one minority, they're just testing the...

    There was a topic about this, but it got deleted by a site admin.

    The UK needs to wake the up about this. The hate groups funding this crap won't stop with one minority, they're just testing the waters. Abortion is a future target, but they'll just go after the rest of the LGBT community if they don't feel confident enough yet - after all, their rhetoric barely needs repurposing, being largely recycled homophobia. But they're playing the long game to drag the country kicking and screaming down to their Christofascist nightmare.

    9 votes
    1. [5]
      TanyaJLaird
      Link Parent
      Any idea why it got deleted? I get that some people may be triggered by exposure to negative headlines like these, but it's still vital to cover important news. Deleting stories about attacks on...

      There was a topic about this, but it got deleted by a site admin.

      Any idea why it got deleted? I get that some people may be triggered by exposure to negative headlines like these, but it's still vital to cover important news. Deleting stories about attacks on trans people out of some misguided attempt to help trans people is downright Orwellian and completely infantilizing.

      3 votes
      1. Felicity
        Link Parent
        On the other hand, allowing people to promote these talking points under the exact same guise of "helping trans people" is giving them an equal playing field that they really do not deserve. The...
        • Exemplary

        On the other hand, allowing people to promote these talking points under the exact same guise of "helping trans people" is giving them an equal playing field that they really do not deserve.

        The topic in and of itself might not have been deleted if it was

        1. Tagged properly,
        2. Posted outside of ~lgbt.

        I recall writing a similar comment, but I'll say it again; trans people have heard all of this a hundred times. I've been told repeatedly during my transition in my early twenties that I should look at my surroundings and my mental state, as if being trans is something that you acquire, that medical transition is "unnecessary" as if I wouldn't grow increasingly depressed growing up as my assigned gender.

        Call it Orwellian, but I have little to no interest in reading an article from a country that has shown again and again to not give a damn about its trans population, especially not in a tag that is supposed to be for lgbt folk, and even less if it seems that people actually agree with the contents in it.

        17 votes
      2. vektor
        Link Parent
        Deimos is the only admin who actually does the kind of "hard" housekeeping like bans and deletions. Considering he's busy with life currently, it's become a bit of a habit of his to delete topics...

        Deimos is the only admin who actually does the kind of "hard" housekeeping like bans and deletions. Considering he's busy with life currently, it's become a bit of a habit of his to delete topics before they turn into dumpster fires, because by the time they do, Deimos might be at work or asleep for another 8 hours, leading to much more substantial fallout. It's certainly not perfect, but it's better than leaving a dumpster fire to burn for extended periods of time, which would lead to a more hostile atmosphere.

        I can certainly imagine that there was a bunch of Malice tags being thrown OP's way in that thread, and the atmosphere was already starting to show signs of a bit of flaming. Leave it up another 8 hours, and you've got a dumpster fire. It's not an effort to baby sensitive trans snowflakes; it's an effort to keep people from starting a flame war that affects the entire site. You can talk about difficult topics, but there's an implied responsibility to do so in a way that does not start a flame war. Any topics where that is not actually possible, yes, that conversation can indeed not currently happen on tildes for practical reasons.

        10 votes
      3. DefinitelyNotAFae
        Link Parent
        It's generally about not having any actual staff to manage and moderate discussions. And the ones that ramp up become difficult to keep up with. I'd rather this one not end up in the trash as...

        It's generally about not having any actual staff to manage and moderate discussions. And the ones that ramp up become difficult to keep up with.

        I'd rather this one not end up in the trash as there are already a number of useful links here I'd like to keep. And there is only so much anti-trans apologia I can handle.

        8 votes
      4. sparksbet
        Link Parent
        I can only speculate, but the article itself for the previous topic was written from a perspective that was much less critical of the Cass report and there was at least one person arguing in...

        I can only speculate, but the article itself for the previous topic was written from a perspective that was much less critical of the Cass report and there was at least one person arguing in support of its conclusions in the comments. I suspect that was a factor in its removal.

        7 votes
        1. Removed by admin: 5 comments by 3 users
          Link Parent
      5. Removed by admin: 9 comments by 5 users
        Link Parent
    2. Removed by admin: 10 comments by 3 users
      Link Parent
  4. [7]
    0d_billie
    Link
    The Cass Review is recommending against providing any medical treatment for trans children. And it is possible (if uncharitable) to interpret the idea to continue youth care up to the age of 25 as...

    The Cass Review is recommending against providing any medical treatment for trans children. And it is possible (if uncharitable) to interpret the idea to continue youth care up to the age of 25 as an attempt to hold off on any medical treatment for gender dysphoria up to that age under the guise of "holistic care." Treating co-concurrent conditions and situations sounds appealing, but it smacks of ableism to me. It reads like an excuse to deny trans children the care that they need to live because it's more convenient to say "oh, well they're autistic, they just don't understand how society functions, let's teach them not to want to be trans." It's just conversion therapy via the backdoor. Holistic care sounds good, until you find out just how utterly fucked the rest of the provision in the UK is for mental health. I have a friend who works for CAMHS, and it is apparent that a child being referred to the service today will no longer be a child by the time the service has an appointment for them. And the report very much reads to me like treating any gender incongruity would be dead last on the list of priorities, on the hope that it'll just go away if we sort out all of this other stuff. Completely forgetting the wealth of research and evidence that shows that being transgender is not typically environmentally caused.

    This report very much feels to be the thin end of the wedge, as there is now set to be a review of adult transgender care at the seven clinics in England. I am concerned that the recommendations to withhold HRT until such time as a holistic treatment plan has been exhausted will be carried over into the adult care. If this ends up being the case, and with NHS waiting lists the way they are, it effectively bans the NHS from prescribing hormones to trans people. For myself, I am now starting to seriously consider whether I want to buy my first home in the UK or look to migrate to a more trans-friendly country.

    8 votes
    1. [6]
      DefinitelyNotAFae
      Link Parent
      There has been a push in the US to ban or 'delay' trans care for autistic adults, likely because the prevalence of being queer and trans/non-binary is statistically higher among autistic folks. So...

      There has been a push in the US to ban or 'delay' trans care for autistic adults, likely because the prevalence of being queer and trans/non-binary is statistically higher among autistic folks. So it's an easy target and yeah, it's ableist and infantilizing.

      It's frustrating how couched this all is in "concern"

      11 votes
      1. [3]
        sparksbet
        Link Parent
        Honestly the UK situation with trans rights and healthcare is bad enough (and getting worse quickly enough) that I'd probably move back to the US before I'd move there. As tedious and deliberately...

        Honestly the UK situation with trans rights and healthcare is bad enough (and getting worse quickly enough) that I'd probably move back to the US before I'd move there. As tedious and deliberately difficult as the system is here in Germany, it's a fucking trans paradise compared to the UK, and that's sad.

        7 votes
        1. [2]
          DefinitelyNotAFae
          Link Parent
          The US at least has the benefit of having better states to live in. Not sure if Scotland, Wales or NI are any better than England when it comes to the UK's particular brand of transphobia. But it...

          The US at least has the benefit of having better states to live in. Not sure if Scotland, Wales or NI are any better than England when it comes to the UK's particular brand of transphobia. But it helps living where you know that on the whole the government isn't trying to undermine you, or your friends.

          3 votes
          1. sparksbet
            Link Parent
            I know Scotland's government has at least tried to pass more trans-affirming policy and has been repeatedly kneecapped by the English in that respect.

            I know Scotland's government has at least tried to pass more trans-affirming policy and has been repeatedly kneecapped by the English in that respect.

            5 votes
      2. [2]
        nosewings
        (edited )
        Link Parent
        As a cis autistic person, I can't put into words how viscerally furious this makes me. To go "well, being trans isn't a valid identity because it's correlated with autism" is one thing; they can...

        There has been a push in the US to ban or 'delay' trans care for autistic adults

        As a cis autistic person, I can't put into words how viscerally furious this makes me. To go "well, being trans isn't a valid identity because it's correlated with autism" is one thing; they can stick their heads in the sand if they want. But to say that autistic kids are incapable of making informed decisions about their lives because they're autistic is both flagrantly dishonest---they don't really believe it; they'll let autistic people make all kinds of other decisions, just not this one---and yet at the same time a lie that, if repeated enough, will become received truth for people who already have a stake in this issue, potentially leading to harm against me, most of my friends, and countless kids who haven't had the benefit of time to figure out their place in a world that doesn't seem to be made for them.

        6 votes
        1. DefinitelyNotAFae
          Link Parent
          It's why all of this is so infuriating. It's ableism. It's queer and transphobic. It's misogyny. And at least in one state it wasn't just trans kids. I don't recall if it was Florida or Missouri...

          It's why all of this is so infuriating. It's ableism. It's queer and transphobic. It's misogyny. And at least in one state it wasn't just trans kids. I don't recall if it was Florida or Missouri but one of the states targeting adult trans care tried to put the same provision of "delaying care" until mental health problems were "resolved". If it was Missouri it didn't stick. Florida got the NP ban on Rx HRT in place but I don't know if they got that one.

          4 votes
  5. Comment removed by site admin
    Link