'Cass Review' author: More 'caution' advised for gender-affirming care for youth

Dr. Hilary Cass speaking about the publication of the Independent Review of Gender Identity Services for Children and Young People .

HILARY CASS: The quality was disappointingly poor. One of the significant reasons is that they just didn't follow up for long enough, particularly for young people who were taking masculinizing and feminizing hormones. Another problem is that many of the studies didn't take account of the fact that this is a really, what we call heterogeneous, so a mixed population of young people who were very different from each other.

CHAKRABARTI: Okay. So more specifically then, in the systematic review of studies relating to the use of puberty blockers. We should say that puberty blockers do have quite a well-established evidence base for use in some situations, right?CASS: Absolutely right, but it's really important to say that it's a very different thing to take a young person whose hormones are going through the normal increases that you expect to see in puberty. And pausing that.

CHAKRABARTI: To be clear, the report states, quote, that the University of York concluded, and that's the group that did the review.CHAKRABARTI: That there is insufficient or inconsistent evidence about the effects of puberty suppression on psychological or psychosocial health. CHAKRABARTI: This is a really important point that's been brought up by the Cass Review. About did the focus on trying to provide medical forms of therapy perhaps overshadow other forms of care., and they stated that, quote,"Research demonstrates that gender-affirming care improves the mental health and overall well-being of gender diverse children and adolescents," end quote.

There's also the question of, there have been competing claims about whether puberty blockers have negative impact on a young person's bone health.CHAKRABARTI: So, Dr. Cass, one thing that the review notes very clearly at the top is the rapid rise, and actually the exponential rise, in the number of young people, adolescents, in particular, seeking treatment for gender dysphoria.

And then often, by the next visit, the distress, the anxiety just ramps down. And the next time they see her, it's not that the dysphoria has gone away, but it's just slipped into the background. And then they can talk about whatever the other things are that are bothering them, which might be sexuality.

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