The trade union and professional body for doctors and medical students in the UK has reversed its opposition to the Cass Review on puberty blockers following backlash from members.
At the end of July, the British Medical Association (BMA) sparked controversy from hundreds of its members after it rejected the review’s findings and called for the ban on puberty blockers to be lifted. This prompted some highly experienced doctors to resign from the union.
Whilst the findings of the Cass Review were broadly accepted, the BMA had vowed to establish a group to “publicly critique” the report, which the union claimed contained “unsubstantiated recommendations.” The union claimed it was “discriminatory” to ban children and young people from accessing puberty blockers.
The BMA’s council, which consists of 69 members, had been asked to vote on a motion rejecting the Cass Review – which was passed and became formal policy.
However, more than 1,400 doctors, including 900 BMA members, hit back, signing an open letter calling on the union to accept the review’s findings. In the letter, the group of doctors claimed that BMA leaders were “going against the principles of evidence-based medicine and against ethical practices.”
The letter, which was first published by The Times in August, detailed how members were not consulted on the motion, with members describing the meeting as “secretive.”
In the letter, medical leaders and doctors slammed the BMA’s stance as “unacceptable,” adding that it did jot reflect the “views of the wider membership.”
The letter, addressed to Professor Philip Banfield, chairman of the BMA, stated: “We write as doctors to say, ‘not in my name’. We are extremely disappointed that the BMA council has passed a motion to conduct a ‘critique’ of the Cass review and to lobby to oppose its recommendations.“
The passing of the motion was opaque and secretive. It does not reflect the views of the wider membership, whose opinion you did not seek. We understand that no information will be released on the voting figures and how council members voted. That is a failure of accountability to members and simply not acceptable.”
The letter also urged that the implementation of the Cass Review would be essential in order to ensure children receive appropriate care, adding that it “is the most comprehensive review into healthcare for children with gender related distress ever conducted”.
It also called on the BMA to “abandon its pointless exercise” of critiquing the Cass review, adding: “By lobbying against the best evidence we have, the BMA is going against the principles of evidence-based medicine and against ethical practice.”
In a new statement published on its website, in recent days, the BMA announced that members recently voted “for the BMA to retain a neutral position on the Review until that evaluation has concluded.”
In a statement, David Strain, chair of the BMA Board of Science, wrote:
“We will also review the actions that have been implemented in the name of the Cass Review, what is planned, and what remains to be commissioned. According to the founding principles of the BMA, the evaluation we produce will be shared for all to use. I do not know, nor do I pre-empt, what we will conclude.
“By approaching this evaluation with an open mind and a commitment to listening to all perspectives, the BMA aims to foster a more inclusive and understanding healthcare environment. I acknowledge that some members have objected to our evaluation, and I am committed to hearing and understanding their concerns.
“Nevertheless, it is crucial that we move beyond polarising debates and focus on the nuanced realities of those affected, ensuring that their needs are met with compassion and evidence-based care. This process will ultimately contribute to a more informed and empathetic approach to healthcare for children and young people with gender incongruence and dysphoria, aligning with the BMA’s core principles of advancing medical knowledge and improving patient care.”
The Cass Review, authored by paediatrician Dr Hilary Cass, was published in April. The independent landmark report found that children in the UK had been “let down” – citing a lack of reliable evidence on the safety of transitioning children.
The review into gender identity services for children and young people in Britain warned that healthcare professionals were afraid to discuss views on transgender services for children, and found there was no evidence puberty blockers or hormone drugs ‘buy time to think’ or ‘reduce suicide risk’ in that cohort.
The report was undertaken amid concern regarding the controversial provision of ‘gender-affirming care’ (where other mental health factors were not examined nor sufficient counselling given to children), and the huge spike in children presenting at clinics such as the now-closed Tavistock seeking to be put a treatment pathway to change sex.
In response to the damning review, NHS England announced it would no longer be prescribing puberty blockers to children and young people under 18 as a treatment for gender dysphoria. In July, the UK High Court ruled that the ban was lawful – after a trans campaign group took legal action, arguing that Britain’s former Health Secretary had failed to consult patient groups and misused the emergency process.
British Health Secretary Wes Streeting said he welcomed the court ruling, stating that children’s healthcare must be “evidence-led”.