Leading paediatrician Hillary Cass, who led the review of treatment for gender dysphoria for children in the UK, has told BBC that children have been “weaponised” in a strident debate – and that they have been misled about the “sometimes quite brutal” realities of changing sex by what they have seen on social media.
Dr Cass’s review found a lack of evidence for the gender treatment pathways being offered to children, and led to puberty blockers being banned for use by children and young people under 18.
She told the BBC’s Sunday with Laura Kuenssberg that she felt children were ‘let down in all the shouting” between adults – saying it was a “real shame” that children had been “weaponised” by the “people at the extremes”.
Children had been misled by “unrealistic images and expectations on social media” she said. There was a “lack of realism about what transition would really mean and how hard it would be”, she explained, adding that there was not an understanding of how intensive medical treatments werem, and that changin sex sometimes involved “quite brutal surgeries”.
If some young people had “taken more time” they might not have pursued medical treatments, she said.
Quite “a lot of distress” had been caused for young people experiencing gender confusion, Dr Cass also said. The paediatrician said that the vast majority of people in the middle of the debate were silent.
Some trans activists had been “so strident that it’s made it more difficult for trans people themselves who are just trying to live under the radar”, she claimed, while she also believed that people who took the view that no-one should change sex had “similarly made it difficult”.
“There are a tiny number of people who will never be comfortable with their biological sex, with the gender associated with their biological sex,” she told BBC.
“And for them, a medical pathway is the only way they’re going to live their life comfortably. And we don’t understand why that is, but we have to try and help those people thrive as much as the young people who are going to grow out of this.”
She said it was impossible to assess precisely how many children experiencing gender distress would feeling that distress until adulthood, but it would be a “really tiny number”.
And Dr Cass said that the now-shuttered Tavistock clinic in London – where hundreds of Irish children were sent – did not follow up with children in their care who did not go down a medical pathway.
“When the clinic started, there were about 50 children a year in the UK, and then by the time I started my review it had shot up to 3,500 a year,” she said.
“We tried very hard to find out from the Tavistock what happened to the ones who didn’t go on medical pathway. They just didn’t follow them up and they didn’t have that data.
“So that’s one chunk of children who don’t go on a medical pathway, then there are all the ones that me and parents and teachers will tell you about who go through two or three years of gender questioning and then desist.”
She warned that there was a need for caution about very young children because “if they socially transition too early we think they can get locked onto a trajectory that may not have been the correct natural trajectory for them”. Social transitioning occurs where children are facilitated in changing name and in using facilities for a gender that is not their biological sex in schools and other settings.
Dr Cass said that social media was having an impact on the number of children and young people presenting with gender dysphoria.
“I think what has kind of misled children is the belief that if you are not a typical girl, if you like playing with trucks, or boys who like dressing up or that you have same-sex attraction that means that you’re trans and actually it’s not like that but those are all normal variations,” she said.
“I think children and young people were being given a narrative that it’s not okay to be anything but absolutely typical of the other girls on Instagram.”