The Cass Review final report is released tomorrow. I’ve seen the summary and it is as expected.

After a 4 year process the Cass Review final report is a deeply depressing outcome. I have repeatedly, over many years, called for paediatricians to take a role in trans children’s healthcare. In other countries paediatrician-led care has helped shift trans children’s healthcare from harmful and pathologising conversive practices endorsed by those who treat transness as a mental health disorder, into modern, child-centred, trans-positive healthcare. In this, Dr Cass has failed.

The Cass final report fails to take any meaningful steps to improve the lives of trans children. It fails to depathologise trans lives. It fails to centre trans children’s rights. It provides a veneer of credibility to policies, practices and systems that are backwards, pathologising, abusive, and deeply damaging to trans children and young people.

The Cass final report repeats the failings of earlier Cass publications. I have published a peer reviewed analysis and critique of all earlier Cass related reports in the leading journal on trans health (the International Journal of Transgender Health). This analysis highlighted four major concerns with the Cass approach and outputs.

The Cass Review: Cis-supremacy in the UK’s approach to healthcare for trans children

These concerns relate to (1) prejudice; (2) cisnormative bias; (3) pathologisation; and (4) inconsistent standards of evidence.

Each of these concerns impacts the Cass Review’s approach to trans children’s healthcare, with negative repercussions for trans children’s healthcare rights and well-being.

Trans children face unbearable challenges at present in the UK. The scale of hurt, pain and trauma is hard to describe.

There is currently no accessible NHS healthcare for trans adolescents, in part due to the Cass Review. Newly proposed centres will not offer timely affirmative medical intervention, care that is recognised as essential and life-enhancing for many trans adolescents.

There is a real risk that professionals in new NHS centres will be emboldened to adopt pathologising conversion practices that cause immense harm. The Cass Review’s ‘caution’ on social transition will lead to more trans children enduring the harm, shame and trauma of delayed or denied transition, with significant consequences for trans children’s self-esteem and mental health. There is a growing body of global evidence on the benefits of social transition and no evidence of harm. Current guidance will deny many trans children the chance for a shame-free and joy-filled childhood.

Trans children face severe barriers to equality in education, with many experiencing trauma in UK schools.

Too many trans children face rejection and abuse at home, including from families who are mis-led into anti-trans practices by lobbying organisations who fundamentally reject the very existence of trans children.

Trans children face harm and injustice at every turn. The Cass Review’s final report does nothing to help trans children live happy, healthy, safe and confident childhoods.

I hope that those who actually care for trans children will take action today – calling out the dire situation for trans children in the UK and highlighting the failures of the Cass Review. I hope more people will stand up alongside trans children, resisting the most outrageous harms, and defending trans children’s rights.

Trans children have a right to safe, supported and happy childhoods.