A North East MSP says “damning” claims by the author of the Cass review on gender services for under-18s makes the case for an overhaul in Scotland.
The call was made after Dr Hilary Cass spoke about her landmark report with MSPs who were probing its conclusions on Tuesday morning.
Her report found there was “remarkably weak” evidence on medical intervention in care, including the prescription of puberty blockers to under-18s who are questioning their gender identity.
While her work was limited to England, she told MSPs some of her recommendations could be applied in Scotland.
NHS Scotland has already announced a pause in prescribing puberty blockers to children referred to Sandyford specialist gender clinic in Glasgow.
The SNP government said to be considering the findings of the Cass Review.
Dr Cass told MSPs that children with “gender distress” often had struggles with mental health, neurodivergence or family problems.
But she warned these were sometimes overlooked. Clinicians pass children to identity clinics because many are “fearful” of the toxic debate surrounding gender care, she said.
MSPs on the Holyrood committee were also told children accessed unregulated hormone replacement medications “a lot more than we would wish”.
Her review found there was some evidence masculinising and feminising hormone treatments were appropriate for young people – but the evidence for the use of puberty blockers was said to be much less clear cut.
Should review apply in Scotland?
North East MSP Tess White asked Dr Cass which of her 32 recommendations could be applied in Scotland.
Dr Cass told her: “In England we are embedding these services within a broader children’s hospital service setting, so there is access to services for young people with autism, eating disorder and a range of other presentations.”
She added: “There is scope to include Scotland within the research infrastructure and also within the regional network where there is the ability to share and support clinical practice.
“That’s something I think we would welcome in England.”
Speaking after appearnce, Tory MSP Ms White said: “The evidence given by Dr Hilary Cass was absolutely damning and further emphasised the need to undertake a review of gender clinics in Scotland.
“Instead of listening to the science, the SNP have rushed into significant gender reform, ignoring the wellbeing and health of children seeking medical care for issues like gender dysphoria.
“Rather than continuing to focus on their narrow-minded ideology, I’m hopeful the SNP listened carefully to Dr Cass’s session and will finally give her findings their unequivocal backing, in a similar way that is going to happen south of the border.”
‘Worst outcome’
During the discussion, Greens MSP Gillian Mackay asked about concerns her review appeared to suggest transitioning was the “worst outcome” for young people.
Dr Cass said medical transition is an important option for people who would go on to have a long-term trans identity – but there is a risk treatment is started at the wrong point.
She added: “The reason that is a negative outcome is because medical transition does not come without costs in terms of effect on sexual function, fertility, knowns and unknowns about long-term bone health risk, the limitations of surgery.
“All those costs which are well worthwhile if you have a long-term, stable trans identity but it’s a high cost to pay if, in the longer term, you don’t.”
‘Comprehensive document’
A Scottish government spokesperson said: “The Cass Review is a comprehensive and valid scientific document.
“In line with NHS England – for whom the report was commissioned – we are considering all of the recommendations.
“A multi-disciplinary clinical team within the office of the chief medical officer in the Scottish government – including people with paediatric, pharmacy and scientific expertise – is leading this work.
“The chief medical officer will provide a written update to parliament on the outcome of that clinical consideration process before the summer recess.”