The British Medical Association’s decision to challenge the Cass Review and condemn the puberty blockers ban has triggered a civil war within the profession. Over 1,400 doctors have signed an open letter expressing their ‘dismay’ at the BMA’s position.
The Cass Review was a landmark report on NHS child gender services. It found that children had been let down by a lack of research into these controversial medical interventions.
Published by leading paediatrician Dr Hilary Cass, the review found that there is “remarkably weak evidence” regarding the long-term impact of puberty-suppressing hormones, known as “puberty blockers”. Just last month, the Government renewed a temporary ban on the drugs’ prescription to children not already taking them.
Although the review has supported by the vast majority of the medical establishment, on the 31st of July the BMA announced that it would lobby against the implementation of its recommendations.
Following a motion passed by the BMA council, the union said that it will set up a “task and finish” group to “publicly critique” the review. It went on to publicly condemn the Government’s restrictions surrounding puberty blockers.
Many believe that the BMA’s membership is at risk of being riven apart by this extraordinary decision. Already, more than 1,400 doctors have signed an open letter expressing their “dismay” at the BMA’s position. Among them are 70 professors and 23 former or current presidents of medical royal colleges and clinical leaders.
Dame Professor Clare Gerada, for instance, is furious about the decision, demanding to know what right Britain’s biggest doctors’ union has to second-guess the Cass review .
“Cass took four years and did thousands of interviews, eight independent systematic reviews, had endless consultations and has come up with a very good report,” Gerada, a former president of the Royal College of General Practitioners, says. “Then along comes the British Medical Association in a meeting that no one is really invited to and makes this ruling.
“What right has the BMA to second-guess the Cass review, the Academy of Medical Royal Colleges – which represent our professional values – and the three major royal colleges covering psychiatry, paediatrics and GPs?”
“I prescribe medicines to children and adults and every single one of those medicines has been through rigorous clinical studies. I can tell patients what the reason for that medicine is and the risks and benefits. That’s standard.
“All the Cass review is doing is saying we need to do the same for puberty blockers. This is about making medicines safe for children.”
Dr Az Hakeem, a consultant psychiatrist, specialising in treating patients with gender dysphoria was also critical of the move.
Hakeem argues: “The BMA has been taken over by a brigade of people wearing red braces and putting pronouns in their bios who have turned their back on evidence-based medicine in favour of a cult of ideology.”
“To dismiss the very hard work of Dr Hilary Cass and her team and their four years of evidence-based research is a mockery of the position that they hold.”
Consultant psychiatrist Dr Lenny Cornwall has been a member of the BMA since 2016. He argues that the incident exposes the “outrageous way” the doctors’ union is operating.
““I hadn’t quite realised how it [the BMA council] operates in terms of it being so secretive,” he says. “It is taking an ideological decision when the Cass report is a scientific review. That is not an appropriate thing for a medical union to do.”
The motion was tabled by Vassili Crispi, a junior doctor, and consultant anaesthetist Dr Tom Dolphin, who was previously a chair of the BMA’s junior doctors committee.
Last October, posting on X, Dolphin described the Conservative government’s decision to ban trans women who were born male from female hospital wards as “cruel, unworkable and almost certainly illegal”.
Crispi, meanwhile, is the co-author of a paper, published in a medical journal, that called for the adoption of “gender-neutral terminology.” The paper demanded that LGBTQ+ education must be “embedded” with the undergraduate curricula for medics and “regularly revisited during postgraduate training”.
Despite expressing their anger at the BMA’s decision, many medics have taken heart at the widespread criticism it has faced from within the profession. Whilst the adoption of the motion to challenge the Cass review isn’t surprising, the sheer number of medics willing to publicly oppose the BMA’s stance is. The “bubble” surrounding child puberty blockers has now burst.
“This has fired up doctors in a way that I hadn’t quite grasped when I signed the letter,” Cornwall says. “When the signatories go up to more than a thousand you realise that actually there’s a massive strength of feeling here.
“That’s because the Cass review was seen as such a relief because people have been so frightened to challenge gender-affirming care for children for fear of being called a bigot.”
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