Dr Hilary Cass recently published her long-awaited review into support and treatment options for children who suffer from gender confusion, and it offers a strong – some would say unanswerable – challenge to the ‘gender affirmative model’ which in recent years has become the norm in NHS England’s Gender Identity Development Service (GIDS).
Faced with cases of gender distress, this approach encourages clinicians to ‘affirm’ rather than question a child’s chosen gender identity, before then putting them on a medical pathway involving puberty suppressing drugs and cross-sex hormones that can have lifelong, irreversible consequences.
The Cass Review cautions that extreme care should be taken before anyone under the age of 25 transitions; calls for an end to the prescribing of puberty blockers and cross-sex hormones to under 18s; warns that children who change gender may regret it; finds that many gender confused adolescents have experienced trauma, neglect and abuse; and says there is no “good evidence” on the long-term benefits of the treatments that have been given to children.
Although the Cass Review was commissioned by NHS England there have been calls for the Scottish Government to adopt its findings, not least because NHS Scotland’s only gender identity clinic for children, the Sandyford in Glasgow, takes exactly the same approach.
As recently as last week, First Minister Humza Yousaf was reiterating the Scottish Government’s long held position that the Cass Review would be “reviewed”, while seemingly pre-empting the findings of that review by ruling out calls to close the Sandyford, claiming it offered “exceptional health care”. Now, however, the Sandyford clinic has announced action of its own, pausing the prescription of puberty-suppressing hormones for new patients and limiting ‘gender affirming’ cross-sex hormones to those aged 18 and over, in a decision that has the backing of Sir Gregor Smith, the chief medical officer for Scotland.
So is the BBC exploring this developing story impartially, allowing different viewpoints to be heard, holding government ministers to account for their approach, and where necessary fact-checking activists who offer up inaccurate or misleading information live on air? Er, no.
As reported by the Telegraph, campaign group For Women Scotland has made a formal complaint to the public service broadcaster, accusing it of a lack of balance in its Scottish coverage of the Cass Review, and allowing partisan commentators to make unfounded claims unchallenged about puberty blockers.
While south of the border the BBC has covered the issues in depth, the day after the Cass Review was published, BBC Scotland made the deliberate editorial decision to focus on an NHS England decision about migraine tablets, already available in Scotland, on its flagship morning radio phone-in.
Meanwhile, on the day the report was released, it convened a panel made up exclusively of critics of the Cass Review on its nightly news programme, The Nine.
One of those critics was Ellie Gomersall, a transgender woman and activist. Later that day, Gomersall was invited by the BBC to have another go at criticising the review on Scotland’s Drivetime radio show. During that show she claimed, unchallenged by the host, that the effects of puberty blockers were “perfectly reversible”.
Yet as the Cass Review makes clear, it is currently not possible to rule out fears that these drugs cause irreversible damage to cognitive and physiological development and fertility. As per the systematic review undertaken for the Cass Review by researchers at the University of York, for instance, “multiple studies” now demonstrate that “puberty blockers exert their intended effect in suppressing puberty, and also that bone density is compromised during puberty suppression”.
Is this effect “perfectly reversible”, as the activist and Glasgow Green Party campaign manager Ellie Gomersall claims? “Much longer-term follow-up is needed to determine whether there is full bone health recovery in adulthood, both in those who go on to masculinising/feminising hormones and those who do not,” the world-renowned paediatrician Dr Cass concludes.
For Women Scotland’s complaint was made to BBC Scotland’s head of news and current affairs, Gary Smith, and accused the broadcaster of a “dearth of Scottish coverage” over the Cass Review. It went on to say that where the topic had been featured, “appalling editorial decisions” had been made resulting in “frequently misleading” coverage which was “little short of propaganda”.
“Naturally, the Cass Review did not address the provision of services in the Scottish NHS, but even a cursory investigation should reveal that the situation in Scotland is, if anything, worse,” the complaint said.
“Despite the troubling findings of the report, affirmation-only care and dangerous experimental drugs continue to be the only show in town in Scotland.
“A public service broadcaster should, surely, have been asking the tough questions of ministers and the health service which continues to allow this discredited and damaging approach.”
It added: “While we should give credit to Drivetime for attempting to cover the issue at all, we were horrified that they gave air time over to the unqualified, non-medical activist Ellie Gomersall who outright lied about studies being ignored in the Cass Report, and was permitted to make wholly unevidenced claims about puberty blockers, regret rates and medical best practice.”
