Dr Hilary Cass has published her long-awaited review into support and treatment offered to children who claim they are transgender, with the paediatrician warning that the wider social debate on this issue remains “exceptionally toxic”, and “there are few other areas of healthcare where professionals are so afraid to openly discuss their views”.
Writing for the Spectator, UCL Reader in Financial Mathematics John Armstrong says that it isn’t just healthcare professionals that were – in some cases, still are – disincentivised from speaking out, but academics too. Here’s an extract:
Concerns were first raised about the Tavistock by whistleblowing nurse Sue Evans in 2004. Yet, two decades later, the Cass Review found that benefits and harms of puberty blockers and cross-sex hormones for trans adolescents are still unknown, with a systematic literature review attributing this to “poor study design, inadequate follow-up periods and a lack of objectivity in reporting of results”.
Given the clear need for rigorous research on trans healthcare and the apparent availability of generous grant funding, why haven’t academics done this already? A central reason has been the erosion of academic freedom in our universities.
Any academic who dares to question gender-identity orthodoxy can expect obstacles at every stage of the research process. The ethics committee at Bath Spa University blocked research into detransitioning among young people because “Engaging in a potentially ‘politically incorrect’ piece of research carries a risk to the University”. The first study I’m aware of to raise the hypothesis that social contagion might be a factor in rising admissions to gender-identity clinics was denounced as ‘hate speech’, leading the journal to issue a grovelling apology and to insist on publishing a correction, although the results were unchanged. Academics have faced campaigns to defund their research (for using the term ‘biological males’), had papers rejected because it is deemed transphobic to talk about biological sex, and have been no-platformed even when invited to speak about entirely unrelated topics.
Every aspect of academic life is affected. Michele Moore, a disabilities academic, faced attempts to remove her from a journal editorship because of her concerns with the idea that anyone can be born in the wrong body. James Esses, a student psychotherapy student was thrown off his master’s course and had to sue the UK Council of Psychotherapy to get them to concede that the view that gender questioning children should receive counselling rather than being put on a medical pathway was a “valid” professional opinion. For Kathleen Stock the vilification went far beyond her professional life: she was advised by police to stay away from campus and install CCTV at her home.
The freedom to criticise lies at the heart of science. The philosopher Karl Popper argued that scientific beliefs must be falsifiable: there must be some experiment you can perform that puts your beliefs to the test. A belief which cannot be criticised cannot be falsified, and so cannot be science. The silencing of critics is an anathema to science: a scientist must subject their ideas to the severest scrutiny and must welcome the scrutiny of others.
With Cass’s report, the application of science to transgender healthcare has finally gone mainstream. Not everyone will like this. In Cass’s words: “Although some think the clinical approach should be based on a social justice model, the NHS works in an evidence-based way.”
But this does not mean the debate on transgender healthcare is over. Science is born from disputation. As the evidence from the planned studies comes in, there will be a great deal to dispute. What is important is that we engage with the evidence with an open mind and with a willingness to be proven wrong.
Worth reading in full.
