How many trans children are there in Scotland?published at 14:29 British Summer Time 23 April
Like other parts of the UK, Scotland has seen a rapid rise in the number of young people questioning their identity or experiencing gender dysphoria.
For many, this will only require support from family, friends and school but some become so distressed they seek medical help.
The only specialist service for under-18s is the Sandyford clinic in Glasgow.
People can self-refer or can be referred through their GP.
Figures released to BBC Scotland news under a Freedom of Information request showed that at the end of 2023, 1,100 patients were on the waiting list.
The longest wait is 1,692 days, about four-and-a-half-years.
In her report, Dr Cass says the increase in the numbers of young people who have a trans or gender diverse identity, is the result of a "complex interplay between biological, psychological and social factors".
She warns that the "toxicity of the debate" around gender has had a negative impact on the quality of care they receive.
She says many doctors are afraid of working with them, because of the controversy around medical treatments, and that this means they are not getting the individualised care the NHS should provide, including mental health assessments and screening for autism and other neurodevelopmental conditions.