Cass review: Health secretary criticises gender care 'culture of secrecy'

Health Secretary Victoria Atkins says she has had "enough" of a "culture of secrecy and ideology" around gender care for children.

Writing in the Daily Telegraph, she criticised NHS England practitioners, in response to a landmark review into gender care practices.

The Cass review said children had been "let down" by a lack of research on the use of puberty blockers.

It called for gender services to match the standards of other NHS care.

The paediatrician behind Wednesday's report, Dr Hilary Cass, said clinicians were also affected by the "toxicity" of public debate around transgender identities.

"There are few other areas of healthcare where professionals are so afraid to openly discuss their views, where people are vilified on social media, and where name-calling echoes the worst bullying behaviour. This must stop," she wrote.

In response to the review, NHS England said it had already made significant progress in making changes.

It also announced a separate review of adult gender services, and it had instructed adult gender clinics to temporarily pause offering new appointments to under-18s.

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Ms Atkins wrote in the Telegraph that she welcomed the pause and said an urgent update on the practice of hormone prescription must now follow.

"I am hugely grateful to Dr Cass's dedicated team for their detailed and considered work on such a contentious area of healthcare.

"I commend those brave voices who spoke up to raise the alarm about how treatment was diverging so far from guidance.

"A culture of secrecy and ideology over evidence and safety. Today I'm saying 'enough'.

"We simply do not know the lifelong impact of these medical interventions on young minds and bodies to be clear that they are safe," she wrote.

Hormone interventions, or puberty blockers, pause the physical changes of puberty and are prescribed to children questioning their gender as a way of stopping physical changes such as breast development or facial hair.

In her report, Dr Cass said she was "disappointed by the lack of evidence on the long-term impact of taking hormones from an early age."

Writing in the Telegraph, the health secretary also called for adult gender clinics to share data on the patients they have who were given gender treatment as children.

The publication of Dr Cass's report revealed that six of seven adult clinics had refused to take part in the study - meaning that the outcomes for approximately 9,000 people who were moved from child services into adult care were not included in the report.

Dr Cass said this was "hugely disappointing" as these people's experiences would be valuable in studying the long-term impacts of hormone treatments.

The reasons adult clinics gave for not taking part included ethical considerations and concerns about funder motivation and political interference.

Many children were treated at the Tavistock clinic, which was NHS England's only specialist gender clinic for children and young people. It closed last week, four years after it was rated as "inadequate" by inspectors, and is being replaced with new regional centres.

Ms Atkins labelled the lack of participation "disgraceful", adding: "There can be no further delay on their full participation."

The Cass Review had called on the clinics to share their data so that the onward healthcare journeys of those patients could be tracked.

New clinics are to replace the gender identity service based at London's Tavistock and Portman NHS Foundation Trust

Also speaking to the Telegraph, former health secretary Sajid Javid called for "a no holds barred government investigation" into obstruction of the research.

Mr Javid introduced legislation in 2022 which allowed the Cass review access to some medical records.

"Despite it being the unanimous will of Parliament, it is clear vested interests have deliberately frustrated the important data access legislation I brought forward to support Dr Cass's review," he said.

"A no holds barred government investigation should be launched into this obfuscation, documents retrieved and, if necessary, individuals held accountable for failing to provide records."

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Labour's shadow health minister Wes Streeting also expressed anger that some clinics had refused to take part in research.

Speaking more widely to the Sun's Never Mind the Ballots show, Mr Streeting was asked whether he believed trans women were women, and he said he was newly recognising "complexities" in transgender identities.

"If you'd asked me a few years ago... I would have said trans men are men, trans women are women. Some people are trans, get over it, let's move on, this is all blown out of proportion," he told the paper's politics show.

"And now I sort of sit and reflect and think actually, there are lots of complexities," he concluded, adding that he recognises that "ugly rhetoric" is directed towards trans people.

Prime Minister Rishi Sunak has also responded to the review, saying the findings "shine a spotlight" on the need to "exercise extreme caution" when it comes to gender care for children.