The Cass Review found no increase in suicides after blocking prescriptions
Lucy Johnston said:
“the Cass Review and subsequent reviews have shown that removing the puberty blocker prescriptions have not led to an increase in suicides. It is muddy. It's not clear cut.”
Citing a major NHS-commissioned review by name sounds authoritative, and the claim that a policy change did not cause measurable harm appears to be a straightforward empirical finding.
The Cass Review was a systematic review of the existing literature, not a study of what happened to trans young people after the NHS England suspension: it could not have found that removing prescriptions did not increase suicides, because it never looked at that question. The suspension itself is recent, the follow-up period is short, suicide data takes years to collect and interpret properly, and the monitoring infrastructure to track outcomes in this population was not in place before the policy changed. "The evidence is limited" is a fair summary of the state of knowledge; "the evidence shows no harm" is a different claim entirely, and one the review does not make. Families and clinicians told that the safety of withholding treatment has been established are being given a reassurance the data cannot support, and that gap between what was found and what is claimed is exactly where harm hides.
What I said at the time:
“There is not good evidence. I'm sure you will agree. Not good evidence. Can give you the evidence. Lucy, I really don't want to have it because there's extremely good. It's reported in you, for example, reported on the court's website.”
Families of trans young people and clinicians who may be falsely reassured that withholding treatment carries no mortality risk, when the evidence to support that reassurance does not exist.