The Cass Review is the biggest and best systematic evidence review
Helen Joyce said:
“Cass did the biggest and best system system systematic evidence review. Rita Kertu Kaltiala in Finland has done entire population studies. They really don't show anything remotely like gender affirming care being sensible.”
The Cass Review is a real, NHS-commissioned report and invoking it alongside population-level research from Finland sounds like a solid evidence base. Viewers who have heard of the Cass Review will treat this as authoritative.
The Cass Review did not conclude that gender-affirming care is not sensible. It concluded that the studies it reviewed did not meet its own methodological inclusion criteria, which is a different thing entirely: a gap in the research base is not the same as evidence of harm. The Endocrine Society, the American Academy of Pediatrics, and other major clinical bodies have reviewed the same literature and judged that care should continue, carefully and promptly. Kaltiala's Finnish work is real, but the claim that it shows gender-affirming care to be unsound is not what the papers actually demonstrate, and characterising a call for better research as a verdict against treatment is the move that does the damage. What that reading has produced in practice is blanket service closures for young people who cannot wait, paid for in months of unwanted puberty that no review, however large, can give back.
What I said at the time:
“I think the mistakes happened many years before the Cass Review with the Tavistock Clinic.”
Trans young people and their clinicians, who face blanket service closures justified by an overstated reading of a review that actually called for better research and improved services.