This week, paediatrician Dr Hilary Cass released an almost 400-page report that she'd been working on since 2020 into transgender healthcare in the NHS. The report has been widely reported on over the last couple of days, and has been quite controversial because it suggests that there isn't sufficient evidence that the benefits of treatments such as puberty blockers outweigh the drawbacks.
I originally wasn't going to write about this, because I feel that I don't have sufficient evidence myself to fully be able to analyse it. I've heard some complaints from some fellow Trans Rights Activists that the report isn't especially comprehensive and gives away the author's own bias quite a bit... but I'm hardly an expert in transgender healthcare and what do I know? However, from venturing onto my Twitter account and seeing the hashtag 'TERFsWereRight' trending, I knew that I had to say something. Because this report does not say that. It's completely untrue, and if that's how it's being taken then that's a very dangerous narrative that needs to be called out straight away.
Let me be very clear about something. Even if the Cass Report contained irrefutable proof that every single person throughout history who has ever questioned their gender was doing it because of pressure from external sources (which it doesn't) that still would not mean that TERFs were right. The reason it would not mean that is that if the evidence were to show that, that would ultimately still mean that transgender people were some of the most vulnerable people in the world, some of the most at risk of being abused both physically and psychologically. As it happens, transgender people are some of the most vulnerable people and most at risk of these things, just for different reasons. But the morality of that would remain the same.
If all TERFs were doing was questioning the safety of people who say they want to transition, even if I disagreed with exactly which aspect of their safety they were concerned about, I would at least be able to recognise that the concern itself comes from a kind place. But this is not what TERFs do. TERFs pretend that the inclusion of trans people (particularly trans women) is a threat to the safety of cis people. TERFs ignore the fact that trans people are over four times more likely than cis people to be victims of violent crime, to imply that it's actually trans people who are likely to be committing the violent crimes (very often, they don't explicitly say this, but it tends to be implied). TERFs talk about things that have existed for years as though they're very modern - for example, trans women have competed against cis women in sporting events for two decades, there hasn't been an influx of trans champions (which would have happened if they had advantages significant enough to be noteworthy) and nothing has happened recently to suddenly make it a relevant topic right now.
TERFs are not the slightest bit concerned about anyone's safety, as very often they have been prepared to sacrifice the safety of cis people as well in order to justify their suspicion of trans people. As an example of this, the debate about transgender women accessing women's toilets regularly comes up - but how is anyone meant to know whether someone in a women's toilet is a trans woman or not? Are we proposing security guards at the door, with no entry to anyone who doesn't produce a birth certificate saying that they were assigned female at birth? There have been instances of cis women who appear slightly manly being harassed in women's toilets out of suspicion of being trans women - this is essentially a witch hunt. Never mind the fact that if trans women were forced to use men's toilets, this would also mean that trans men would have to use women's toilets, however far through the transition process they were (and also cis men would be able to claim to be trans men to use them as well, so it results in the same thing). TERFs know this, and know that the obvious solution is to make all public toilets gender neutral (if they're single-occupancy, there's no possibility of anyone of any gender being abused, which would protect cis people just as much as it would trans people). But, they aren't interested in actual solutions. They're only interested in creating a moral panic around transgender people, most particularly trans women.
There are 67 million people in the UK. Less than 300,000 of them are transgender. Between 2014 and 2019, news stories about transgender people increased by 414%. I don't know why this was, apart from the fact that it was their turn to be the subject of the moral panic which was gifted to gay men in the 1980s and 1990s, benefit claimants in the 2000s and immigrants (particularly Muslims) in the early 2010s. There's always a scapegoat for social injustice, it's usually some kind of minority person and at the moment it's transgender people. As to why it's transgender people right now, I have a couple of theories - but they're just guesses, so there's no guarantee I'm right. The first is that same-sex marriage was legalised in the UK in 2013, with the first same-sex marriage ceremonies taking place in 2014. This to many felt like a major victory for the gay rights movement - it felt like a concession from the far-right, and meant that there wasn't a political mood to scapegoat gay people anymore, so a different but related group was targeted instead. My other theory is that developments in technology caused people who had transitioned to find it easier to live in their gender identity, without it being visibly obvious that they were trans, than they had done before. I think sometimes, people were okay with trans people existing as long as they were obvious on the street and therefore could be seen as freaks and subject to harassment. The idea that you could talk to, get to know and become friends with someone who'd transitioned before you knew them, without knowing that fact about them, came disturbingly close to having to treat trans people with basic dignity and respect, which is absolutely terrifying to certain sections of society.
Whether I'm right in any of my theories, I don't know and I'll probably never know. But for whatever reason, transgender people are facing far more discrimination nowadays than they did in the past. This article from PinkNews talks about the transgender character who was in the soap Coronation Street in the 1990s, and how much more she was accepted by society than trans characters who have appeared in things more recently. It is TERFs who are perpetuating this. It is these people who are deliberately creating a false narrative about trans people which causes them to be viewed with increased suspicion, and in some cases, like that of poor 16-year-old Brianna Ghey, has led to their murders. The verdict reached in that case was that transphobia was a factor in Brianna's murder - it probably wasn't the only factor, but it was a factor, and anyone who has participated in the moral panic around transgender people helped to create the sociopolitical circumstances which led to this horrific attack, and countless others.
Are there problems in the NHS' treatment of gender dysphoria in children and adolescents? Most likely - there are problems in all areas of the NHS, and I see no reason why this would be the special exception. Can the recommendations of the Cass Report help to solve them? I don't know. I think probably not, because from what I've seen it's a highly biased report that is more likely to leave people who are worried about gender-related issues out in the cold, but that's a matter for people who are far more informed about the quality of these services than I am. But if you think for a moment that it vindicates TERFs, ask yourself: is there any other instance where you would think that someone deserves to be bullied, harassed, ignored, mocked by everyone from comedians to politicians in the House of Commons, sexually assaulted and possibly murdered, because a mistake might have been made with the prescription of their medication? No. It's a preposterous question. But this is what we're being asked to accept when we're told that the Cass Report proves TERFs right.
I will just finish by saying that there is one thing that Dr Hilary Cass has said in interviews about her report that I do agree with her on, although I suspect not for the same reasons she says it. She says that children are being let down by the toxic debate on this issue. I agree - they are. If a child or an adolescent is worried about their gender identity and how to express it, they need to be given some quiet time with their family and friends to work this stuff out. Statistically, most of the time they'll come to the conclusion that they're cisgender anyway. And in the cases where they don't, they can be treated in a way that is dignified, respectful and gets them the help they need. What they do not need is to be the topic of the day for politicians who want votes, news websites that want clicks and faded writers of children's books who want attention. The angry, suspicious, hateful rhetoric that currently surrounds trans issues did not come from children. It came from adults, who have seen what has happened to Muslims, to the disabled, to gay people, to benefit claimants, when they were targeted in this way, and should have known better. And if you're an adult who knows a child or adolescent who is worried about these issues, you should show some basic human compassion and be an example to them.
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