10 April, 2024 – England’s Cass review ignores the consensus of major medical bodies around the world and lacks relevance within an Australian context, say medical practitioners, trans advocates, parents and human rights groups.
The Cass review downplays the risk of denying treatment to young people with gender dysphoria and limits their options by placing restrictions on their access to care.
“The Cass review recommendations are at odds with the current evidence base, expert consensus and the majority of clinical guidelines around the world,” said Dr Portia Predny, Vice President of The Australian Professional Association for Trans Health (AusPATH).
“In Australia, our guidelines for gender affirming care for young people already prioritise holistic, individualised and person-centred care with the involvement of multidisciplinary teams of clinicians with all kinds of areas of expertise, to help and support young people to navigate their gender journey.”
Dr Predny said applying the findings and recommendations of the Cass Review to the care of young people in Australia “was fundamentally flawed” because it looked specifically at the NHS system.
“The way that gender affirming care is accessed and provided in Australia is substantially different to the way that that care is or has been provided in the NHS,” she said.
Dr Predny also said there were many areas of medicine where it was not feasible or ethical to conduct Randomised Control Trials to collect the “highest quality” of evidence.
“One such area is gender affirming care but there are many others, including perinatal care, and a lot of paediatric care generally,” she said.
“Additionally, when you have multiple observational studies looking at a particular intervention and those studies are producing similar findings, the cumulative evidence becomes compelling.”
Jennifer Shields, President of PATHA, The Professional Association for Transgender Health Aotearoa said:
“PATHA welcomes further research into the things that we know support the wellbeing and lives of trans people of all genders and trans communities locally and globally. The evidence base in support of gender affirming care is clear, and we're disappointed to see this review discard so much hard work from researchers around the world.”
Teddy Cook, Director of Community Health at ACON, said Australia has a world-leading model of care for young trans people and their families.
“Trans people everywhere should have access to the highest attainable level of health through a robust, evidence based, multi-disciplinary and affirming approach, an approach that demonstrably saves trans lives,” he said.
“In ignoring key evidence and research, the Cass Review does not meet that standard and has today let down the very people, families, health providers and communities it seeks to support.”
Equality Australia Legal Director Ghassan Kassisieh said Australia already requires trans young people to go to court to access treatment where their parents or medical team can’t agree on the best pathway forward.
“With a case-by-case assessment required by our courts, it is already too difficult for trans young people to access the care and support they need – we don’t need to place more barriers to accessing healthcare,” he said.
In February, Australia’s peak medical body, the Australian Medical Association (AMA) called for improved access to gender-affirming care and protections for the doctors providing it.
It stated that gender-affirming care was linked with a range of positive health outcomes for people and that studies indicate regret from undergoing gender-affirming surgery was rare.
The AMA also condemned the “systemic discrimination, abuse, and prejudice against young trans and gender diverse people seeking gender-affirming care”.
Carlie Morris, Parent Representative of Parents for Trans Youth Equity, PTYE said:
“We love our kids, we want them to be their best and we want them to have all the options available to them. Young people know who they are and can work with clinicians to seek out options for their care.
“Accessing gender affirming care is nuanced and closely monitored, particularly where young people are involved. There are political actors who seek to limit access to the healthcare needs of our kids, and we are sick of having to defend the basic healthcare of our kids when similar scrutiny is not applied to other types of healthcare.”
Jeremy Wiggins, CEO of Transcend said:
“Families with trans children deserve timely access to gender affirming healthcare. It’s a major protective factor and safeguard against poor mental health and suicidality.
“Families deserve to be provided with all the available evidence about medical treatment, which the Cass Review has failed to do by excluding a significant amount of global research.”
Jackie Turner, Director of the Trans Justice Project said:
“The Cass Review can’t be allowed to shape trans healthcare in Australia. Trans people, their clinicians, and families should always be involved in decisions and research about trans healthcare. The Cass review has delivered a set of recommendations that will put the lives and wellbeing of trans youth at risk.”
Son Vivienne, CEO of Transgender Victoria said:
"We cannot allow misinformation and biases in public debate to dictate the healthcare options available to the transgender community, especially vulnerable youth. If you’ve got time to talk about trans people, you’ve got time to listen to trans people too."
Eloise Brook from the Gender Centre said:
“The Cass Review commits people to potentially intrusive research in order to access healthcare that is available elsewhere and flies in the face of decades of research and clinical practice.”
Joe Ball CEO Switchboard Victoria Said:
“All children deserve child centred healthcare. We have already seen the distressing impact of the Cass Review in England and cannot allow disinformation to proliferate and be used in Australia to prevent transgender children and young people from accessing health care.”
Jain Moralee CEO of twenty10 said:
It is widely proven and understood that access to timely, gender affirming healthcare can not only save the lives of young trans people but allow them to thrive – which every young person here in Australia and around the world deserves. The Cass Review makes harmful recommendations that are in opposition to evidence and the lived experiences of young trans people, and their families, to whom we will continue to provide gender affirming support and services to ensure positive mental health and wellbeing outcomes.
This press release is also endorsed by A Gender Agenda, TransFolk of WA, Thorne Harbour Health, Living Proud and LGBTIQ+ Health Australia.
Contact: Emily Mulligan emily.mulligan@equalityaustralia.org.au, 0411 207 633
Mike Hitch, mike.hitch@equalityaustralia.org.au, 0426 812 115
