The BMA is to undertake an evaluation of the Cass Review – the independent report on gender identity services for children and young people in the UK, published earlier this year.  
 
Members of the BMA’s Council recently voted in favour of a motion which asked the Association to ‘publicly critique the Cass Review’, after doctors and academics in several countries, including the UK, voiced concern about weaknesses in the methodologies used in the Review and problems arising from the implementation of some of the recommendations¹.
 
 A ‘task and finish’ group, established by the BMA’s Chair of Council Professor Philip Banfield, who will also appoint the group’s chairperson, will pay particular attention to the methodology used to underpin the report’s recommendations. There have been ongoing discussions within the BMA about the Cass Review since it was published; before that the BMA attended meetings with Dr Cass when the review was being written. These, together with the Council’s wishes, have helped to shape what will be a detailed, evidence-led piece of work.  
 
The BMA is calling for a pause to the implementation of the Cass Review’s recommendations whilst the task and finish group carries out its work. It is expected to be completed towards the end of this year. In the meantime, the BMA believes transgender and gender-diverse patients should continue to receive specialist healthcare, regardless of their age.  
 
The BMA has been critical of proposals to ban the prescribing of puberty blockers to children and young people with gender dysphoria, calling instead for more research to help form a solid evidence base for children’s care – not just in gender dysphoria but more widely in paediatric treatments. The Association believes clinicians, patients and families should make decisions about treatment on the best available evidence, not politicians.
 
Professor Banfield said: 
“It is vitally important we take time and care to get this work right. This is a highly specialised area of healthcare for children and young adults with complex needs, and as doctors we want to be sure they get the most appropriate care and the support they need. The task and finish group will make recommendations to improve the healthcare system that has, for too long, failed transgender patients. It will work with patients to ensure the evaluation invokes the old adage in medicine of ‘no decision about me without me’. It is time that we truly listen to this group of important, valued, and unfortunately often victimised people and, together, build a system in which they are finally provided with the care they deserve.”   
 
Ends 

Notes to editors

The BMA is a professional association and trade union representing and negotiating on behalf of all doctors in the UK. A leading voice advocating for outstanding health care and a healthy population. An association providing members with excellent individual services and support throughout their lives.

1. See: https://law.yale.edu/sites/default/files/documents/integrity-project_cass-response.pdf
   https://osf.io/preprints/osf/uhndk
   
   
2. Terms of Reference
   The Terms of Reference for the Task & Finish Group will require it to produce a critique of the Cass Review to be shared with UK Council at its January 2025 meeting, with particular attention given to the methodology used to underpin the report recommendations. The Group will be tasked with establishing principles for long-term BMA policy work on transgender healthcare and providing advice and guidance on BMA engagement on this policy area, including in response to government implementation of the Cass Review recommendations. The Group will also be asked to make recommendations to UK Council on the need for additional or revised BMA policy, if necessary.  Membership of the Group will include representation from the BMA’s Board of Science, Medical Ethics Committee, Equality and Inclusion Advisory Group, and its Patient Liaison Group. The Group will ensure contributions and/or representation from those with relevant personal lived experience, those with recognised and relevant clinical expertise, and those with recognised and relevant academic or specialist expertise.
   
   
3. The Motion reads
   ‘This meeting recognises that the provision of gender identity services in the United Kingdom is inadequate, and that transgender people should be treated with compassion and respect for their bodily autonomy. Following the publication of the Cass Review on Gender Identity Services for children and young people, this meeting is concerned about its impact on transgender healthcare provision because of its unsubstantiated recommendations driven by unexplained study protocol deviations, ambiguous eligibility criteria, and exclusion of trans-affirming evidence. Therefore, this meeting calls on the BMA to:
   i. Publicly critique the Cass Review; 
   ii. Lobby and work with other relevant organisations and stakeholders to oppose the implementation of the recommendations made by the Cass Review; 
   iii. Lobby the Government and NHS in all four nations to ensure continuity in provision of transgender healthcare for patients younger than 18 years old; 
   iv. Lobby the Government and NHS in all four nations to ensure continuity in provision of transgender healthcare for patients aged 18 or older; 
   v. Publicly state support for transgender people, particularly transgender youth, and provision of prompt access to gender identity services and treatment at all ages; 
   vi. Condemn the increasing political transphobia which is ostracising transgender people and discriminating against them by blocking their access to healthcare’.