British Medical Association calls for pause on implementation of Cass Review

The British Medical Association (BMA) has announced it is to undertake an "evaluation" of the Cass Review into gender identity services for children and young people.

Restrictions on puberty blockers and cross-sex hormones for under-18s have been brought in since the publication of the review earlier this year.

Written by paediatric specialist Dr Hilary Cass, it found there was a "weak" evidence base for this area of medicine and recommended "extreme caution" in the use of hormones for minors.

Cass raised serious concerns over the impact of hormone therapies on bone density and called for a greater focus on mental health for young patients.

But critics questioned the validity of her findings and the BMA, a trade union and professional body for doctors, has now said it will investigate the paper.

Professor Philip Banfield, BMA's chair of council, 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."

Members of the BMA's council recently voted in favour of a motion which asked it to "publicly critique the Cass Review".

A "task and finish" group has now been established and will focus on the methodology used by Cass in her four-year review process, which was commissioned by the last UK Government.

The UK and Scottish Governments have since announced the suspension of the prescription of puberty blockers for under-18s reporting gender identity issues, pending further clinical evidence.

The decisions, made separately, drew criticism from trans rights campaigners and the initial backlash to the Cass Review from members of the Scottish Greens was instrumental in the ending of the Bute House Agreement which had taken that party into government for the first time.

The BMA is now calling for a pause on the implementations of the Cass Review as the task and finish group works.

Its findings are expected "towards the end" of the year.

The motion on the matter further called on the association to "condemn the increasing political transphobia which is ostracising transgender people and discriminating against them by blocking their access to healthcare".

Banfield said: "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."