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DIAG RESPONSE TO THE
CASS FINAL REPORT

For Immediate Press Release
April 18, 2024

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Based on the long-awaited release of the evidence review initiated four years ago by NHS England and lead by respected — and independent — pediatrician, Dr. Hilary Cass, the UK has taken significant steps to protect children from the dangerous, experimental medical pathway known as “Gender-Affirming Care.” Children in England and Wales will no longer be prescribed puberty blockers for gender-related distress. Other changes include a holistic approach to treatment centered on mental health support with more anticipated following additional reviews of forthcoming data for the 9,000 young adults 18-25 who sought care.

 
The report characterizes pediatric gender-transition treatment as based on “remarkably weak evidence,” and underscores that clinicians in this field have operated outside standard medical best practices, following an ideological instead of clinical approach.


Cass also unequivocally states that social transition should be treated with the same caution as prescribing pharmaceuticals, signaling the death knell for the common practice of schools facilitating this psychosocial intervention.


The report reiterates what we already knew from recent studies: that there is no evidence that gender-affirmative treatments reduce suicide, meaning that the drumbeat of “affirmative care” as “lifesaving medical care” is not supported by the evidence.


In the assessment of clinical guidelines — recommendations on how healthcare and other professionals should care for people with specific conditions, Cass underscores that there are currently no reliable guidelines (Sweden’s and Finland’s coming close but both still found lacking). The two most influential guidelines, from WPATH and the Endocrine Society, engage in “citation laundering,” in which they reference the other’s unfounded guidelines circularly as evidence. The AAP also failed reliability tests by explicitly acknowledging the poor evidence base yet still recommending irreversible interventions. The actions of WPATH, the ES and the AAP are both morally and medically reprehensible.


As for the clinic data on those 9,000 young adult patients, 6 of 7 clinics holding this data (assuming it was even collected) refused to provide it, citing concerns that “the study outcomes focus on adverse health effects, for which the clinics do not feel primarily responsible.” It should be of grave concern that secrecy and ideology were allowed to take precedence over evidence and safety.


DIAG’S POSITION
The failings of the major medical organizations, our trusted media, our schools and universities, and our elected and appointed officials have resulted in a tragically misinformed populace unable to make informed decisions about medical care; countless people harmed, their future options and freedoms stolen, including the potential for biological parenthood, the ability to breastfeed, and full sexual function; and a dangerously ill-informed and misguided clinical cohort in whom families across the country placed their trust.


We call on the following organizations to follow the lead of the NHS, and take meaningful steps to safeguard children and vulnerable adults in the United States from harmful sex-trait modification.

  • The American Medical Association

  • The American Academy of Pediatrics

  • The American Psychological Association

  • The Endocrine Society

  • American Academy of Child and Adolescent Psychiatry

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Given, as Cass demonstrates, that the new spike in those seeking interventions for gender-related distress extends to those up to age 25, and that crucial neurodevelopment for most extends into the mid-twenties, for all people 25 and under, DIAG calls on these groups to:

  • Provide non-invasive, evidence-based care that respects human biological processes and does not result in sterilization, anorgasmia, or increased risks of severe health impacts, with exploratory therapy as the first, and primary, treatment for gender distress

  • Prioritize treatment of comorbidities

  • Develop and provide robust care for detransitioners

 

For those under 18:

  • End the pathologizing of puberty and support all children to go through puberty unimpeded

  • End use of puberty blockers for all pediatric purposes other than for treating precocious puberty

  • Adjust practices to reflect the seriousness and harm of social transition

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The Democratic party itself has broadly promoted unfounded, dangerous “affirmative care,” and systematically attempted to shut down civil discourse on this urgent issue. Therefore, we ask our Democratic leaders to take an active role in ending this medical scandal.
 

DIAG calls for the US government to adopt the recommendations of the Cass Review, and form a bipartisan commission to fully investigate the influences in our educational institutions and online driving the exponential increase in young people adopting a gender identity, and identify methods to mediate those influences.


To learn more about DIAG, please visit di-ag.org.

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