Bishop’s Stortford's MP Julie Marson has told the House of Commons that her constituents are afraid of speaking out in the "toxic debate" about gender-questioning children.
Parliament was considering the Cass Review commissioned by NHS England to make recommendations on improving support for children and young people who identify as a member of the opposite sex.
The investigation by consultant paediatrician Dr Hilary Cass was prompted by a rapid increase in the number of youngsters being referred for NHS support over the past five to 10 years.
The Secretary of State for Health and Social Care Victoria Atkins introduced the report on Monday, saying: “This review strikes hard and sure at an area of public policy where fashionable cultural values have overtaken evidence, safety and biological reality. This must now stop.”
She said that in 2009, there were 60 child referrals to the NHS’ only gender identity development service and just 15 of the youngsters were adolescent girls.
By 2016, over 1,700 children and young people a year were referred—a 34-fold increase and more than half were teenage girls.
In 2022, more than 5,000 children and young people were referred to gender identity clinics, and almost three-quarters were female.
The Secretary of State said Dr Cass had concluded that a cultural shift alone “does not adequately explain” the surge in young women being referred to gender services.
Ms Atkins said: “She paints an alarming picture of digitally engaged young women who are frequently exposed to pornography involving violent, coercive, degrading and pain-inducing acts.
“Is it any wonder that more and more of them are looking for ways to opt out of becoming women? That is deeply troubling and, as Dr Cass makes clear, we have a duty to support those young women with considered, evidence-based care.”
Mrs Marson, Conservative MP for Hertford and Stortford since 2109, told her: “My experience of speaking to my constituents on this subject has been characterised by fear—it is often the fear of mothers about their daughters, the fear of what is happening to their children and the fear of speaking out because of the group-think and the toxicity of the debate.
“Does my right honourable friend agree that Dr Cass’s extensive, evidence-based report should mark an absolute turning point, in ensuring that we spearhead our approach to this debate by putting children first and being non-ideological in all areas—across Government, in all departments, not just the NHS, in education and in our public bodies?”
Ms Atkins responded: “We must treat not just the child or young person, but the family with care and respect, trying to support them to get to the right place for the child.”
As well as identifying the changing pattern of referrals for help from mostly pre-pubescent boys to adolescent girls, Dr Cass was also concerned that the young people experiencing gender distress may also have other risk factors including autism spectrum disorder and mental health issues or have experienced trauma or abuse.
She found there was a dearth of reliable and robust evidence for the NHS’ current approach and she recommended a different pathway, “more closely aligned with usual NHS clinical practice that considers the young person holistically and not solely in terms of their gender-related distress”.
She said: “The central aim of assessment should be to help young people to thrive and achieve their life goals.”
In July 2022, Dr Cass’s interim findings prompted the NHS to announce the closure of the UK's only dedicated gender identity clinic for children and young people, run by the Tavistock and Portman NHS Foundation Trust.
From 2015 to 2022, the trust was chaired by Paul Burstow, who is now chair of Herts and West Essex Integrated Care Board.
In March, the NHS confirmed children questioning their gender identity would no longer routinely be prescribed puberty blockers to prevent sexual maturity.
Dr Cass’s full report reinforces that decision. She said: “The rationale for early puberty suppression remains unclear, with weak evidence regarding the impact on gender dysphoria, mental or psychosocial health. The effect on cognitive and psychosexual development remains unknown.”
She added: “The use of masculinising/feminising hormones in those under the age of 18 also presents many unknowns, despite their longstanding use in the adult transgender population.
“The lack of long-term follow-up data on those commencing treatment at an earlier age means we have inadequate information about the range of outcomes for this group.
“Clinicians are unable to determine with any certainty which children and young people will go on to have an enduring trans identity.
“For most young people, a medical pathway will not be the best way to manage their gender-related distress. For those young people for whom a medical pathway is clinically indicated, it is not enough to provide this without also addressing wider mental health and/or psychosocially challenging problems.”
She concludes: “Innovation is important if medicine is to move forward, but there must be a proportionate level of monitoring, oversight and regulation that does not stifle progress, while preventing creep of unproven approaches into clinical practice. Innovation must draw from and contribute to the evidence base.”