RUTHFULLY YOURS

Just like that, a trickle becomes a flood. After years of gender-critical voices being dismissed or ignored by mainstream media, they can be dismissed and ignored no longer.

The landmark Cass Review into gender-identity services in England, published today, has laid bare the scandal of the NHS’s treatment of ‘gender confused’ kids. There was never any evidence for subjecting troubled, often gay, often autistic, youngsters to life-altering hormones, drugs and treatments. But clinicians did it anyway, in thrall as they were to gender ideology.

The review is on the front page of the newspapers today. The BBC is platforming trans-sceptical experts – and not just so they can be hissed at live on air. Keir Starmer’s ever-opportunistic Labour Party is saying it agrees with everything in the report.

Of course it’s far too early to be declaring victory, and far too late for many of the victims caught up in this to celebrate, but something monumental happened today. The unsayable has become sayable, on gender at least.

The review, produced by top paediatrician Dr Hilary Cass over four years, is a stunning piece of work: a 400-page triumph of reason over unreason. It doesn’t tell us much we didn’t already know, but it tells us in painstaking detail and with undeniable, data-driven authority.

There is ‘no good evidence’, Cass writes, ‘on the long-term outcomes of interventions to manage gender-related distress’. Puberty blockers – now all but banned by the NHS – were brought in ‘based on a single Dutch study’. While these drugs are certainly effective at halting the natural march of puberty, and almost certainly have other punishing, physical side effects, ‘no changes in gender dysphoria or body satisfaction were demonstrated’.

Despite this, the ‘vast majority’ of children put on puberty blockers move on to cross-sex hormones. While they are sold to troubled families as a brake on puberty, blockers in fact appear to be an accelerator towards transition – and to sterility. ‘There is no evidence that puberty blockers buy time to think’, writes Cass. ‘There is also a lack of evidence’, she adds, that ‘hormones improve a young person’s body satisfaction and psychosocial health’. But ‘there is concern over the impact on fertility, growth and bone health’. While cross-sex hormones currently remain available to over-16s, Cass urges ‘extreme caution’.

Even social transition – ie, a child changing names and pronouns and ‘presenting’ as the opposite sex – is not without its risks. There is also ‘no clear evidence that social transition in childhood has any positive or negative mental-health outcomes… However, those who had socially transitioned at an earlier age and / or prior to being seen in [a] clinic were more likely to proceed to a medical pathway’.

The tone of the review is detached and neutral – and yet also apologetic. There are some genuflections to trans ideology, to notions of ‘lived experience’, to the gender jargon of ‘birth-registered males’ and ‘birth-registered females’ rather than boys and girls. There’s also a fair bit of irritating bothsidesism. Still, Cass goes about slaying one sacred cow after another.

The claim that ‘trans kids’ must be ‘affirmed’ and put on hormones, lest they commit suicide? This horrendous bit of moral blackmail has been uttered time and again to wary parents in gender clinics across the West. But as many already knew, there’s zilch to back this up: ‘The evidence found did not support this conclusion.’

The stats about the explosion of kids accessing NHS ‘gender care’ aren’t new, either. But they are still staggering. In 2009, the Gender Identity Development Service saw fewer than 50 kids, predominantly boys. By 2016, it was closer to 2,000. Most of them were girls.

The scale of the increase and the radical switch in proportion between boys and girls makes it unlikely, Cass observes, that this is all down to children feeling more accepted and free to ‘come out’. She doesn’t use the word ‘social contagion’, but she does gesture to it, noting that online ‘influencers have had a substantial impact’ on some young people’s desire to transition.

So, after years of gaslighting and cancellations, what has been going on in those NHS gender clinics is now staring the great and good in the face. The question now is, how was this ever allowed to happen?

The review points to some of the more immediate reasons. Namely, the shoddiness of the evidence base for various treatments combined with the conspiracy of silence around this. Shockingly, Dr Cass says her research was actually ‘thwarted by a lack of cooperation from the adult gender services’. ‘I do think it was coordinated’, she tells the Guardian. ‘It seemed to me to be ideologically driven.’

But there is a deeper question here too – not just for the health service but for the media, academia and polite society. These cruel goings-on in the NHS have been an open secret for literally decades. And yet only today, with Cass’s report, is it being properly digested. Mental-health nurse Susan Evans, then working in the now-shuttered Tavistock clinic, first blew the whistle in 2004, after learning that a 16-year-old had been referred for hormone treatment after just four appointments.

2004! Back then, Julie Bindel was still writing for the Guardian, Graham Linehan could still walk unarmed through Muswell Hill and JK Rowling was still a beloved luvvie children’s author, whose ‘controversy’ section of her Wikipedia page related mainly to the Harry Potter book-burnings staged by the religious right. And yet it has taken 20 years – and the demonisation of these three gender-critical warriors and countless more – for the truth to become socially acceptable.

This all shows that woke ideology is the water our elites swim in. It shows that, for our supposed betters, virtue-signalling and being on ‘the right side of history’ has replaced genuine virtue and rational thought. Indeed, they preferred to strike poses against some dreamt-up ‘transphobic’ backlash than think for 30 seconds about what it is they were supporting – which turned out to be the reckless sterilisation of kids who, left to their own devices, would have grown up to be gay. They were the real reactionaries all along.

The Cass Review may not have defeated gender extremism, but it has thrown down a gauntlet. Confronted with the horrendous error of their ways, can our elites now right themselves, or will they remain under the spell of this homophobic, misogynistic and cruel ideology? Are our supposedly liberal, secular, rational institutions too beholden to this ersatz religion to succumb to devastating old facts? We’re about to find out.

Tom Slater is editor of spiked. Follow him on Twitter: @Tom_Slater_