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Dr Hilary Cass, author of a recent government review focusing on the care of children and young people exploring their gender identity, has highlighted how children have been exploited by opposing sides in the contentious transgender rights discussion. Speaking on Sunday with Laura Kuenssberg, she expressed concern that individuals with extreme views on both ends of the debate have caused significant distress among young people. Cass pointed out that unrealistic portrayals and expectations on social media platforms have misled many children, often pushing them toward medical interventions without sufficient reflection.
Her 2024 review critically examined the foundation of gender medicine, describing it as built on “shaky foundations” regarding evidence supporting medical treatments for young people. Cass emphasized the lack of a realistic understanding of what transitioning entails, including the demanding nature of medical procedures and the possibility of undergoing “sometimes quite brutal surgeries.” She acknowledged that while a small number of individuals will never feel comfortable with the gender aligned to their biological sex—and for these individuals, medical intervention remains essential—many young people may find their feelings evolve over time if given space and care.
Cass underscored that children have frequently been caught in the crossfire of adult debates, particularly over issues like single-sex spaces, sports participation, and safe areas for women, which are not directly related to children but have nonetheless affected them. She lamented that children have been “weaponised” in these wider social conflicts. According to her, the louder voices at the extremes dominate the conversation, silencing the majority who hold more moderate views. Both vocal activists and opponents of transition contribute to difficulties that affect transgender people simply trying to live quietly.
The review emerged amid rising concerns about increasing referrals to gender services, especially at the Tavistock Clinic in London. Cass advocated for cautious approaches to very young children beginning social or medical transitions, warning that starting too early can lock them into a trajectory that might not reflect their natural identity development. Notably, she mentioned that while some children proceed down a medical pathway, others spend several years exploring their gender identity before deciding not to transition. Cass described changes in societal attitudes, saying fewer people are bound by traditional gender stereotypes, but also criticized narratives promising that children must conform to stereotypically “typical” presentations of gender, particularly as seen on social media.
On the topic of puberty blockers, drugs used to pause physical development in children questioning their gender, Cass stressed the importance of conducting controlled clinical trials to ensure safety and proper medical governance. These drugs had been banned for those under 18 following concerns raised by her review, although a trial to investigate their risks and benefits was initiated last year. She warned of the dangers posed by unregulated access to these medications, including online sales. Cass reassured that the new gender clinics would provide individualized treatment plans and emphasized that current delays in care mostly stem from backlogs rather than barriers in access
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