Trans and Gender Diverse Peer Support Project

Supporting growth and sustainability of trans and gender diverse peer support across Victoria. Supported by the Victorian Government.

Protecting Vital Gender-Affirming Care: Debunking the Flawed Cass Review

By Son Vivienne, CEO Transgender Victoria

Every person deserves to live authentically and access the healthcare they need to thrive. For transgender and gender-diverse individuals, gender-affirming care is essential to their well-being and identity. Yet, a recent UK review threatens to undermine this fundamental right based on misinformation and biases.

The Cass Review, led by Dr. Hilary Cass, is expected to ratchet up opposition to gender-affirming care for trans youth. While purporting to address concerns around access and long-term effects, this review excluded the voices of trans people, their families, and expert clinicians from the process.

Trans and gender diverse people have the right to be involved in the decisions that affect their lives and health care. In developing its advisory structures the Cass Review has intentionally excluded those with lived experience of being trans, people who are parents of a trans person, or those who have relevant medical expertise.

Excluding trans people, their families, and clinicians from a review of trans health is no different to having a male-only advisory team for a review of women’s health. It raises severe concerns about the potential biases, assumptions, and motivations of the team behind the review.

Gender-affirming care enjoys broad medical consensus and has been endorsed by leading health organisations worldwide, including the Australian Medical Association and the Royal Australasian College of Physicians. The largest study of transgender Americans found that, of those receiving hormone treatment, 98% reported increased life satisfaction.

The review's interim report cited long wait times as a reason for closing the Tavistock clinic, not concerns over the care itself. Anti-trans organisations have falsely claimed that 1000 families are joining a class action lawsuit against Tavistock. There is no sign of any such lawsuit or even 1000 families that would be willing to join it.

Additionally, the "rapid-onset gender dysphoria" or "social contagion" theory peddled by these groups has been thoroughly debunked and retracted by publishers.

Behind the statistics are real people whose lives and well-being depend on access to gender-affirming care. As a trans person myself, gender-affirming care has enabled me to live authentically as my full self.

Every time our lives are debated in mainstream media and in the toxic corners of the internet (which tends to be quite often), trans people like myself feel the personal physical shocks to our bodies, and can spiral into vortexes of poor mental health. We need compassion, not vitriol. And our culture needs to care more, and do better, for and with gender diverse people. Young and old. Here in Australia, and around the world.

I’m writing this the same day I attended the Health in Difference conference in Canberra, where I heard a cisgender clinician and fabulous ally speak about the impact: ‘We’re having more parents ask about the relative merit of ‘watch and wait’ versus puberty blockers… when puberty blockers DO give young people opportunity to take time on their journey! It’s just misinformation!’. 

The thought of young people and their allies having to have these conversations with their families, over and over again, breaks my heart… again.

We cannot allow misinformation and biases to dictate the healthcare options available to the transgender community, especially vulnerable youth. It is crucial to challenge harmful narratives and advocate for inclusive, affirming policies that prioritise the well-being and autonomy of all individuals. If you’ve got time to talk about trans people, you’ve got time to listen to trans people too.

Big thanks to Jackie Turner and the Trans Justice Project for their excellent work in unpacking the Cass Review and coordinating an Australian response. Click here to read the full Cass Review Fact Sheet.

And to learn more about the realities of living as a gender diverse person in Australia, listen to my interview with the Sydney Morning Herald and the Age on their podcast “Behind the headlines: talking frankly about gender identity and transition”

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