British Labour says it will implement Cass findings on care for trans children if it wins election

Landmark report finds ‘toxic’ transgender debates have intimidated some doctors and recommends ‘extreme caution’ with puberty blockers for young people

Retired consultant paediatrician Dr Hilary Cass with a copy of her Independent Review of Gender Identity Services for Children and Young People. Photograph: Yui Mok/PA Wire

The British Labour Party says that if, as expected, it wins this year’s UK general election, it will fully implement the Cass report, which recommended a total overhaul of medical treatment for children in England who have gender dysphoria.

The landmark report, by retired paediatrician Hilary Cass, was published on Tuesday after a four-year review commissioned by the National Health Service in England. The report eviscerated the quality of public health services provided to transgender young people, citing the routine prescription of puberty-blocking drugs by NHS services without “good evidence” that they were safe for children.

Dr Cass also sharply criticised the “toxicity” of the transgender debate on medical services for young people, and said it had made some doctors “nervous about seeing” children who presented as trans. Prominent among the 32 recommendations in her report was a call for doctors to exercise “extreme caution” in prescribing body-changing hormones and other irreversible treatments for young people.

It also called for a follow-on gender service for young people up to the age of 25, recommending a cautious medical approach overall for people with gender dysphoria until well into adulthood.


Prime minister Rishi Sunak welcomed the report and said its recommendations broadly aligned with the policies of the Tory government. The prescription of puberty blockers has already been effectively banned under the NHS in England, except for clinical trials.

Puberty blockers can still be prescribed to young people under the NHS in Scotland, where health services are administered separately. The devolved governments in Scotland and Wales both said they would review the Cass findings.

No evidence young people with gender dysphoria ‘fast-tracked’ to hormonal treatments – HSEOpens in new window ]

With Labour more than 20 points ahead in the polls, much attention on Tuesday was focused on the reaction of its shadow health secretary, Wes Streeting, who is seen as likely to be in overall control of the NHS by year end. He described the Cass report as a “watershed moment” for the treatment of children with gender dysphoria.

“Children’s healthcare should always be led by evidence and children’s welfare, free from culture wars,” he said. “The government must now immediately act, but if they do not, the next Labour government will work to implement the expert recommendations of the Cass review.”

Speaking later on the Sun newspaper’s Never Mind the Ballots online show, Mr Streeting said a Cass finding that body-changing treatments had been routinely given to young people on weak evidence was “scandalous”.

He also said he was “pretty angry” that some NHS trusts in England had not fully co-operated with the Cass review. “[They] won’t get away with it,” he said.

Mr Streeting’s strong support for the Cass findings threatened last night to open up old rifts in the Labour Party, which has been roiled in the past by internal disagreements over trans debate issues. The Labour for Trans Rights group said the Cass report “disregards years of evidence” and criticised Mr Streeting for accepting the report “so nonchalantly and uncritically”.

Labour MP Rosie Duffield, a gender critical activist who has long been critical of the party’s hierarchy for its approach to the transgender debate, appeared to take a swipe at Mr Streeting by criticising male politicians for taking “praise and credit for simply listening to an expert”.

‘Adversarial’ adult trans debate is hindering teenagers, report findsOpens in new window ]

Some trans activists in the UK reacted negatively to the Cass report. India Willoughby, a prominent trans campaigner and journalist, criticised the suggestion in the report that a cautious approach be taken with young people with gender dysphoria into their mid-20s. She said that for some trans people, this would mean joining a “10-year queue” for hormones and other major medical interventions at the age of 25. “That’s 35 years of your life gone,” she said.

Mark Paul

Mark Paul

Mark Paul is London Correspondent for The Irish Times