A senior Australian psychiatrist has welcomed a landmark review into the use of puberty blockers and cross-sex hormones for young children experiencing gender dysphoria, saying that it is a “return to evidence-based treatment.”
“I was so relieved to read the Cass Review final report because it signals a return to a careful and evidence-based treatment approach,” psychiatrist Jillian Spencer said in an interview with 2GB.
“Unfortunately, the current model that’s in use, called the Affirmation Model, was implemented at the behest of transgender activists.”
Dr. Spencer is a child psychiatrist who was removed from her role at the Queensland Children’s Hospital on the grounds of being a danger to trans and gender-diverse children.
The decision, however, came after the publication of an NHS review that found the field of gender medicine was “built on shaky foundations.”
Chair of the report, Dr. Hilary Cass, concluded that NHS England was failing thousands of children by prescribing puberty blockers and cross-sex hormones despite “remarkably weak evidence,” adding that the “toxicity” of the debate was “exceptional.”
Of the 32 recommendations made in the report, one found that prescribing hormones to under-18s should be done with “extreme caution” and only after a “clear clinical rationale” for why the child wanted the transition to be done.
“It is important not to lose sight of the fact that hormonal surges are a normal part of puberty and are known to lead to mood fluctuations and depression, the latter particularly in girls,” the report states.
“It is not unexpected that blocking these surges may dampen distress and improve psychological functioning in the short-term in some young people, but this may not be an appropriate response to pubertal discomfort.”
Report Downplays Treatment Options for LGBT People: Lobby
Meanwhile, Equality Australia, a national lobby group for LGBT people, claims the Cass report ignores the consensus of major medical bodies around the world and lacks relevance within an Australian context.
“The way that gender-affirming care is accessed and provided in Australia is substantially different to the way that that care is or has been provided in the NHS,” Dr. Portia Predny, vice president of the Australian Professional Association for Trans Health (AusPATH), said.
“In Australia, our guidelines for gender affirming care for young people already prioritise holistic, individualised, and person-centred care with the involvement of multidisciplinary teams of clinicians with all kinds of areas of expertise, to help and support young people to navigate their gender journey.”
In February, the Australian Medical Association (AMA) updated its position statement on LGBT health, saying that gender-affirming care—such as puberty blockers, hormone treatments, and gender affirmation surgery—is linked with a range of “positive health outcomes” for people who have gender dysphoria, including reduced substance abuse, and reduced harm from self-prescribed hormones.
Government Should Implement Recommendations ‘Today’: Dr. Spencer
Ms. Spencer said that if the Australian government wanted to provide “safe and evidence-based care” for Australian children with gender dysphoria, it should start implementing the recommendations from the Cass report today.
The Albanese government has said the report was “significant” and will consider the review, reported The Australian.
“[T]hat would require health service executives to change policies so that all clinicians are not required to immediately use the preferred pronouns of children, and they’re not required to take an affirming approach to children with gender dysphoria,” she said.
Dr. Spencer also called for the disbanding of paediatric gender clinics, saying that the funding should be distributed to general child and adolescent clinics, which can provide psychosocial interventions for gender dysphoria.
“Puberty blockers should not be prescribed outside of a high-quality, ethics-approved research trial, and cross-sex hormones should be reserved for the treatment of adults with consideration given as to what makes it safe to go ahead with that,” she added.
The federal health minister’s department has been approached for comment.