We asked for an expert to evaluate the NHS child and adolescent service that was responsible for providing services to trans children in the UK. The evaluator they chose, Dr Hilary Cass, behind the now-infamous Cass Report, was no expert or even novice in the realm of gender-affirming care. What’s more, her final review blindsided the UK trans community and amounted to nothing short of betrayal.

We’d heard that the NHS gender service was failing patients. Some said it was pushing young people through too quickly. Others said it was shockingly slow. Some said their assessments and policies were inadequate. Others said they were, frankly, abusive.

We expected an expert in the medical and psychosocial care of transgender children. Instead, we got Dr Cass.

Dr Hilary Cass Has No Expertise in Gender-Affirming Care

NHS England reassured us with titles: “OBE”, “Consultant Pediatrician”, “Former President”. But did Dr Cass have the NHS core values that we needed? Was she “caring”, “compassionate”, “competent”, “communicative”, “courageous”, or “committed”?

We expected Dr Cass to listen to the voices that mattered and to act on their experiences. The voices of the young trans people who had accessed the service and the parents who drove them there. We asked them to listen to experts in the field (doctors, nurses, therapists across the world who had supported and guided trans youth through their transitions) and follow their advice.

Dr Cass seemed to listen, but we didn’t see her take note. How much weight did she give the true experts? How much weight did she give instead to the people whose only expertise in trans healthcare is to shout loudly to deny it?

Cass Report Ignores Global Expert Transgender Healthcare Guidance

We asked for an evidence-based approach: what does the research say? How do we best support a trans child? How do we get the best outcome? What’s the best medicine? What’s the best approach? What gives the best results? Dr Cass clearly reviewed a different set of research than did the Professional Associations of Transgender Health because her recommendations couldn’t be more different.

We wanted a review of the NHS service: was it fit to care for our transgender youth? Was it providing the excellence that we expect our NHS to provide? Dr Cass’s recommendations in the Cass review closed that clinic, leaving our trans children with no access to care. The recommendations she has made now mean that there is no care in its place.

We wanted Dr Cass to help our trans youth get the best outcomes: better school results, better qualifications, better social relationships, better intimate relationships, better jobs, and better life satisfaction scores. What we hear is worsening social isolation, worsening school attendance, worsening mental health, and increasing suicide.

A Betrayal of Transgender Youth in the UK

Mums tell us how much happier their child was since facilitating their social transition. They tell us how much relief their pubescent youngster felt when they got access to puberty blockers. Mums tell us how well their teen was doing in puberty that matches their gender.

Dr Cass didn’t seem to hear those voices. Her analysis was so very different, so different to the advice from the people who are trans and so different to the advice of the thousands of medical experts in transgender care across the world.

‘Don’t let them social transition, don’t let them have puberty blockers, don’t let them have gender-affirming hormones.’ The anti trans groups applaud, the trans families weep and despair.

Cass Report Values Professional Liability Over Real Transgender Youth Lives

Dr Cass urged our Minister for Equalities to be careful about banning conversion therapy in case it potentially harmed medical professionals. How can conversion therapy possibly even exist when we know what harm it causes those patients they are trying to convert?

Dr Cass will have blood on her hands, she has failed to follow the world experts’ advice on how best to help this patient group, and instead she has made recommendations that are resulting in their death. Young death. Tragic death.

Read More: Trans Youth in the UK, How to Support a Trans Child: FAQ Answered by GenderGP Specialists, Puberty Blockers FAQ, A Response to the Cass Review