The culture war of the “gender-critical” has broken the NHS

The Cass Report, billed as an independent review into NHS provision of transgender provision for adolescents was published today. I’ve read the summary and recommendations (the whole report runs to over 300 pages), and running throughout it are the scars of the so-called “culture war”—a social movement where transphobes who hold so-called “gender critical” beliefs have been campaigning to marginalise trans people and roll-back hard won protection in equality law.

The report itself acknowledges the toxicity of debate around transgender healthcare. I’m going to try and be fair to the report here and deal with it as neutrally as I can. Transphobia does not seem to be seeping out of its pores in the same way that a recent Department for Education consultation did, which explicitly framed the discussion through the lens of the “gender critical” philosophy.

It is undeniable the harm that the culture war fuelled by transphobia has caused, and this comes through in the report.

Anti-trans campaigners are litigious and well-funded (allegedly by far-right American fundamentalists), and using these legal weapons has been effective in securing their campaign goals in places with a management culture focussed on risk management and minimisation.

The result of this atmosphere of fear created by the anti-trans movement is one the review describes as a situation where other services in healthcare are scared to do anything when gender dysphoria is present. Instead, everyone is referred to the specialist gender services for unrelated or co-existing conditions, which they might not be able to deal with. This is well-known in the trans community as “trans broken arm syndrome“. This is true in both children and adults.

There is no doubt that in part this is due to the fear within the healthcare community of being dragged into the frontline of the culture wars, which has had the chilling effect of marginalising trans people so that only the gender clinics can help.

The Cass Review strongly advocates moving away from single specialist centres to a regional model of trans healthcare, closer to primary care. This is also something many trans people and advocates (including myself) believe would be a better system of healthcare delivery, but it describes the current situation as far from that. Other recommendations in the report are fair assessments of the current situation. In the void left by the failure of NHS healthcare, private providers like GenderGP have emerged, but their standards of care fall short of best practice (trans streamer F1nn5ter recently did a video about this). The Cass Report is right to be critical of this, and this is one of the biggest indicators of how current NHS provision fails.

Much is made in the report of the lack of quality research covering transgender health. Transgender health has often been seen as at best niche, and at worst, something to be actively destroyed. During Nazi rule, the world’s first and leading research centre was ransacked and the research burnt, as well as trans people being among the identities targeted in the holocaust. Other research has overly focussed on transgender women and bears an undercurrent of the fetishisation that we’re often targets of, yet remained influential in the field for decades.

One example of this is that there has never been a longitudinal study of the impact of progesterone alongside estrogen in feminising hormones, which are routinely denied due to evidence showing no effect on breast growth, but anecdotally has an effect on mental health, which has never been evaluated. The assumption of medical researchers that trans women are only interested in breast development, and not in the mental health benefits of the hormone which is available to cis women, is one example of research being rooted in trans misogyny.

So more research is welcome if conducted away from a basis in transphobia or fetishisation. Worryingly though, I have also seen discussion that the Cass Report is asking a higher bar of research into transgender health than it would be of other health mechanisms. I am not a health researcher to evaluate this claim, but it is clear that expecting a higher quality level of transgender health research than other areas is not a fair ask. Overall, the most concerning part of the report to me is the section on detransition research which acknowledges that this is also low quality by the report’s standards, but nevertheless gives credence to anecdotal data about detransition rates. No other research gets given the benefit of the doubt.

The report is also critical of adult gender services for lack of participation. Once again, we see the chilling effect of the culture war in place. It is not surprising that adult gender services wish to avoid harm to their patients by staying away from the Cass Review, and risk also being dragged into this particular front in the culture war. It is also a shame and another example of how institutional transphobia hinders research. Without the toxic environment created by the anti-trans movement, a more cooperative approach might have been possible which would probably have been a good thing.

There are also some good recommendations in there. The fundamental idea of moving to a network closer to primary care is one I support, and more investment into research is good, but in the meantime denying people access to transgender healthcare due to a culture of fear will be once again damaging to a generation that badly needs a caring, supportive NHS. Similarly, properly fixing the NHS spine IT system which requires reissuing an NHS number when someone transitions would definitely make life better.

It’s hard to see how to move transgender healthcare forward. Transphobes move with impunity into positions of power, and scream out or sue they’re being silenced when criticised or blocked from being able to cause damage. They have been empowered by a series of judicial decisions which are then distorted to feed their false narrative, founded in the incorrect decision to rule their philosophy as non-totalitarian. But when the gender-critical belief necessitates the elimination of the recognition of transgender people from society, it’s clear that it is totalitarian, and therefore not worthy of respect or protection.

Trans people have been so traumatised by systematic and institutional transphobia, now brought to a head with the current culture war, that everything, including this report, is viewed with suspicion and distrust. There is a lot of work needed to be done by society to heal the scars left by transphobic extremists, and then for public services to be able to rebuild trust with the trans community. Public services and institutions should be seen as supportive and trusted, rather than just gatekeepers—this hostility in public service delivery is of course seen in more than just trans healthcare, but also in areas such as immigration or benefits and is the sad outcome of years of various degrees of authoritarian government. It is hard to see how to fix trans healthcare whilst transphobes continue to influence the relevant policy with their dangerous rhetoric, and move with protection in their campaign to marginalise trans rights and push an ideology that casts trans people as mentally ill predators.

The transphobic culture war is deeply harming our society, and to compromise is to accept that harm. The reaction to the publication of the Cass Report is symptomatic of the harm done by the transphobic culture war. Lies published on the evening of the report by transphobic campaign group Sex Matters were that under-25s would no longer be able to access healthcare. These lies were then repeated by The Times. This is a twist of what the report actually says, which is that an interim transition service between children’s and adult services may be beneficial.

Similarly, discussion in the report of moving gender services into a holistic model which also can better support children presenting with multiple conditions is now seen as an opportunity for the system to exclude autistic children from trans healthcare. As an autistic trans person myself, I am interested in the seemingly higher likelihood of co-occurrence of these two identities, and it is understandable that this is viewed with suspicion and hiding a true agenda. Such behaviour has been seen before, and there is no evidence this would be different.

No matter what, an emboldened hate campaign was going to twist whatever the report said to fit its agenda, and a traumatised community will accept the most pessimistic view, because it has been a long time since there’s been actual cause for hope from our public services.

The report is clear and says what we already knew. NHS transgender healthcare provision is broken. The fear though is that this report will now be weaponised in a culture war to instead rebuild this provision to make it worse. And it’s hard not to believe that this fear is likely to be realised.

* Chris Northwood (she/her) is a councillor in Manchester, deputy group leader of the Manchester Liberal Democrats and member of Federal Council.

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36 Comments

  • Andy Hinton 10th Apr '24 - 1:10pm

    A depressing but fair analysis, I think. However couched in reasonable language the report may be, we cannot ignore the context that this report was commissioned by the current government, who never miss an opportunity to make a cheap jab at trans folk. And the current government will be the ones deciding how to take it forwards. Given their woeful record on the NHS more widely, it’s hard to imagine that this will be the one bright spot.

    As far as the relationship to evidence, it does appear that the report has taken a pretty high bar for what constitutes good evidence, in a sector where the highest standards of experimental research are simply not practicable in many cases. Declaring that all medical interventions must end until they can be double-blind trialled would be a tendentious way to halt all sorts of valuable and long-proven medical practices.

  • Alisdair McGregor 10th Apr '24 - 1:12pm

    The way it goes after the intersection of Autism and Trans rights is deeply, deeply worrying; it seeks to infantilise both trans and autistic people and deny them agency in seeking their healthcare needs be met. The useful idiots who are supporting the culture war against trans people are going to end up removing all agency from huge swathes of people in their bigoted obsession – and it won’t be long before these same arguments are leveraged into an anti-abortion, anti-women’s rights crusade by the far right backers of transphobia.

  • Is possible that this report makes everything better for everyone. Possible. Expanding mental health services would be a good thing.

    But I’m so worried that this will just lead to gatekeeping anybody under 25 and all autistic people from trans health care.

    There’s already been chat on the radio today that puberty blockers should be an adult only decision, like there’s any point in trying to block a puberty that’s already happened.

  • James Brough 10th Apr '24 - 3:20pm

    As Alisdair suggests, I think this is just step one. Today trans people, with a side swipe at autistic people, tomorrow other queer people, the mentally ill, women… In short, given time, anyone who’s not cis, white and male and who can be “othered”.

  • lorna munro 10th Apr '24 - 5:35pm

    Scientists are taught to critically appraise articles, not cherry pick and look for confirmation bias. By contrast, with the media interest surrounding publication of this review, I think there is an issue whereby people are now picking out what they think the Cass review said- and I’d include trans people in that assessment, people who are trying to salvage something from the wreckage.

    Cass has routinely used words like ‘toxic’, ‘ideology’ and ‘both sides’, but when you actually look at the composition of the report, the framing, it is unequivocally bad for trans people. She has given interviews in which she appears even handed, as a way of selling the Review to an audience who have no skin in the game, but it is clear that she intended to apply the narrative of cis-normativity from the outset, and sought out overtly transphobic sources of information to validate her approach.

  • George Cooper 10th Apr '24 - 6:49pm

    Thank you Chris for providing an excellent summation of the settled position of the Liberal Democrats on Cass. It will be interesting to see how events pan out over the next few months following Rishi Sunak’s comments today and Labour’s reverse ferret led by Wes Streeting and Yvette Cooper.

  • Charlie Murphy 10th Apr '24 - 11:56pm

    Thanks for this very well-considered piece Chris. I’ve been looking around for something like this from someone trustworthy today as I’ve not had a chance to review the report myself yet.

    I had also taken the most pessimistic view, and felt anxious because of what I have been hearing from friends who are trans. This gives me some precious comfort that there are good, evidence-based recommendations in the report. It’s also reassuring to see that the discussion about healthcare for under 25s isn’t as bad as initially feared.

    Not at all sunshine and roses, but thankfully it seems like it’s not all bad news. Thank you very much for your analysis.

  • Jenny Barnes 11th Apr '24 - 7:31am

    Rowling last week, Cass this week. what next?

  • Nonconformistradical 11th Apr '24 - 9:05am

    Is this worrying? :-

    https://www.independent.co.uk/news/uk/politics/government-rishi-sunak-england-national-education-union-andrew-tate-b2526773.html
    “Young people are turning to online sources to learn about relationships and sex which is leaving them vulnerable to potentially “dangerous” and “untrustworthy” information, the Sex Education Forum charity has warned.

    A poll, of 1,001 students aged 16 and 17 in England, suggests that 30% of young people turned to social media as their main source of information about sexual orientation and gender identity, ahead of school (25%).

    The survey, carried out by Censuswide on behalf of the charity in February, found that 22% of young people said the internet was their main source of information on pornography, while 15% said they turned to pornography itself as their main source of information on the topic.

    Around a fifth said social media and websites were their main source of information about unhealthy relationships (21%), healthy relationships (18%) and sexual health (18%).”

  • Alan Henness 11th Apr '24 - 10:32am

    When you say, “The Cass Report, billed as an independent review into NHS provision of transgender provision for adolescents”, is your implication that it was not independent?

  • Matthew Radmore 11th Apr '24 - 11:59am

    I am honestly baffled by the comments above.

    The report is 388 pages, I have read pages 1 to 45, carefully and in-depth.

    It does appear to be independent, balanced, well considered, it was commissioned by NHS England (Civil service) after the CQC rated the Tavistock Clinic inadequate, affected persons were consulted through various forums and groups, certain aspects were outsourced to the University of York and international studies were referenced.

    I do not detect “the dark hand of conservatism” within it.

    I wonder if the LGBTQIA+ membership and community at large are so battered by inadequate health care, support, abuse, discrimination, etc. that it is hard to be objective?
    Has this community got caught up in the battle in a way that does not serve the long-term interests of those that are to follow?

    The Liberal Democrats are about a free, fair, just, open and inclusive society, but Lib Dem policies are about reason and evidence and long-term thinking. It is this combination of factors that first attracted me into this wonderful party, let us be open-minded and use this new information for the best possible future.

  • There’s a lot going on here, but for me the main takeaway is that in order to do better for trans people we need to be critical friends to healthcare providers and aspire to the same quality of evidence for trans care as we expect from other medical disciplines.

    The real tragedy is the debate becoming so polarised, because there a lot of people who share many of the same goals, but the fixation on differences of opinion gets in the way of all progress. The loudest voices remind me of the bitter fighting of the middle ages between Catholics and Protestants. The extremists in both camps included those with a passionate and sincere desire to save souls in keeping with their understanding of the truth. They lost focus on what was important, and some convinced themselves ostracising/torturing/killing heretics was righteous.

    I don’t have the time or expertise to do my own review of the Cass Review, but I know enough to recognise multiple examples of cognitive dissonance and the Dunning-Kruger effect in action. However well intentioned, that does not help those who need better care.

  • Brandon Masih 11th Apr '24 - 12:52pm

    @Alan Henness – I do have doubts on Cass’ independence in her conclusions yes, it’s more dismissive of the evidence feeding into the systematic reviews carried out by York (and is where the unreasonable standards for treatment of studies in this context is coming from.)

    https://www.erininthemorning.com/p/cass-met-with-desantis-pick-over – but also this about links with Cass and Florida’s review on trans healthcare.

    Appreciate Chris pointing out that some recommendations could deliver better outcomes, albeit if it were in a more positive context, and thank her for taking time to mention it in her piece. Just the framing through the report, the weighting on puberty blockers and high focus on detransitioners (who ofc should also be supported!) to make the argument against intervention effectiveness makes it clear that just accepting the review’s recommendations won’t be improving trans healthcare. Certainly we shouldn’t find ourselves watering down our stance on trans healthcare because of the Cass review, I just hope we don’t end up with a very ambivalent approach to the review if we do have a press release forthcoming on it.

  • Matthew Radmore 11th Apr '24 - 1:05pm

    Having now properly read the main 45 pages and now having skimmed the rest I genuinely and in good-faith cannot see the problem with the report. It is definitely independent, well and widely sourced, it has fair, sensible and useful recommendations. I don’t understand the concerns expressed in the article or following comments. It is a serious report, not a conservative trojan horse. As a Liberal with a belief in the power of good policy, I recommend that it is an input to any policy reviews.

  • Jenny Barnes 11th Apr '24 - 1:58pm

    It seems to me that the report starts from the position that alleged trans children are misled or making it up, and in evidence we have the multiple conditions presented by some children at GIDS. If one started from the positiion that at least some, possibly most, of those presenting with gender dysphoria were genuinely trans, we wouldn’t have the almost knee-jerk banning of puberty blockers (where’s the evidence that doing nothing is better?) nor the refusal of “social transition” to be deferred for a period of “watching and waiting” (for what, exactly?) Clearly the waiting lists for GIDS and for mental health interventions are far too long. In this context the length of waiting lists for treatment is analogous to a 10 month lead time for maternity care.

  • Tom B (Reading) 11th Apr '24 - 2:36pm

    As a biologist, the flaws in the review are obvious, and it’s worrying that the two big parties have accepted them uncritically.

    Cass unjustifiably downgrades the reliability of almost all the studies into the subject based on flimsy grounds. Now, look, in most cases it’s better to have double-blind studies, but that simply isn’t viable when we’re talking about hormones. It is quickly apparent whether one is taking a control, which renders blinding moot. A scientist should appreciate that.

    Cass then concluding that the evidence is weak is at best reckless, and falls well below the standards that would be expected in a peer-reviewed journal.

    If Cass truly was independent and unbiased, why did she come to the opposite conclusion to every other review? Why has 100 studies been enough for everyone working in the field, every professional body, every academic… but not the Cass review? Why should we put Cass on a pedestal and ignore the work of internationally-renowned groups like WPATH (https://www.tandfonline.com/doi/pdf/10.1080/26895269.2022.2100644) or the Endocrine society? (https://www.endocrine.org/clinical-practice-guidelines/gender-dysphoria-gender-incongruence)

    Our party should advocate for trans people to receive WPATH-compliant healthcare. The Cass review is not entirely tarnished, but we mustn’t uncritically swallow it. We don’t need to chase the votes of the worst people in society, leave that to the Tories and Labour. We’re liberals and we support people’s right to affirm their gender identity and receive the appropriate healthcare.

  • Alan Henness 11th Apr '24 - 2:55pm

    @Brandon Masih

    This is from the bmj today, ‘The Cass review: an opportunity to unite behind evidence informed care in gender medicine’:

    One emerging criticism of the Cass review is that it set the methodological bar too high for research to be included in its analysis and discarded too many studies on the basis of quality. In fact, the reality is different: studies in gender medicine fall woefully short in terms of methodological rigour; the methodological bar for gender medicine studies was set too low, generating research findings that are therefore hard to interpret. The methodological quality of research matters because a drug efficacy study in humans with an inappropriate or no control group is a potential breach of research ethics. Offering treatments without an adequate understanding of benefits and harms is unethical. All of this matters even more when the treatments are not trivial; puberty blockers and hormone therapies are major, life altering interventions. Yet this inconclusive and unacceptable evidence base was used to inform influential clinical guidelines, such as those of the World Professional Association for Transgender Health (WPATH), which themselves were cascaded into the development of subsequent guidelines internationally (doi:10.1136/bmj.q794).7

  • Chris Northwood 11th Apr '24 - 3:09pm

    Matthew Radmore- I’m a bit baffled by your comments that you can’t see the impact of the toxicity of the debate in the report. It’s explicitly called out by Cass in the foreword acknowledging the challenging, as well as in the second paragraph in the Summary section. Additionally, in paragraph 4, it acknowledges that clinicians are fearful, and paragraph 5 explicitly uses the words culture war. The culture war is explicitly present throughout the sections you’ve read so I’m not sure how you’ve missed it?

    If I was to try and interpret your comments in a different way, I think you’ve drawn the incorrect conclusion that I’m saying the report must be discarded. This article does not say that, it was intended to show how it’s set within a wider context, and then apply a critical lens to analyse the recommendations. This article is mostly around the atmosphere that surrounds the report, not the report itself. I’d suggest you’d read my closing paragraph again, where the criticism isn’t directed at the review itself, but how it now will be used as further ammunition in a culture war and the substance of the report discarded in favour of twisting it to whoever’s agenda is useful. Given the front page headlines and online discussion that has followed this, I think it’s clear that this is now happening.

    In response to publishing this, I have had messages calling me a paedophile, a criminal, mentally ill, a groomer, a threat to children, been told to end my own life, delusional and in need of locking up for the safety of others. This is not a healthy environment for debate, and Cass correctly acknowledges that even if somehow you’ve missed it.

  • @matthew – the problem is you read the report and didn’t just rely on what unreliable social media influencers are wanting you to believe.

    @Brandon – that linked article is a laugh, especially the section on gendered toys. Anyone who has had girls and boys and the full range of toys will be able to tell you they play differently with the same toys, even when playing together.

  • David Allen 11th Apr '24 - 8:00pm

    “The real tragedy is the debate becoming so polarised”

    Hear, hear!

    Culture war is a nasty divisive political tactic, used by the Right to stir up anger, distract attention from government incompetence and rapacity, and seek votes on an essentially dishonest anti-woke prospectus.

    So the last thing we should do is to join in the culture war, fight uncritically for the opposite side, demonise doctors as “transphobes”, and meet hate speech with hate speech!

  • If there is opposition to the Cass review as outlined above the Liberal Democrats will get my son and my votes. Alongside many younger trains-inclusive voters. But it needs to be official. Trans rights are human rights.

  • If there is official opposition to the Cass review as outlined above, given the culture of transphobia that has become more acceptable over recent years and which the Cass review reflects, then the Liberal Democrats will get my son and my votes. I have been a lifelong Labour voter, but the transphobia that the Conservatives and Labour seem either impotent or unwilling to challenge, alongside the normalisation of transphobia, in mainstream media and by cis people of my generation (I’m 54) mean I don’t have a brave, equality-focused party to vote for. I am a cis woman.

    If trans rights are human rights, and if transgender people have an equal right to exist, as non-transphobic people believe, then loudly and proudly delivering this message is, of course, liberal. Transphobia, alongside misogyny, disability discrimination, racism, and homophobia are not liberal values.

    Younger voters get this more, I hope. As without hope, this fear and cowardice (or, generously misunderstanding) will be of harm. And in today’s cultural context of those with voices, Cass has done harm.

  • @chris re In response to publishing this…
    That is unacceptable, but does seem to be becoming normal behaviour for the internet, possibly partly due to the disconnect between online accounts and real world people.

    This reminds me of the abuse a close friend got after announcing their cochlea implant, the troubling aspect of this, most of the abuse was from other members of the Deaf community…

    This abuse drew attention to the lack of real care and support available from the NHS during the initial weeks and months as they adjusted to the implant and what it and didn’t do. A concern I therefore have is whilst there are some good recommendations in the report, can the NHS deliver. Particularly, in the much more distributed and localised delivery of service, given how a specialist centre such as the Tavistock failed to deliver.

  • Jenny Barnes 12th Apr '24 - 9:33am

    For trans people, going through puberty is “permanently life altering”. Where is the evidence that allowing this to happen is better than using puberty blockers? For those who then go on to need a number of major medical interventions to reverse the effects of puberty, it is clearly worse.

  • Kieran Seale 12th Apr '24 - 9:59am

    Readers should be aware that there are different opinions on this subject amongst party members but they are being systematically censored.

  • @Kieran Seale. No-one is being censored, and the comments have reflected a variety of views. But here on LDV we do have a comments policy: https://www.libdemvoice.org/comment-policy

    “Comments that stray over the line into abuse of individuals or groups of people will be moderated. If in doubt, try being extra polite! In particular:
    Avoid abusive, racist, sexist, threatening, homophobic, biphobic, transphobic or coarse language.”

    I get the impression that some keyboard warriors forget that real people read what they write and simply don’t recognise that they are being abusive. That is why we have to pre-moderate comments on sensitive issues such as this.

  • Thelma Davies 12th Apr '24 - 2:29pm

    Mary; Comments have been withdrawn after being published for a few hours , or in some cases have been taken down after 24/48hrs. None of those comments fitted the criteria you’ve outlayed in your post to Kieran.
    Even today, a critical but thoughtful post was withdrawn.

  • Mary Fulton 12th Apr '24 - 2:47pm

    @Jenny Barnes
    You make a very valid point. I think what the Cass Review was trying to suggest is that giving puberty blockers to children who it is later discovered were not actually suffering from gender dysphoria also has a massive, life changing impact.

  • @Jenny, it seems to me the historical failure of those treating trans teens to collect the necessary information that would allow a good quality analysis so experts could make that decision is what we should be angry about, and is something we should be pushing to improve.

    Our party often brags about how our environmental policies are more effective than those of the Green party, despite there being a few too many climate change deniers/diminishers in our membership for my liking. The main reasons usually given are the Green’s enthusiasm for the subject doesn’t compensate for their lack of attention to detail, and our own tradition of being evidence-led helps us to avoid popular, well-intentioned, but ineffective strategies.

    We need to ensure we don’t abandon that commitment to evidence because we’d rather fight a culture war. It’s right the party considers and critiques the report. But declaring the whole thing ‘transphobic’ because we read some memes that confirmed our prejudices, but misrepresented the contents doesn’t help trans people, it doesn’t make us the good guys and instead just makes us look like zoomers.

    In particular, it’s a shame that one of the big conclusions that almost everyone can agree on – more mental health support for children and teens – is not getting the attention it deserves. If done right it will produce the data required to make better decisions about treatment options in the future.

  • @Thelma Davies. Unfortunately one of our commenters has been misgendering the OP. That is completely unacceptable and the comments were removed once it was spotted.

  • Jenny Barnes 13th Apr '24 - 10:32am

    I agree with the points about evidence. And indeed it does seem odd that the incidence of trans presenting assigned female at birth children has risen by such a large amount. Evidence for some of the fears of those supposedly protecting women would be good too. For example how many men have invaded female changing rooms by claiming to be trans women? I suspect not many.

  • Jenny, I’m not sure if you read this article from the Guardian on issues around gathering evidence, that mentions that point. I think the article is a useful summary of the current obstacles to progressing our understanding.

    https://www.theguardian.com/society/2024/apr/12/this-isnt-how-good-scientific-debate-happens-academics-on-culture-of-fear-in-gender-medicine-research

    As a party, we’d do well to think carefully about how any official response will help to encourage the honest research and scientific debate that every discipline needs to make progress.

    It’s years since I read Ben Goldacre’s “Bad Science”, and could do with an update, but I’d recommend it as a good, if occasionally pompous, introduction to and potential pitfalls around evidence based medicine. I gave my copy away, so can’t check, and I think it’s some of his follow-on work (including “Bad Pharma”) that looked at how to deal with scenarios where blinding is tricky. He’s written about the anxieties of denying a control group what is assumed to be the better treatment somewhere too.

    I recommend anyone interested in evidence based policy give it a read. It won’t directly answer questions on how to assess and improve trans care, but it provides some much needed context for those who want to cut through the hyperbole.

  • Laura leigh 25th Apr '24 - 2:09pm

    This article was published soon after that Cass review. It seems to have been written pretty fairly considering the amount of time there was to take in the full implications of the review. As a Trans woman I know a great number of people in the trans community and I can say as a community we are genuinely scared. I mean that, not concerned, not worried but actually scared.
    Unless we can afford private healthcare the waiting list have gone from months to years and are now moving into decades just for a first appointment not treatment. That’s just a chat with a nurse to see if we are “trans enough” to get to see a doctor in maybe another year to 18 months. For an adult that’s traumatic for a trans child it’s a life changing and traumatic. Doing nothing is not a neutral act.
    I was a Labour voter and was considering joining the party a few years ago to fight against the far right that is in government and gaining more power all the time. As Labour moves to increasingly transphobic nastiness that path is now blocked.
    Now that enough time has passed and the true effect off the Cass review is becoming obvious as it’s being used around the world to attack trans people and our rights I really want to see a statement of support for the trans community with an admission of the harm that the Cass report s doing.

  • Alex Hosking 27th Apr '24 - 12:29am

    I’d like to point out several potential fallacies in this

    1. Ad Hominem: The frequent use of terms like “transphobes” and “anti-trans campaigners” suggests a tendency to attack the character of opponents rather than engaging with their arguments directly. It’s important to address differing viewpoints with respect and engage in constructive dialogue.

    2. Appeal to Fear: The narrative heavily emphasizes fear, portraying the debate as driven primarily by fear rather than acknowledging the complexity of the issues at hand. While fear is a legitimate concern, a nuanced understanding requires consideration of multiple factors.

    3. Straw Man: The argument simplifies the discourse into a binary opposition between those supporting transgender rights and those labeled as “transphobes.” This oversimplification may obscure the diversity of opinions within the debate.

    4. Loaded Language: The use of emotionally charged language like “transphobic extremists” and “emboldened hate campaign” can polarize discussions and limit constructive dialogue. It’s important to use language that fosters understanding and openness.

    5. False Dichotomy: The article presents a false dichotomy between supporting transgender rights and perpetuating a “transphobic culture war.” In reality, discussions around transgender healthcare provision can benefit from a more nuanced approach that considers diverse perspectives.

    6. Appeal to Authority (Anecdotal Evidence): While personal anecdotes are valuable for understanding individual experiences, relying solely on anecdotal evidence to substantiate broader claims about healthcare provision and societal attitudes may not capture the full complexity of the issue.

  • Alex – I’ve addressed your points below:

    Ad Hominem
    ‘Transphobe’ is a loaded term, but ‘anti-trans’ describes someone questioning the legitimacy of transgender identity and isn’t a slur—it specifically applies to those opposing transgender existence.

    Appeal to Fear
    This claim holds only if it influences those who fear as a result. Since it primarily concerns trans people, it doesn’t constitute an appeal to fear.

    Straw Man
    Although ‘transphobe’ may not be useful here, I contest its consistent application as you suggest. Public opinion is varied, but distinguishing between those affirming versus denying transgender rights is essential. ‘Anti-transgender’ precisely identifies those opposed, similar to distinctions in race or sexuality debates. Using binary terms in human rights discussions is necessary, not an oversimplification.

    Loaded Language
    Emotionally charged terms like ‘transphobic extremists’ are critical in contexts where fundamental human rights are at stake, reflecting the urgency and severity of threats. In life-or-death situations, such as a prisoner debating execution methods, emotional responses are inherent and necessary to convey the gravity of the threat.

    False Dichotomy
    It’s crucial that complex issues like transgender healthcare are discussed within the medical community, not in public debates.

    Appeal to Authority (Anecdotal Evidence)
    The article, as an opinion piece, does not rely on anecdotes to substantiate its claims, making this critique inapplicable.

  • Just want to mention that I had written a much lengthier response without realising there was a character limit – so apologies if the language seems a bit fragmented in places – it was late at night and I was tired lol. Thinking back – I probably should have done it in several posts 🙂

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