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The UK Mistreated Kids with Gender Dysphoria for Years Lisa Selin Davis

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Keira Bell detransitioned after being put on puberty blockers by the NHS, aged 16. (Photo by PA Images/Alamy Stock Photo)

A long-awaited report out this week found that medical professionals in the UK who advocate for gender transition in children are misguided ideologues.

Written by British pediatrician Dr. Hilary Cass, The Cass Review, which is nearly 400 pages and took more than four years to compile, comes to the following conclusions:

Thousands of vulnerable young people were given life-altering treatments with “no good evidence on the long-term outcomes of interventions to manage gender-related distress.” 

“It has been suggested that hormone treatment reduces the elevated risk of death by suicide in this population, but the evidence found did not support this conclusion.”

“Social justice” ideology is driving medical decision-making, and “the toxicity of the debate” has created an environment “where professionals are so afraid to openly discuss their views.”

Activists insist the science on this matter is settled, but Cass’s tone recalls a stern British nanny calmly explaining to unruly children how to get their room in order. She shows us that everything about this issue is unsettled, and unsettling. For instance, she notes that “social transition”—when very young children assume other gender identities—is an “active intervention” that may set youths on a path to medical transition. And it may even make gender dysphoria worse.

The review, commissioned by England’s National Health Service, comes after more than a decade of whistleblowing by clinicians at the country’s Gender Identity Development Services, or GIDS, which was established in 1989 (but mostly off the radar for its first 20 years, because few children and families sought its services). 

These whistleblowers detailed how kids were fast-tracked to medication while a culture of fear grew around raising any concerns, even as demand for youth gender medicine exploded. Eventually, the NHS decommissioned GIDS and hired the neutral, no-nonsense Cass to detail what went wrong and what to do right moving forward.

Her report made the further damning conclusions:

Clinicians “are unable to reliably predict which children/young people will transition successfully and which might regret or detransition at a later date.”

A disproportionate number of patients were “birth registered females presenting in adolescence. . . . a different cohort from that looked at by earlier studies.”

Many parents feared their children had been medicalized by professionals who didn’t take other difficulties into account, “such as loss of a parent, traumatic illness, diagnosis of neurodiversity, and isolation or bullying in school.”

There is a lack of strong evidence to show that puberty blockers “may improve gender dysphoria or overall mental health.”

The majority of gender-dysphoric patients in early studies found that their symptoms desisted during puberty, with most coming out as gay or bisexual later.

Cass notes that “for most young people, a medical pathway will not be the best way to manage their gender-related distress.” She supports expanding the treatment to regional, holistic centers, essentially ending the specialist gender clinic model. That treatment should be based on unbiased psychological care, and robust and consistent evaluation tools must be developed so reliable evidence can finally be gathered. 

This final report—and an interim one Cass issued in 2022—echoes what a number of Western nations, such as Finland and Sweden, have found when they reviewed their own youth gender services. It also underscores what we see in the United States: poor quality research, an unstudied population, and detransitioners traumatized by the treatment they received.

Today, red states are banning the medicalization of gender dysphoric youth, while some blue states have declared themselves medical sanctuaries for minors seeking transition. Medical associations—from the American Academy of Pediatrics to the American Psychological Association—continue to support the “affirmative” model criticized by Cass in her report. 

In her review, Cass directly addresses the 9,000 young people who have moved through gender treatments via the NHS, stating bluntly: research “has let us all down, most importantly you.” 

The U.S. needs to form a truly bipartisan commission that looks at the evidence regarding youth gender medicine. As things stand now, we will continue to be stuck in a perpetual culture war, with parents and distressed kids paying the price.

Lisa Selin Davis is a journalist and author of Tomboy. Read her piece exploring The Beginning of the End of ‘Gender-Affirming Care’, and follow her on Twitter at @LisaSelinDavis.

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Stop Making Cents? Charles Lane

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On Sunday, President Donald Trump announced that he has ordered his administration to cease production of the penny. The argument for the move seems straightforward enough. It costs more than a penny to make a penny (3.7 cents, according to the U.S. Mint). Given inflation and the move to digital payments, ditching the coin is just common cents, right?

Not necessarily. Life’s about more than just making the numbers add up, and amid all the government waste, doesn’t the humble penny deserve a carve out for sentimental reasons?

Today, we debate the penny’s fate. Good riddance or gone too soon? Deputy Editor Charles Lane supports Trump’s move. Consulting Editor Jonathan Rosen opposes it. Have at it, gentleman.

Charles Lane: President Trump’s decision to end production of the penny has my total support. This mite of a coin betrayed me, quite directly and personally, over the course of 13 years.

“Save your pennies, Chuck,” a supervisor at work told me in 2002, responding to some angst I expressed about future college tuition costs. This was her way of not getting the hint that I needed a raise.

Attitudinally positive as always, I took her advice. I told my 5-year-old son that we would henceforth be keeping every one-cent coin we received as change, found on the street, or won playing dreidel until the moment he left for college.

What a father-son project! So rich in lessons about thrift, consistency, and long-term thinking! And so we collected and collected, filling first one large glass jug and then another, until July 2015, when it was time for the big reveal: We had accumulated 10,142 pennies, about 2.19 per day.

They were worth $101.42, not even enough to cover a month’s fraternity dues.

Wrapping the little suckers in paper rolls to enable deposit at a bank took me several days. Valued at the federal minimum wage of $7.25 per hour, the time wasted offset any wealth embodied in our hoard—with change left over.

So I did not need the DOGE to tell me the government lost over $179 million in fiscal year 2023 minting more than 4.5 billion one-cent pieces at a cost of three-plus cents each. I already knew that a penny is much more trouble than it’s worth.


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Nellie Bowles: The Triumph of the Plastic Straw Nellie Bowles

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The biggest environmentalist craze of my generation started in 2011 with Vermont 9-year-old Milo Cress cooking up an arbitrary number for how many plastic straws Americans used daily. This 9-year-old figured it was so many. He says he called up straw manufacturers and calculated 500 million a day. Boom, big number, good number. The mainstream media was off to the races. That 500 million a day number was cited in The New York Times, The Wall Street Journal, and The Washington Post. Suddenly the most important thing we could do for the environment—for our children!—was ban plastic straws.

States and cities passed laws against them. California banned them from restaurants outright in 2018. New York, in 2021, changed the law so the only straws on display were paper (you were allowed to ask for plastic). Official fact sheets from Ron DeSantis’s state of Florida instruct Floridians to “Skip the Straw,” citing the 500 million figure. Did anyone question the basis of this?


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It Pays to Be a Friend of Donald Trump Joe Nocera

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Two dodgy Democrats had a great day on Monday—thanks to our new Republican President Donald J. Trump.

The first, former Illinois governor Rod Blagojevich, was granted a full pardon. Back in 2009, after he’d been charged with corruption, Blagojevich got himself booked on Trump’s show, Celebrity Apprentice. (You can see his appearance in these YouTube clips. He was fired, of course.) I don’t know if Blagojevich had a premonition that Trump might someday be in a position to help him, but it sure has turned out that way. Transforming himself from a high-profile Democratic governor to a big-time Trump supporter was the single best move he could have made.


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