Cass Report has “high risk of bias”, U.S.A. medical experts warn

U.S.A. experts have criticised the Cass Review of trans care for young people, claiming it violates “medical law, policy, and practice.”

According to ‘The National Scot’, law professors Daniel G. Aaron and Craig Konnoth expressed their concerns in the New England Journal of Medicine regarding the review’s methodology and the application of its recommendations. They argue that if Dr. Hilary Cass’s work had been published in the U.S.A., it would have breached federal law due to non-compliance with legal standards safeguarding the scientific process.

The review, according to the experts, has been utilised by U.S.A. states aiming to prohibit gender-affirming care (GAC) and has influenced the UK’s permanent ban on puberty blockers for those under 18.

Key criticisms outlined in the New England Journal of Medicine include:

• The review was not “verified by experts,” diverging from usual practice and suggesting it would violate federal law if done similarly in the U.S.A.

• It “deviates from pharmaceutical regulatory standards in the UK” and demands evidence standards for GAC not seen in other paediatric medicine.

• It does not meet international norms as it fails to list contributors, raising concerns about potential bias against LGBTQ+ individuals.

• It possesses a “high risk of bias” and a “substandard level of scientific rigor.”

• It improperly excluded non-English studies and certain non-peer-reviewed literature due to its limited search strategy.

Professors Aaron and Konnoth highlighted that the review’s deviation from accepted standards reflects a historical trend of using medicine to enforce gender norms. They argue the Cass Review signifies a regression amidst efforts to promote inclusivity in medicine and reproductive services.

Craig Konnoth holds a professorship at the University of Virginia and Daniel G. Aaron is an associate professor at the University of Utah.

Previously, Yale Law School and Yale School of Medicine academics also criticised the Cass Review, asserting it misrepresents data and misuses scientific methods.

In the UK, the Cass Review has faced opposition from the British Medical Association (BMA), with over 1000 medical professionals signing a letter against it. Though initially opposing it, the BMA later declared a neutral stance and pledged to reevaluate Cass’s conclusions.

Despite opposition, the Cass Review has been accepted by the Labour Party and SNP Governments in the UK.

Jolyon Maugham, KC and director of the Good Law Project, commented on the US intervention, stating it won’t alter Labour’s stance, which he views as aligned with figures like JK Rowling and Rupert Murdoch.

Hilary Cass was appointed to the House of Lords as a crossbench peer by former Prime Minister Rishi Sunak.

A ban on puberty blockers was enforced by the Tory government through emergency legislation, restricting prescriptions to clinical trials. Labour announced that this ban on under-18 private prescriptions is now indefinite. The decision, though health is devolved, applies across the UK, with agreement from Scottish, Welsh, and Northern Irish governments.

Plans for a clinical trial on puberty blockers are set for next year, aiming to recruit participants by spring.