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Posted: 2 July 2024 Author: Oli Belas

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*With thanks to Emily Arthur, Seán Henry, and Alex Baird for comments on an earlier draft.

 

Despite its overwhelmingly positive reception by the press, the so-called Cass Review is a problematic document bearing witness to a problematic research process. The methodological, ethical, and epistemic flaws of the Review will be taken up in a future post (or series of posts).[i] The aim of this piece is to bring to the fore the wilful misreading of the Review which, its flaws notwithstanding, does not say what many anti-trans voices think or would have us believe it does.

 

I

The Cass Review is not, despite a recent mischaracterization, a review of gender identity. As its full title makes clear, and as Dr. Cass herself has emphasized, The Independent Review of Gender Identity Services for Children and Young People focusses on gender identity services: the mechanisms and systems of care the state offers young people who are, in the Review’s terms, ‘gender questioning,’ ‘gender dysphoric,’ or experiencing ‘gender distress’ (see New Statesman; Cass 2024: 12).

As stated in its opening sentence, the Cass Review

is not about defining what it means to be trans, nor is it about undermining the validity of trans identities, challenging the right of people to express themselves, or rolling back on people’s rights to healthcare. It is about what the healthcare approach should be, and how best to help the growing number of children and young people who are looking for support from the NHS in relation to their gender identity. (Cass 2024: 12)

Despite its ‘neutral’ position on gender identity, however, such a report could never be strictly neutral. The Review’s remit is to make recommendations for the improved care of young persons, trans youth especially; and, far from being neutral, both Cass and the final report are strident on the ways in which healthcare systems have failed young people. Cass has described the inability of the NHS to care for trans and-or gender dysphoric young people as ‘an injustice,’ while the Review describes some of the testimonies from trans young persons as ‘heartbreaking’; states, clearly, that, ‘whatever your views on gender identity,’ young persons experiencing gender distress ‘should receive the same quality of care as other children and young people experiencing distress’; and calls for a ‘compassionate and kind society [which] remembers that there are real children, young people, families, carers and clinicians behind the headlines’ (Cass 2024:232, 22).

Though a theory of gender identities is beyond the Review’s scope, in trying to establish the broad context of inquiry, the final report does offer this:

There is broad agreement that gender incongruence, like many other human characteristics, arises from a combination of biological, psychological, social and cultural factors. (Cass 2024: 26)

The Review, then, accepts multiple genders as a basic, psychosocial reality. That so basic an act of recognition is needed, and that it could not be presumed, is bleak. It is also crucially important precisely because it could not be presumed – indeed, ideologically anti-trans commentators have claimed the Cass Review as a victory.[ii] Either they have not noticed, or do not care to notice, Cass’s acceptance of the reality of trans identities, nor the purpose of the Review, nor even (to come full circle) the Review’s full title.

Despite its flaws and the many valid criticisms of it, the Cass Review does not intend to support anti-trans ideology.[iii] The passages quoted above should make it clear that it is either careless or wilful misreading to claim otherwise. To say that trans young persons need better care services is, on some level, to recognize trans young persons (which, again and to be clear, is not to say the Review’s positionality isn’t problematic: it is (e.g. Horton 2024). And as Freddy McConnell writes in his incisive commentary on the Cass Review and its reception, the Review’s headlines speak directly to the concerns of trans persons, their friends, families, and allies. The Review’s

key words – read plainly and in good faith – can hardly be disagreed with […]. Care for trans young people that is ‘unhurried, holistic, therapeutic, safe and effective’? What’s to dislike? This is only what prospective patients, patients and their parents and caregivers have been calling for all along.[iv]

Nevertheless, the Cass Review has further emboldened anti-trans commentators and actors, including the current Conservative government, and the effects of this are being felt at the level of education policy.

 

II

One week before Parliament was dissolved on 31 May 2024, ahead of the general election, Health Secretary Victoria Atkins announced she would make extraordinary use of legislative powers to introduce a ban on so-called puberty blockers, specifically for trans young persons. This targeting was not made clear in Atkins’s Commons announcement (she mentioned only ‘limited exceptions’), though it is clearly stipulated in the legislation itself:

the prescription or direction [of so-called puberty blockers to persons under the age of 18] must be for a purpose other than treatment for the purpose of puberty suppression in respect of either or a combination of gender dysphoria and gender incongruence.

In its press release, the government cited the Cass Review in justification of the emergency legislation, even though Cass has not called for a ban. Her recommendation is for cautious use of puberty blockers in controlled research contexts.

A week prior to Atkins’s announcement, Education Secretary Gillian Keegan published draft revised Relationship, Sex and Health Education (RSHE) guidance. Developing the advice set out in its non-statutory guidance to schools and colleges on ‘gender questioning children,’ the new RSHE guidance stipulates that ‘[s]chools should not teach about the broader concept of gender identity,’ because it is ‘a highly contested and complex subject.’ The government’s stance, it should be noted, is out of step with most of the country. The draft guidance goes on to make the following bizarre and alarmist statement:

If asked about the topic of gender identity, schools should teach the facts about biological sex and not use any materials that present contested views as fact, including the view that gender is a spectrum. Material suggesting that someone’s gender is determined by their interests or clothing choices should not be used as it risks leading pupils who do not comply with sex stereotypes to question their gender when they might not have done so otherwise. (DfE 2024: 12)

The same definition of gender identity as appears in the RSHE is also used in the non-statutory guidance on gender-questioning children (DfE 2023: 7). In the latter document, though, gender questioning is explicitly linked to ‘gender identity ideology’ (DfE 2023: 6). Whether or not the authors of the guidance documents believe what they have written, the implications of their text are clear: gender is ‘nothing but’ ideology; sex, because it is biological, is real, and therefore non-ideological (reality knows no ideology, it just is – an ideological proposition if ever there were one). But the idea that sex – specifically human sexual dimorphism – is immutable, a biological constant, is a philosophically contested claim. Crucially, given the governmental line, it is scientifically contested, too.[v] The government is unable or unwilling to recognize its position as ideologically laden.

 

III

The educational implications of the new RSHE guidance are profound: this feels, as many have been quick to point out, like Section 28 all over again. The government seems to believe (or it wants us to believe it believes) gender is reducible to sex, and that transness is a divergence from the inevitable starting point of sex-gender binarism – again, an ideological assumption mistaken as ‘raw fact.’ The Cass Review is being marshalled to ‘evidence’ such a view, to which, sadly and regardless of its intentions, it lends itself because it is framed by a tacit, normative epistemology of sex-gender binarism. But that said, the Review does not support the implied governmental line that transness is a contagious form of viral false consciousness, transmitted by conversation about ‘interests or clothing choices.’

The Cass Review suggests that ‘it certainly seems to be the case that there is much greater acceptance of trans identities, particularly among younger generations’ (Cass 2024: 26). Perhaps, as the Review suggests, this is true among young people. But the claim is not mirrored by UN and Council of Europe findings on transphobia in the UK. If the RSHE guidance comes into effect and remains, its thinly veiled unkindness and conceptual incoherence means schools and teachers will be faced with an impossible task. How, for example, to teach gender reassignment without teaching gender identity and expression; or, the very thing the government claims it is doing, to combat misogyny and gender stereotyping without contextualizing it in sex and gender studies discourses? Assuming the Conservatives don’t get to rewrite the Equality Act so that it refers only to biological sex assigned at birth, the draft guidance in its current form is, the charity Mermaids points out, likely unlawful. And, as an RSHE lead told me recently, the guidance would also force schools to roll back their work in response to the 2021 Ofsted rapid review of sexual harassment in schools. Many of the timely and necessary conversations that have just begun in schools will be cut short, and the enforced culture of silence will mean trans youth are yet further marginalized in, even erased from, educational spaces and discourse.

Bridget Phillipson, at the time of writing Shadow Education Secretary, has been gently critical of the draft RSHE policy. Should there be a change of government this July, let’s hope this policy is scrapped, for in its current form, it flies in the face of the Cass Review exhortation for ‘a kind and compassionate society.’

 

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NOTE: The draft RSHE guidance is open to public consultation until 11 July 2024. Brook, a sexual health education and advocacy charity, has produced a guide on how to respond to the consultation

 

Endnotes

[i] See Pink News, Ruth Pearce, The Kite Trust, Trans Safety Network, Yale Law School

[ii] E.g. The Cass Review: the end of the trans cult?¸ The Cass Review is a devastating blow to trans ideology, and The Cass Review shames the gay-rights establishment from Spiked; People are in denial following the Cass report from The Telegraph; Let’s hope the Cass Report is the end of making kids swap gender… from The Sun; The Cass review of gender identity services marks a return to reason and evidence and Thanks to Cass, evidence not ideology will be used to guide children seeking gender advice from The Guardian, which also published the piece cited above by McConnell

[iii] For concerns about the Cass Review, see programmes by Novara Media and Pod Save the UK; see also Cass’s interview on the New Statesman podcast. See responses from the Kite Trust, the Trans Safety Network, Stonewall, Mermaids; see this list of responses from LGBT+ organizations. See the Kite Trust’s Q&A with Cass

[iv] See also the Stonewall statement

[v] See, e.g., interviews with Judith Butler, Sally Haslanger, Alice Dreger