On ‘Gender-Affirming Care,’ Canada’s Medical Establishment Refuses to Follow the Evidence

If the treatment of gender dysphoric youth were treated like any other medical topic, there would be little controversy about how patients should be cared for. Two years ago, Dr Hilary Cass, a former president of Britain’s Royal College of Paediatrics and Child Health, released an exhaustive report that examined the most reliable peer-reviewed research from around the world. She concluded that the laissez-faire policy of reflexively “affirming” gender-distressed minors, which has been ideologically fashionable since the mid-2010s, isn’t supported by science. She debunked the myth that puberty blockers are harmless drugs that merely hit the “pause” button on a child’s development; as well as the morbid propaganda claim that speedy “affirmation” is necessary to prevent gender-distressed individuals from committing suicide.

In the weeks that followed the report’s release, transgender activists—along with their allies in journalism, psychotherapy, and medicine—howled in outrage, insisting that Dr Cass’s analysis must somehow be flawed. For many in this camp, questioning the wisdom of medicalised gender transition is not only inherently pseudoscientific, but also indicative of transphobic bigotry.

Another line of argument had it that Dr Cass’s conclusions weren’t relevant outside the UK—despite the fact that the studies she reviewed were international in scope. In Canada, where I live, the CBC waited five days to report on the Cass Review. The article it finally produced largely consisted of quotes from Canadian doctors who insisted that doling out puberty blockers to gender-distressed Canadian children and teens is still the right thing to do.