The Cass Report just landed in the UK. It’s a 388-page study of youth gender medicine in England and Wales authored by an eminent pediatrician, Hilary Cass. It recommends reform but not revolution, trashing puberty blockers but staying silent on the side effects of steroids.
In this post I’ll tell you what Cass says (and doesn’t say) about gays, medical harms of synthetic hormones, and gender identity.
Note: I haven’t read the whole thing. I hadn’t planned to write about it all, but then I realized it would be sadly easy to cover how it addressed topics I care most about. So here goes. Normally I edit my pieces to tone down sarcasm but I won’t do that tonight since it’s breaking news. I’m soooooo sorry.
Gays
Hannah Barnes’ 2023 book about this exact subject — youth gender medicine in England — identifies homophobia as a menace that’s driving gay kids to seek gender medicine. It repeatedly quotes clinicians expressing their shock about the anti-gay bullying kids suffer. Callous straight clinicians and supervisors appear, in her reporting, to be part of the problem. (I’ll be writing about Time to Think in an upcoming post.)
There’s another reason it’s important to understand the gay-trans connection: because homosexuality has a biological basis, and since so many trans people are actually gay, the forces of trans are able to produce studies that show a correlation between, e.g., prenatal androgen exposure and saying you’re trans. But the truth is there’s no biological basis for gender identity.
You can’t understand trans without understanding gay, but Cass only deals with homosexuality superficially.
Page 67: Mentions that historically, most kids with “gender-identity disorder” (a nonsense diagnosis) grew up to be gay.
Page 96: Mentions the number of trans-identified suicide victims who were LGB. No commentary.
Page 100: Sexuality basics. “Females are most commonly attracted to male partners,” etc.
Page 101: Correlations between DSDs and sexual orientation.
Page 118-19: Section on “changes in concepts of gender and sexuality.”
“It is important to consider the relationship between sexual identity and gender identity given that sexuality contributes to a person’s sense of identity[.]”
Acknowledges that a lot of trans-identified kids are gay (also mentioned on page 68).
Mentions GIDS clinicians don’t have a lot of data on sexuality. Why not? “[M]ixed responses were given by GIDS clinicians about the extent to which they explore sexuality with patients[.]” Doesn’t point out that “gender” clinicians who don’t discuss sexuality with their adolescent patients are a disgrace.
“gender” clinicians who don’t discuss sexuality with their adolescent patients are a disgrace
“Clinicians and parents reported that gay students are still being stigmatised and bullied in school and there is sometimes a perception that there is less validation for them than for trans pupils. However, the Review also heard multiple testimonies attesting that having a diverse gender identity is a difficult path with young people subjected to bullying and abuse.”
The experience of gay kids must never receive its own paragraph free of trans shit. Thank you, Hilary Cass, for your conscientiousness in observing this law. I guess she’s implying the old cliche, “no one would choose to be trans over gay,” but her point isn’t clear. No analysis. The second sentence is her excuse for not thinking about the first sentence at all.
“In some strictly religious cultures, being transgender is seen as preferable to being same-sex attracted as it is then perceived as a physical rather than a psychological issue.”
I wonder where they got that idea from. The New Testament? The Quran? No, the answer is 1970s gender doctors. (The opposite is true: attraction is rooted in pheromone processing and gender confusion is caused by metaphorical brain worms.)
“In reality, for any individual young person, there will be different socio-cultural influences that impact on their understanding of both their gender and sexual identity, and this is an area that warrants better exploration and understanding.”
Or you could just rely on deductive reasoning skills to determine that gender identity doesn’t exist, and then quickly get to helping gay kids. But no, further study instead.
Page 122: mentions “gender non-contentedness” is “more often associated with same-sex attraction[.]”
Page 188: Mentions Littman study where 23% of detransitioners cited internalized homophobia as a reason they transed. Doesn’t mention that Littman hadn’t even asked about it — the number would likely be higher if she had.
Vaginas
I searched the document for vaginas because I was trying to see whether Cass addressed the physical harms of overdosing on synthetic hormones (“cross-sex” isn’t quite right since women naturally produce testosterone and men, estrogen), which include painful vaginal atrophy.
Here’s the report’s only mention of vaginas:
¨If puberty suppression is started too early in birth-registered males it can make subsequent vaginoplasty (creation of a vagina and vulva) more difficult due to inadequate penile growth.¨
There’s no mention of clitorises, which can become painfully and permanently enlarged by taking synthetic T and chafe against clothing.
Six mentions of penises.
The section on synthetic hormones begins on page 182. It’s mostly about mental health. Here’s Cass’s excuse for skipping over the medical problems with poisoning young gays:
“Understanding side effects and longer-term complications [of synthetic hormone overdoses] are important for the health of the transgender community, but in terms of patient choice are unlikely to have a major impact on treatment decisions.”
Translation: these young people are too brainwashed to care about their health so we’re not even going to state the facts about their health in this report.
In 2023 I compiled a very incomplete list of stories on risks/side effects of synthetic hormones here (bottom).
Notes on Santa Claus
Cass uses the term gender identity 395 times. Here’s how she defines it:
“In 1966, Kohlberg set out a theory of gender identity development. Kohlberg’s theory describes the typical progression of children acquiring gender identity (realising they are boys or girls) at 2-3 years old, acquiring gender stability (realising that gender does not change) at 3-4 years, and acquiring gender constancy (realising that superficial indicators such as clothes do not change gender) at 5-6 years.
“Modern childhood experiences are different from when Kohlberg was writing, and contemporary research is needed to better understand and examine these fundamental principles, as well as the influence of early childhood experiences on gender identity development.”
Kohlberg’s theory explains how kids learn about sex, not gender. We do not need further research. This is an outright cop-out.
I do like the acknowledgment that kids today have different experiences. Perhaps Kohlberg would name the new developmental stage “gender mindfuck.” Kids reach it whenever the schools start indoctrinating them.
I'll give you an off-the-cuff comment in the hot take spirit of your post. I dunno how I really feel about this, but it's what I'm thinking right at the moment.
Social acceptance of homosexuals is still very new, very fragile and in many ways still constitutes a long, frustrated sigh from large swathes of society that it's a problem they can't do anything about so they might as well just get on with it.
But it is worth remembering that is still quietly seen by many, including many who jumped on the "love wins" bandwagon out of simple tribal loyalty or social expectation, as a problem. Just one they accepted couldn't be "fixed".
Now, many of those who just grudgingly went along with it, are being offered a solution for this problematic little category of people that they still feel icky about. It all sounds very serious and medical and academic and professional. And, especially for many of the "progressive" tribe, it's a solution that doesn't endanger their status with their peers.
What a disappointment to learn that Cass & her team have also been so pickled by these poisonous lies that they can’t write about what’s actually happening without resorting to cult language & concepts.
I was encouraged by the interest in the report by the US & UK news media, but obviously the original source bears further reading & reflection. Thanks again UB—your perspective is so smart & valuable.