The rationale for early puberty suppression remains unclear according to a report out this morning which demolishes the basis for the current model of treating gender-distressed children.

Dr Hilary Cass has submitted her final report and recommendations to NHS England in her role as Chair of the Independent Review of gender identity services for children and young people.

The full report into gender care in England and Wales for children under 18 provides 388-pages of key findings, highlighting everything from the dearth of research on puberty blockers to the weak evidence for existing standards for care.

Among the findings it says that children should receive counselling which addresses the mental health issues they may have, instead of being rushed or put on drugs to change their gender.

Doctors it says should be cautious with their treatment of minors and it warns  that it is incorrect to assume it is in the child’s best interest to change gender if they think they are trans.

One key finding of the report is that “the rationale for early puberty suppression remains unclear, with weak evidence regarding the impact on gender dysphoria, mental or psychosocial health. The effect on cognitive and psychosexual development remains unknown.”

The report also says that “it is important to view” social transitioning–changing name, pronouns, dress, hair, etc.–“as an active intervention because it may have significant effects on the child or young person in terms of their psychological functioning or longer-term outcomes.”

Commenting on the report Greater Manchester’s Woman’s Rights Network said

“Children have been utterly failed. The Cass Review’s final report is a wake-up call for NHS England, the media, politicians, childcare professionals & all adults who have overlooked the well-being of children. It exposes society’s failure to safeguard their health & welfare.”

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