It's been three and a half years in the making but at last the Cass Report, a deep investigation into the most controversial issue of recent years — the medical treatment of those who feel they are living in the wrong gender — has finally been published.

There's a long-standing approach to reports of this kind. Find someone highly respected in their field. Pay them to make their enquiries and write a report. Publish and read the report. Put it on a shelf and forget about it.

This must not happen with the Cass report. The subject matter is far too important to ignore.

Hilary Cass is a paediatric consultant. Her concern is children, their treatment and the way they've been influenced by what they've been told about being a girl or a boy and changing sex.

Of equal concern is the way the medical profession and other adults charged with the care of the young have dealt with the pressure from the trans lobby from as long ago as 2010 when the Equality Act included gender reassignment as a protected characteristic.

Keira Bell sued the Tavistock for its haste in giving her puberty blockers and hormones to become a boy, which led to her having a double mastectomy

London's Tavistock clinic finally closed last month, and a few weeks ago NHS England  confirmed gender identity clinics would no longer prescribe puberty blockers

When former Minister for Women and Equalities Maria Miller took over the newly-formed Women and Equalities Committee in 2015, the first subject they chose to tackle was 'equality issues affecting transgender people'.

Why, I asked at the time, when trans people are such a tiny minority? Surely, she should be concerning herself primarily with women — with violence in the street and at home, with equal pay, discrimination, lack of childcare. The list was long and familiar, but it was brushed away. It was trans people who experienced widespread suffering she'd been told. She must consider their needs first.

It was the first hint I had of a powerful lobby, concerned with those who were not happy with the sex they'd been born with. No-one was talking then about children suffering from 'gender dysphoria'. And no-one thought children needed special services. In 2009 only 97 children were referred to GIDS – The NHS gender development service, based at the Tavistock Centre. By 2021 over 5,000 children were referred. What was going on?

My anxiety grew after an interview on Woman's Hour with the trans activist India Willoughby. What influence was Stonewall having on the NHS and the seeming erasure of women in maternity care? Why were trans women calling themselves real women? Why were so many kids seeking treatment after 'being born in the wrong body'?

My anxiety grew after an interview on Woman's Hour with the trans activist India Willoughby (pictured on BBC Question Time in February)

In my research for an article I spoke to Stephanie Davies- Arai, director of Transgender Trend. She was desperately worried about young children being given puberty blockers — drugs that had not been properly tested – which seemed to be leading young people towards surgery to change their gender. I was appalled and expressed my horror in an article I wrote.

Friends had warned me not to get involved in this toxic debate. I could not ignore the damage that was being done to women and children but, inevitably, like so many others who were equally shocked, I suffered the full onslaught of the trans lobby.

Awe-inspiring power of the solar eclipse

The solar eclipse bypassed Britain this year, but in 2001 we happened to be on holiday in northern France for the first total eclipse of the 21st century.

It was awe-inspiring. The world darkened. The birds stopped singing. The gathered crowds were silent. Then the light came on and the birds sang again. Catch one if you can.

The eclipse seen from Ohio on Monday

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There were threats of murder and rape. My alma mater, Hull University, was told it must not name a lecture theatre after me. (The vice chancellor was brave enough to ignore them.) The BBC ignored demands to sack me but became terrified of discussing the issue. I was not sacked. I cancelled myself by quitting. Of course, the bullying from the trans activists hasn't stopped.

Dr Cass has suffered just as I have. In the introduction to her report, she writes of the criticism she's faced for talking to people on both sides of the debate — those who advocate for gender affirmation and those who urge more caution. The knowledge of experienced clinicians was sometimes dismissed. 'There are,' she writes, 'few areas of healthcare where professionals are so afraid to openly discuss their views, where people are vilified on social media, and where name calling echoes the worst bullying behaviour. This must stop.'

It's a brave woman who's endured such nonsense for nearly four years of her life.

It was the appearance in court of Keira Bell that brought damage to children to the forefront. She was suing the Tavistock for their haste in giving her puberty blockers and hormones to become a boy which led to her having a double mastectomy. She'd been only 16 when she was treated at the Tavistock and argued in court that it had been too young to give informed consent.

In 2021 she lost the case, but it was her bravery in speaking out and the actions of the Tavistock's whistleblower, the psychiatrist Dr David Bell, that fatally undermined the power the Tavistock had enjoyed. Dr Bell reported that too many children who had come as patients were not fit to make an informed choice. Some were simply too young, some suffered from autism, some were gay. What they needed was talking therapy, not powerful drugs.

Since Dr Hilary Cass began her investigation some of what Dr Bell said has been taken on board — albeit belatedly. The Tavistock finally closed at the end of last month. And a few weeks ago NHS England finally confirmed gender identity clinics would no longer prescribe puberty blockers.

Two new gender clinics are scheduled to open this month in London and Liverpool where the emphasis will be on talking about gender dysphoria. What psychological difficulties is a child facing, what effect is home life having on a girl or a boy? It is surely better to talk about anxieties with an informed professional than take powerful drugs that will change your life forever.

Dr Cass is not only concerned with medical intervention, but 'social transitioning'. It is, she says, 'an active intervention because it may have significant effects on the child or young person in terms of psychological functioning...it is not a neutral act and better information is needed about outcomes.'

I'm hoping this means no more primary school teachers being encouraged to allow kids to change their name without informing parents. They are teachers not psychiatrists.

And if you have a five-year-old son who wants to go to school in his sister's skirt, just let him do it. It's about style, a bit of fun, maybe jealousy or maybe, as in my case, defiance. My son, aged six, trying on shoes for school, opts for widely advertised Princess shoes. 'No,' said the shopkeeper, 'they're for girls'. 'Don't care,' my son replied.

I bought them. One week later, 'Mum,' they're uncomfortable. Can I get some trainers?' Of course. No need to make such a fuss about it.

And Cass must be cheered for her courage and common sense.

 

Nicola's my kind of leading lady

Why on earth would Bridgerton star Nicola Coughlan be surprised to be the romantic lead in the Netflix drama? Why do people assume she finds herself 'hideous', as she asked in a recent interview?

Coughlan is talented, lovely and attractive. As Penelope Featherington, she'll make a fine leading lady in the forthcoming third series of Bridgerton — and give the rest of us hope that you no longer have to be tall and thin to be a sex symbol.

Nicola Coughlan gives us hope that you don't have to be tall and thin to be a sex symbol

 

The worst hospital? It's mine!

It's a worry to find nationwide data places your local hospital as the worst place in the country to break a bone. Especially when the report, produced this week, is by the Royal Osteoporosis Society (ROS).

Twelve years ago, I was rushed to the Royal Free Hospital in Hampstead with an agonisingly painful left arm after I'd slipped on the ice outside my house.

I had an X-ray. A nurse said he wasn't sure what state my humerus was in and sent me home in a sling. A week later, it was found to be so badly broken I needed surgery.

Then last November I fell at home and was rushed to the Royal Free only to find, eventually, that I'd broken a vertebra. After a long wait, they decided to let it heal itself.

On neither occasion was I offered a bone scan. The ROS says every hospital should have a Fracture Liaison Service to ensure bones are tested after the first break and medication given if osteoporosis is detected.

Let's hope I don't break anything else before the change is implemented.