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UK pediatrician who led review of child ‘transitions’ says US medical groups ‘misleading the public’

Published

12 months ago

6 minute read

Dr. Hilary Cass, author of the Cass Review

From LifeSiteNews

By Calvin Freiburger

The American Academy of Pediatrics’ support for surgically and chemically mutilating gender-confused children ‘is now demonstrated to be out of date by multiple systematic reviews,’ Dr. Hilary Cass told the New York Times.

The typically left-wing New York Times published an interview on Monday with consultant pediatrician Dr. Hilary Cass on her comprehensive review of so-called “gender medicine” in the United Kingdom, indicating that awareness of the damage due to surgical and chemical “transitioning” continues to spread despite the best efforts of LGBT activists.

Released in April, 366-page Cass Review was commissioned by National Health Service (NHS) England following ongoing scandals about the practices of British “gender clinics” such as the Gender Identity Development Service (GIDS), operated by the Tavistock and Portman NHS Foundation Trust. The four-year project consisted of comprehensive reviews of current research and international standards, as well as extensive interviews with gender-confused children and adults, family members, detransitioners, doctors, and activists.

It found that “gender medicine” is “built on shaky foundations” and that while such interventions require a great deal of caution, “quite the reverse happened in the field of [so-called] gender care for children,” and that “[w]hile a considerable amount of research has been published in this field, systematic evidence reviews demonstrated the poor quality of the published studies, meaning there is not a reliable evidence base upon which to make clinical decisions, or for children and their families to make informed choices.” Her findings led NHS to stop prescribing puberty blockers to children with gender confusion earlier this year.

Speaking to the Times, Cass explained that she was planning her retirement when she was first asked to tackle the project and was initially apprehensive about wading into the controversy.

“The most important concern for me is just how poor the evidence base is in this area,” she said. “Some people have questioned, ‘Did we set a higher bar for this group of young people?’ We absolutely didn’t. The real problem is that the evidence is very weak compared to many other areas of pediatric practice.”

The Times acknowledged that her “findings are in line with several European countries that have limited the treatments [sic] after scientific reviews. But in America, where nearly two dozen states have banned the care outright, medical groups have endorsed the treatments as evidence-based and necessary,” including groups the paper contacted for its latest story. Cass described American medical consensus as “out of date” on the issue.

“When I was president of the Royal College of Pediatrics and Child Health, we did some great work with the A.A.P. [American Academy of Pediatrics],” she elaborated. “They are an organization that I have enormous respect for. But I respectfully disagree with them on holding on to a position that is now demonstrated to be out of date by multiple systematic reviews.”

“It wouldn’t be too much of a problem if people were saying ‘This is clinical consensus and we’re not sure,” she added. “But what some organizations are doing is doubling down on saying the evidence is good. And I think that’s where you’re misleading the public. You need to be honest about the strength of the evidence and say what you’re going to do to improve it.”

A significant body of evidence shows that “affirming” gender confusion carries serious harms, especially when done with impressionable children who lack the mental development, emotional maturity, and life experience to consider the long-term ramifications of the decisions being pushed on them.

Yet while mounting evidence against youth “gender transitions” is prompting European nations such as the United Kingdom and France, which are normally to the left of America, to move away from the practice, in America, the medical establishment and the Biden administration continues to dig in their heels, despite Biden’s own Substance Abuse & Mental Health Services Administration (SAMHSA) releasing a since-deleted report last year acknowledging that “lesbian, gay, and bisexual adults are more likely than straight adults to use substances, experience mental health conditions including major depressive episodes, and experience serious thoughts of suicide.”

The White House’s comprehensive pursuit of the transgender agenda has included reopening the military to recruits afflicted with gender dysphoria, promoting gender ideology within the military (including “diversity” and drag events on military bases), holding White House events to “affirm transgender kids,” condemning state laws against underage “transitions” as “close to sinful,” promoting underage “transitions” (potentially at taxpayer expense) as a “best practice,” and trying to force federally funded schools to let males into female athletic competitions and restrooms.

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Alberta

Alberta’s move to ‘activity-based funding’ will improve health care despite naysayer claims

Published on May 8, 2025

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From the Fraser Institute

By Nadeem Esmail

After the Smith government recently announced its shift to a new approach for funding hospitals, known as “activity-based funding” (ABF), defenders of the status quo in Alberta were quick to argue ABF will not improve health care in the province. Their claims are simply incorrect. In reality, based on the experiences of other better-performing universal health-care systems, ABF will help reduce wait times for Alberta patients and provide better value-for-money for taxpayers.

First, it’s important to understand Alberta is not breaking new ground with this approach. Other developed countries shifted to the ABF model starting in the early 1990s.

Indeed, after years of paying their hospitals a lump-sum annual budget for surgical care (like Alberta currently), other countries with universal health care recognized this form of payment encouraged hospitals to deliver fewer services by turning each patient into a cost to be minimized. The shift to ABF, which compensates hospitals for the actual services they provide, flips the script—hospitals in these countries now see patients as a source of revenue.

In fact, in many universal health-care countries, these reforms began so long ago that some are now on their second or even third generation of ABF, incorporating further innovations to encourage an even greater focus on quality.

For example, in Sweden in the early 1990s, counties that embraced ABF enjoyed a potential cost savings of 13 per cent over non-reforming counties that stuck with budgets. In Stockholm, one study measured an 11 per cent increase in hospital activity overall alongside a 1 per cent decrease in costs following the introduction of ABF. Moreover, according to the study, ABF did not reduce access for older patients or patients with more complex conditions. In England, the shift to ABF in the early to mid-2000s helped increase hospital activity and reduce the cost of care per patient, also without negatively affecting quality of care.

Multi-national studies on the shift to ABF have repeatedly shown increases in the volume of care provided, reduced costs per admission, and (perhaps most importantly for Albertans) shorter wait times. Studies have also shown ABF may lead to improved quality and access to advanced medical technology for patients.

Clearly, the naysayers who claim that ABF is some sort of new or untested reform, or that Albertans are heading down an unknown path with unmanageable and unexpected risks, are at the very least uninformed.

And what of those theoretical drawbacks?

Some critics claim that ABF may encourage faster discharges of patients to reduce costs. But they fail to note this theoretical drawback also exists under the current system where discharging higher-cost patients earlier can reduce the drain on hospital budgets. And crucially, other countries have implemented policies to prevent these types of theoretical drawbacks under ABF, which can inform Alberta’s approach from the start.

Critics also argue that competition between private clinics, or even between clinics and hospitals, is somehow a bad thing. But all of the developed world’s top performing universal health-care systems, with the best outcomes and shortest wait times, include a blend of both public and private care. No one has done it with the naysayers’ fixation on government provision.

And finally, some critics claim that, under ABF, private clinics will simply focus on less-complex procedures for less-complex patients to achieve greater profit, leaving public hospitals to perform more complex and thus costly surgeries. But in fact, private clinics alleviate pressure on the public system, allowing hospitals to dedicate their sophisticated resources to complex cases. To be sure, the government must ensure that complex procedures—no matter where they are performed—must always receive appropriate levels of funding and similarly that less-complex procedures are also appropriately funded. But again, the vast and lengthy experience with ABF in other universal health-care countries can help inform Alberta’s approach, which could then serve as an example for other provinces.

Alberta’s health-care system simply does not deliver for patients, with its painfully long wait times and poor access to physicians and services—despite its massive price tag. With its planned shift to activity-based funding, the province has embarked on a path to better health care, despite any false claims from the naysayers. Now it’s crucial for the Smith government to learn from the experiences of others and get this critical reform right.

Nadeem Esmail

Senior Fellow, Fraser Institute
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Autism

NIH, CMS partner on autism research

Published on May 8, 2025

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From The Center Square

By 

Officials at the the National Institutes of Health and the Centers for Medicare & Medicaid Services announced a partnership Wednesday to research “root causes of autism spectrum disorder.”

As part of the project, NIH will build a real-world data platform enabling advanced research across claims data, electronic medical records and consumer wearables, according to the agencies.

“We’re using this partnership to uncover the root causes of autism and other chronic diseases,” said HHS Secretary Robert F. Kennedy Jr. “We’re pulling back the curtain – with full transparency and accountability – to deliver the honest answers families have waited far too long to hear.”

CMS and NIH will start this partnership by establishing a data use agreement under CMS’ Research Data Disclosure Program focused on Medicare and Medicaid enrollees with a diagnosis of autism spectrum disorder or ASD.

“This partnership is an important step in our commitment to unlocking the power of real-world data to inform public health decisions and improve lives,” NIH Director Dr. Jay Bhattacharya said. “Linking CMS claims data with a secure real-world NIH data platform, fully compliant with privacy and security laws, will unlock landmark research into the complex factors that drive autism and chronic disease – ultimately delivering superior health outcomes to the Americans we serve.”

Researchers will focus on autism diagnosis trends over time, health outcomes from specific medical and behavioral interventions, access to care and disparities by demographics and geography and the economic burden on families and healthcare systems, according to a news release.

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