The upcoming review emphasizes the need for holistic mental health support over immediate gender transition paths for children

A groundbreaking report due for release this week is anticipated to mark a significant shift in how transgender children are supported, recommending a more cautious approach towards gender transition. Spearheaded by Dr Hillary Cass, the review is expected to challenge current practices, suggesting that children who identify as transgender might also be grappling with mental health issues.

The Cass review awaited with keen interest, aims to reshape the support and medical treatment extended to transgender children. Amid increasing concerns over children changing gender at school without parental consent and the contentious use of puberty blockers, the report’s findings could redefine protocols in England’s NHS and beyond.

Sources close to the review have indicated it will highlight a disproportionate occurrence of mental health problems among children who identify as transgender, often rooted in challenging family dynamics or experiences of abuse. The review is also likely to discuss the higher incidence of neurodiversity within this group.

Central to the report’s recommendations is the prioritization of counselling to address these underlying issues comprehensively, rather than fast-tracking children onto a path of gender transition. This approach underscores a shift towards treating the child’s well-being holistically, rather than focusing solely on gender identity concerns.

The review is also set to express reservations about the automatic assumption that transitioning genders is in the best interest of the child. It calls for extreme caution in the use of puberty blockers and cross-sex hormones, extending this cautionary stance to individuals over 18 years of age.

Particularly alarming to the review authors is the surge in the number of young girls seeking to transition to boys, a group believed to require additional support. This observation aligns with Downing Street’s recent statements, emphasizing child and adolescent safety and well-being as paramount, and heralds potential government action based on the review’s conclusions.

In 2022, the interim Cass report already pointed to the complexities surrounding social transitioning in schools, describing it as “not a neutral act.” It led to the restructuring of the NHS’s approach to gender identity services, notably with the closure of the Tavistock and Portman NHS Trust’s service in London. The final report is expected to delve deeper, advising against allowing very young children to socially transition, citing the risk of cementing a trans identity that might have otherwise resolved naturally.

With the NHS’s recent ban on prescribing puberty blockers to minors outside of clinical trials, the Cass report adds another layer to the ongoing discussion about the best approaches to support transgender children. It highlights the necessity of viewing each child’s situation through a holistic lens, considering all possible underlying issues before making life-altering decisions.

The impending release of Dr. Cass’s review signals a critical moment in the conversation around gender identity and children’s mental health, urging a balanced, careful approach that prioritizes the long-term well-being of each child.