The Studies Show

Un-paywalled: Youth gender medicine & the Cass Review

Dec 31, 2024

Reflecting on the Cass Review, the discussion highlights the controversies surrounding youth gender medicine and the lack of strong evidence in the field. The closure of the Tavistock clinic is analyzed, alongside the challenges families face navigating gender dysphoria treatment. The critical evaluation of existing studies on puberty blockers raises ethical questions about safety and efficacy. Amidst rising referrals, the episode emphasizes the need for rigorous, evidence-based practices in healthcare and open dialogue on the complexities of gender identity.

01:15:24

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Quick takeaways

The Cass Review highlights the alarming lack of robust evidence supporting treatments for youth gender dysphoria, raising questions about their efficacy.

An overwhelming increase in patient referrals to the Tavistock clinic indicates shifting societal attitudes towards gender identity, complicating treatment implications.

Critics of the Cass Review argue that its methodological rigor may inadvertently hinder the development of knowledge in the evolving field of youth gender medicine.

Deep dives

The Context of Youth Gender Medicine

Youth gender medicine, particularly regarding gender dysphoria treatment, is explored amidst a complex backdrop. The UK's only gender clinic, the Gender Identity Development Service (GIDS) at Tavistock, has witnessed a significant rise in patient referrals, from two in its first year to over 2,500 by 2017-2018. Despite this increase in treatment accessibility, the Cass Review reveals a concerning lack of robust evidence supporting treatment efficacy, highlighting that many studies have been exaggerated or misrepresented. The review calls for a careful examination of the psychological dimensions and potential distress experienced by youth with gender incongruence, emphasizing the distinction between incongruence and clinically significant discomfort.

Intro

1min

Exploring the Controversial Cass Review on Youth Gender Medicine

2min

Understanding GIDS and Youth Gender Dysphoria

5min

Unpacking Youth Gender Medicine: Trends and Controversies

18min

Navigating NHS Guidelines in Youth Gender Medicine

4min

Examining Youth Gender Medicine

9min

Examining Youth Gender Medicine: The Cass Review Critique

17min

Challenges in Evidence-Based Medicine and Ethics in Clinical Trials

2min

Navigating the Complexities of Gender Medicine

18min

This week, as a gift for New Year’s Eve, we’re opening up a previously-paywalled episode so that everyone can listen. It’s our episode from April 2024 on “Youth gender medicine & the Cass Review”. Since the show notes were previously behind the paywall, they’re copied below.

If you’d like to listen to all our paywalled episodes—which are of course ad-free, like this one—you can subscribe by visiting thestudiesshowpod.com.

Normal service will be resumed next week. Happy New Year!

Show notes

* The Cass Review’s final report

* List of systematic reviews from University of York researchers that were commissioned by the Cass Review

* Hannah Barnes on why the Tavistock gender identity clinic was forced to close

* VICE interview with a Tavistock doctor, including information on patient numbers

* Original Dutch single-case study on puberty blockers

* Somewhat larger Dutch study of puberty blockers from 2011

* The “Early Intervention” study from England (not published until 2021)

* Article that’s critical of the “cis-supremacy” in the Cass Review

* BMJ editorial on the Cass Review

* Billy Bragg claims that the Cass Review only included 2 studies out of 102

* Owen Jones’s video where he claims studies were “arbitrarily” excluded from the report

* Fact-checking post from Benjamin Ryan, covering some of the criticisms of the Cass Report

* Hilary Cass interviewed by The Times

* Episode of BBC More or Less that addresses some of the criticisms

* 2020 study on the small proportion of medical treatments where there’s strong evidence

* More recent (2022) study by the same authors finding an even more depressing picture: “More than 9 in 10 healthcare interventions studied within recent Cochrane Reviews are not supported by high-quality evidence, and harms are under-reported”

* The book Medical Nihilism

* The BMJ review of the book, quoted in the episode

Credits

The Studies Show is produced by Julian Mayers at Yada Yada Productions.

This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.thestudiesshowpod.com/subscribe

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The Studies Show

Un-paywalled: Youth gender medicine & the Cass Review

Podcast summary created with Snipd AI

Quick takeaways

Deep dives

The Context of Youth Gender Medicine

Evidence Weakness and Treatment Implications

Rising Demand and Changing Demographics

Treatment Evidence: Puberty Blockers and Cross-Sex Hormones

Controversies Surrounding Treatment and Evidence Interpretation

Remember Everything You Learn from Podcasts