England, Wales and Scotland section of International Socialist Alternative

After Cass: Fight for trans liberation!

By Jack Blacklaws, Socialist Alternative Coventry

The final report of the Cass Review, released in April, is the latest weapon in the right-wing’s war on the open existence of trans people. Though it claims to focus on outcomes for children experiencing gender dysphoria, it starts with the premise that transition is the worst possible outcome for all cases, that it should be slow-rolled until the last possible moment, even recommending that patients shouldn’t be transferred to “adult services” until they are 25! Meanwhile, the report legitimises so-called “exploratory” approaches, a less loaded name for ‘conversion therapy’, where the patient’s trans identity or gender dysphoria is instead pathologised as the result of trauma or neurodivergence.

Indeed, the report makes hay about the “co-occurrence” of gender dysphoria with autism, ADHD, anxiety and depression, implying that these should be addressed rather than providing gender-affirming care and again questioning the ability of trans and gender questioning people to provide informed consent. The influence of anti-trans groups, who seek to frame trans youth as brainwashed and trans adults as ‘insidious groomers’, lays heavily on this report and echoes the homophobic rhetoric of Section 28, legislation introduced under Thatcher which prohibited the “promotion of homosexuality” by local authorities. Hillary Cass herself met with Patrick Hunter, a member of Florida Governor Ron DeSantis’s hand-picked Board of Medicine that are pushing through their own anti-trans legislation.

The report also dismisses over 100 studies on gender affirming care as being “low quality” based on the criticised NewcastleOttawa Scale bias assessment tool, or for not following “double blind trials”, which require secretly giving the subject a placebo. The unethical nature of giving placebos instead of puberty blockers to a trans youth, as well as the obviousness of it failing to block puberty, is apparently lost on the authors.

Despite its blatant conflicts of interest, poor methodology and stunningly abominable conclusions, the Cass Report has been hailed by both Tory and Labour alike as a landmark investigation that must be followed and the heads of Specialised Commissioning have declared they will be implementing it’s recommendations.

Let us be clear: trans people have always existed, do exist and will continue to exist. What is causing the apparent “increase” is the tireless work of those fighting for LGBTQ+ liberation over the years against the inherent bigotry of capitalism and putting the right-wing on the backfoot. In an effort to continue to keep the working class divided against one another, the ruling class has embarked on the demonisation of trans people to distract from the compounding crises of the capitalist system. Even when dressed up as “reports” or “consultations”, the constant litigation and “debate” over the right for trans people to exist openly in society is doing and has already done serious harm to the trans community, through suicides and transphobic murders, such as that of 16 -year old Brianna Ghey.

We call on health unions to fight against this transphobic agenda within the NHS and all trade unions must openly declare their support and actively take part in the struggle for trans liberation, to fight against trans hatred in workplaces and support fellow trans workers and youth. Only through a struggle by workers, rooted firmly in socialist feminism, can we overthrow the capitalist system and achieve true liberation for all.


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