Immediately following the Review's publication, Kamran Abbasi, editor-in-chief of the British Medical Journal, acknowledged that the evidence base for gender medicine-"From social transition to hormone treatment"-is "Threadbare." He called the report "An opportunity to pause, recalibrate, and place evidence informed care at the heart of gender medicine."
In her report, Cass writes that social transition "In an NHS setting" is "An active intervention because it may have significant effects on the child or young person in terms of their psychological functioning and longer-term outcomes." Cass and her team recommend that, for children, mental-health professionals advise parents "On the risks and benefits of social transition as a planned intervention, referencing best available evidence."
If, as established, social transition is an active psychological intervention, the next question is: Does it help? The Biden DOE, which in 2021 encouraged schools to "Use the name a student goes by, which may be different from their legal name, and pronouns that reflect a student's gender identity," thinks so.
The department's position mirrors that of the World Professional Association for Transgender Health, which, in its Standards of Care for the Health of Transgender and Gender Diverse People, Version 8, says, "Research indicates social transition and congruent gender expression have a significant beneficial effect on the mental health of people."
Cass and her team commissioned seven systematic reviews of evidence and medical guideline quality from experts at the University of York, one of which dealt specifically with the question of social transition.
While data on the relationship between social transition and gender-identity outcomes is limited, the possibility that social transition solidifies a cross-sex identity is supported by desistance literature.
Crucially, the kids in those studies had not been socially transitioned in the way gender transition advocates now recommend.
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