Today, August 1st 2024, the AMRC chose to dismiss the critical appraisal of the Cass review findings by Yale and No-one et al, risking global discreditation rather than addressing the criticism. In it, they describe the "validity of the evidence" and "consequently the findings" as issues, rather than directly addressing the problems of double standards, high risk of bias, and methodological floors in its process and findings. Further, the body claims "speculative work risk[ing] greater polarisation". However, the criticisms, rather than speculating on the evidence base directly, analyse and criticise the methodology highlighting how the Cass review failed to meet academic standards for minimising bias and how it subverted the process of creating clinical guidelines. This leaves the NHS, its colleges, and practitioners vulnerable to discreditation worldwide.
This astonishing statement comes to light as clinicians and academics alike raise concerns in the light of these post-publication critical appraisals. Global organisations, such as WPATH, the World Professional Organisation for Transgender Health and the United States Professional Association for Transgender Health were some of the first to raise concerns, followed by academics in the United Kingdom, and abroad. Even the World Health Organisation recommends "Gender affirming care"(meaning psychological support and medical transition if required ). While the AMRC claims "greater polarisation", its actions seek to politicise and silence rather than address the concerns in academic discourse. If anything, they add fuel to the fire.
Even the member organisation, the Royal College of Psychiatrists published quite a critical statement following the Cass report hinting at (among other things such as highly restrictive service provision due to limited resources) the glaring hole in the report: not including trans young people and adults in its production. This flaw was later highlighted by the Yale review criticising the way it
"subverted the well-established process for making clinical recommendations from systematic review findings".
This suggests at least some agreement among dissenting bodies from both sides. "There is a strong view that the report makes assumptions in areas such as social transition and possible explanations for the increase in the numbers of people who have a trans or gender diverse identity, which contrasts with the more decisive statements about treatment approaches. During implementation, these views should be taken into account to ensure every child, young person and their families feel supported by all. This will require individuals with lived experience being directly and comprehensively involved in the ongoing process. "
The "transgender issue", so highly charged and politicised, is clearly breaking cohesion of its member bodies, following the British Medical Association (BMA) statement yesterday.
While the rest of the world is mostly in agreement with the principles of gender-affirming care, the UK seems committed to punitive measures and restrictive healthcare, ensuring that no transitioned women will ever play competitive sport (with some organisations requiring NOT going through a "male puberty" as a condition of entry). Not treating young people's physical dysphoria is not a neutral option and transitioned women will face exclusion from sport, and in need of future operations such as vocal surgery, facial feminisation surgery and breast augmentation. Not to mention that they are more likely to appear physically different to their cisgender peers, leaving them open to a lifetime of discrimination.
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