The Cass Report, led by Hillary Cass, reviews gender medicine practices in the UK, particularly regarding children and the assessment of gender dysphoria. It concludes that the field lacks robust evidence, with many studies being methodologically flawed. Critics argue over the report's methodology, particularly regarding the exclusion of low-quality studies, which some believe could support opposing narratives. The report has prompted significant changes in clinical practices in England and Scotland, including halting the prescription of puberty blockers. Discussions focus on the validity of the GRADE rating system used to assess study quality and whether excluding low-quality studies from evidence synthesis is appropriate. Critics also highlight ethical concerns regarding the feasibility of conducting rigorous studies in this area, particularly around control groups and blinding. Overall, the debate centers on the adequacy of existing evidence to justify medical interventions for children experiencing gender dysphoria.
