The Cass Report

You remember that? I wrote about it here, here, and here. The report condemned puberty blockers, well a new report is out this time from Australia.

Puberty blockers a 'safe, effective and reversible' form of gender-affirming care, finds review triggered by Westmead Hospital investigation
ABC News Australia
By Patricia Karvelas
September 6, 2024

In short:
An independent review into gender-affirming care for children has found that puberty suppression treatment is still "safe, effective and reversible".
The NSW government commissioned the report in the wake of a Four Corners investigation into Westmead Hospital's troubled gender clinic.

What's next?

• The review calls for more long-term quality research, acknowledging the strength of the evidence is low.
• An independent review commissioned by the NSW government in the wake of a Four Corners story into gender-affirming care for children has found that puberty suppression treatment is still "safe, effective and reversible" but calls for more long-term quality research, acknowledging the strength of evidence is low.
• The NSW government commissioned the report by the Sax Institute in the wake of a Four Corners report into gender-affirming care and a growing dispute among some clinicians in NSW about what was best for children with gender issues, as a polarising and sometimes toxic debate over the gender "affirmation" model plays out around the world.
• Gender-affirming care can include puberty blockers to suppress puberty for young people distressed by their changing body. In some cases, this is followed by cross-sex hormones to change people's bodies to align with their gender.

Meanwhile back in Britain…

BMA stance on Cass review of transgender care ‘has damaged its reputation’
‘Climate of fear’ at British Medical Association after it rejected findings of landmark study, leading member claims
Jacky Davis: The BMA no longer speaks for doctors trying to protect children
The Guardian
By Denis Campbell, Health Policy Editor
7 Sep 2024

The British Medical Association has threatened the reputation of all UK doctors by rejecting the findings of the landmark Cass review of transgender healthcare, a leading member of the BMA has told the Observer.

Dr Jacky Davis claims that the doctors’ union’s stance on the Cass review is “irrational”, has created a “fracture” between its leadership and the grassroots doctors it represents and left the medical profession “in an uproar”.

The BMA refused to endorse the findings of Dr Hilary Cass, whose review was published in April and was widely welcomed. It claimed the review contained “unsubstantiated recommendations” and its council called on members to “publicly critique” it. Last month, the BMA also called for the ban on prescribing puberty blockers for under-18s to be lifted.

The far-right in Britain just like the far-right here,

Doctors on the BMA’s ruling council who have dared to challenge its criticism of the Cass review have been subject to “abuse” and its decision-making body is now shrouded in “a climate of fear and intimidation”, Davis claims.

Writing in the Observer, Davis, who has been a member of the association’s council for 18 years, says: “The BMA now finds itself isolated in its opposition to Cass, and with its reputation and integrity damaged.”

All of this negative press is having an affect on trans people here.

Transgender health care bans are sweeping across America. So are the repercussions
The Hill
By Laura Stamm
September 7, 2024

The 11th Circuit Court of Appeals recently allowed Florida’s ban on gender-affirming care for transgender youth to go back into effect.

In a dissenting opinion, Judge Charles Wilson stated, “This matter is a medical issue, where patients are best left to make decisions alongside health professionals, with access to complete, unbiased information, as needed.”

Wilson’s words demonstrate how bans like the one in Florida not only affect transgender individuals, but also disrupt health professionals’ ability to communicate with patients about evidence-based care.

While we should not forget transgender youths and their families are the central target of these bans, the legislation also interferes with healthcare providers’ ability to do their jobs. The systemic impact of these providers’ moral distress, and the medical brain drain and burnout that follows, means that these bans affect every single person in this country seeking health care.

As an LGBTQ health researcher, one of my current projects is interviewing gender-affirming care providers across the country to understand the impact of legislation on their practice. One thing has become abundantly clear: providers of gender care also provide other types of essential care to the general population.

Yup, my endo also treats me for my diabetes and she treats a host of other endocrine diseases.

While it’s true that a small number of provider specialists work solely at gender health clinics, the majority of people who provide gender-affirming care work in diverse fields of medicine, including pediatrics, adolescent medicine, family medicine, obstetrics and gynecology, and endocrinology, and are critical to providing lots of other types of care to all types of patients.

For example, one family medicine provider in the Midwest which provides gender-affirming care is also a key provider in a rural medicine clinic that serves multiple counties. That provider delivers babies, prescribes antidepressants, diagnoses acute health incidents and provides general primary care to people of all ages. Should the state pass a ban and cause this provider to move to a permissive state, the entire patient population will suffer.

Trans people have been fleeing the Republican states but they are not the only ones fleeing…

An increasing number of clinicians are moving to other parts of the country due to gender-affirming care bans and the politicization of medicine. Laws banning essential care for transgender patients interfere with providers’ medical judgment and ability to make healthcare decisions with patients and families. Additionally, providers must take on heavy administrative and financial burdens to stay up to date on the legal landscape. Together, these conditions often are the cause of medial brain drain.

However, it is not just doctors fleeing but also the students, who want to learn in states that only teach you half of what you need to know; how to treat a patient who needs a medical abortion? Or how to treat us.

Moreover, medical students, residents and fellows are electing not to attend training programs in states where they cannot learn to provide gender-affirming care. Pediatrics residency programs and adolescent medicine fellowship programs are not filling in states like Iowa, Alabama and Texas because learners want a comprehensive education. If pediatric training programs aren’t filled, there will be shortages of providers for children and adolescents in these areas. This will lead to access issues and higher healthcare costs, and will disproportionately impact states in the South and large rural areas where significant health disparities already exist.

One day the citizens in the Republican states are going to wake up one day and wonder where all the doctors went.

Vote Blue to end this madness.