Review of the sources underpinning criticisms and misrepresentations of the Cass Review – particularly McNamara et al of “The ‘Integrity’ Project” web page.
Gender medicine and the Cass Review: why medicine and the law make poor bedfellows
In Gender medicine and the Cass Review: why medicine and the law make poor bedfellows, authors Cheung et al. painstakingly review the two sources underpinning the original BMA council motion to ‘publically critique’ the Cass Review. That BMA council motion has now been altered to a ‘position of neutrality’, following widespread protest from the BMA membership, as well as the wider clinical community.
An extract from the abstract of the paper, published in the BMJ’s Archives of Disease in Childhood, reads:
In July, the British Medical Association Council, without consulting its own members, unexpectedly passed a motion calling for a public critique of the
Review, citing concerns over methodological weaknesses – a position it then softened following public criticism from members, concluding that their review would come instead from a position of neutrality. The original motion was based on two non-peer-reviewed online papers, prominently the work of McNamara et al—a paper which was written for a primarily litigious, rather than academic, purpose. We critically examine these sources and analyse the wider
legal context in which they have been applied. We conclude that these sources misrepresent the Cass Review’s role and process (specifically, by mistakenly
comparing the Review to clinical practice guideline development), while many of the methodological criticisms directed at the Cass Review, including its use
of evidence appraisal and systematic reviews conducted by York University, are unfounded. These misunderstandings, based on flawed and nonpeer-reviewed analyses intended for legal (rather than clinical) purposes, jeopardise the implementation of crucial reforms in the care of gender dysphoric youth.
The UK clinical community should move beyond these critiques and focus on the Cass Review’s recommendations to establish a safer, more holistic and
evidence-based service model for children and young people experiencing gender identity issues.