Parents, 選挙運動者s and former 患者s of the NHS's transgender services for children have あられ／賞賛するd a new 報告（する）／憶測 that 結論するd children 尋問 their gender were 存在 始める，決める on irreversible 治療 paths without 医療の 証拠.
The Cass 報告（する）／憶測 結論するd that the 合理的な／理性的な for giving children puberty blockers 'remains 不明瞭な' and that clinicians could not 決定する 'with any certainty' which young 患者s would go on to live life 永久的に in a transgender 身元.
Hannah Barnes, a prolific reporter on NHS?gender services, said the 報告（する）／憶測 was an 'incredibly 徹底的な' piece of work 診察するing NHS gender services, 追加するing that?society 借りがあるd its author, Dr Hilary Cass, a '抱擁する 負債 of 感謝'.
Others, 含むing detransitioned former 患者 Keira Bell and gender-批判的な 選挙運動者s such as Helen Joyce have welcomed the 報告（する）／憶測's findings.
主要な paediatrician Dr Cass 結論するd there was a '欠如（する） of high-質 研究' on the 影響s of giving puberty blockers to transgender children, 追加するing that the tenets of gender care were built on '不安定な 創立／基礎s'.
Hannah Barnes told Good Morning Britain she was 尋問 why 'it has taken so long' for the NHS's gender services to be scrutinised
She told Ed Balls and Kate Garraway that children 捜し出すing gender-断言するing care were a 'very 攻撃を受けやすい 全住民 of young people'
Dr Hilary Cass 持つ／拘留するs a copy of The Cass Review, her 388-page deconstruction of NHS gender 身元 services
Keira Bell, one of the most high-profile detransitioners in the UK, who took the Tavistock clinic to 法廷，裁判所 over the 治療 she was given in 移行ing in the first place
Helen Joyce said of the care practices criticised in the Cass Review: 'Bad help is worse than nothing'
Ms Barnes?has 報告（する）／憶測d extensively on gender services for the likes of BBC Newsnight, The 後見人 and is 現在／一般に associate editor at the New 政治家, self-述べるd as the UK's '主要な 進歩／革新的な political and cultural magazine'.?
She told Good Morning Britain's Ed Balls and Kate Garraway of the 報告（する）／憶測:?'It's incredibly 徹底的な - I think society 借りがあるs Dr Hilary Cass and her team a 抱擁する 負債 of 感謝 for the time that she's put in and the care - the language is very compassionate.
'For me, it tells us what we've known for very many years and really I'm left with the question of why it has taken so long... to really 取り組む this. We've known this is a very 攻撃を受けやすい 全住民 of young people for many years.
'We've known the 証拠 base is weak and 厳しく 欠如（する）ing for very many years. What has been recommended today is the 権利 pathway - you take a young person and you 扱う／治療する them as an individual, as a whole 存在.'
Keira Bell, who 移行d from a woman to a man at the age of 16 before later detransitioning, said 簡単に on X, 以前は Twitter: 'Thank you Hilary Cass.'
Helen Joyce, director of advocacy at gender 批判的な （選挙などの）運動をする group Sex 事柄s, told BBC 無線で通信する 5 Live: 'It's an amazing piece of work and a stinging 起訴，告発 of the NHS.
'Bad help is worse than nothing. I'm sorry to say that the NHS 治療 for gender-苦しめるd children has been worse than nothing.'
Joyce 支持するs 堅固に against what she labelled in a February 声明 the 'pernicious 影響（力） of gender-身元 ideology'.
But Big Brother contestant Hallie Clarke, who is transgender, told the 駅／配置する that she did not buy the notion clinicians were 強制的に guiding children に向かって 移行ing.
Ms Clarke, who says she began to 移行 at, 13, said: 'People are more 確信して to come out and 調査する their gender 身元. It's not a 事例／患者 of them 存在 影響（力）d. People feel more 確信して 捜し出すing out 医療の health with their 身元.'
NHS England has 発表するd a review into the use of hormones, and has asked 地元の health service leaders to pause first 任命 申し込む／申し出s at adult gender clinics to young before before they turn 18.
It ーするつもりであるs to carry out a major review of adult services に引き続いて the Cass review, which was 焦点（を合わせる）d on services 目的（とする）d at children.
The 388-page Cass 報告（する）／憶測 結論するd that the 合理的な／理性的な for 抑えるing puberty in young children 'remains 不明瞭な', with 'weak 証拠' on the 衝撃 such 治療s have on children.
Dr Cass 設立する that a 医療の pathway would not be the best way to manage questions about gender 'for most young people' without also 演説（する）／住所ing other 関心s such as mental health or neurodivergent 条件s such as autism.?
She used the review to 攻撃する，衝突する out at all 味方するs of the 審議 over how best to 扱う／治療する children 捜し出すing gender-断言するing care, 公式文書，認めるing that the discussions had become exceptionally '有毒な'.
Dr Cass said she had been criticised by both those 支持するing for transgender healthcare and those whom she said '勧める(d) more 警告を与える' - and （刑事）被告 all parties of 'exaggerat(ing) or misrepresent(ing)' 熟考する／考慮するs to support their own 見解（をとる）s.
In 発言／述べるs seemingly 演説（する）／住所d to those on all 味方するs of the discussion, she 追加するd: 'There are few other areas of healthcare where professionals are so afraid to 率直に discuss their 見解（をとる）s, where people are vilified on social マスコミ, and where 指名する-calling echoes the worst いじめ（る）ing behaviour. This must stop.
'Polarisation and stifling of 審議 do nothing to help the young people caught in the middle of a 嵐の social discourse, and in the long run will also 妨害する the 研究 that is 必須の to finding the best way of suppo rting them to 栄える.'
After the 出版（物） of the 暫定的な Cass review in 2022, the Tavistock transgender clinic 発表するd it would の近くに 負かす／撃墜する the Gender 身元 開発 Service (GIDS)
総理大臣 Rishi Sunak has welcomed the 報告（する）／憶測 and called for 'extreme 警告を与える' in 扱う／治療するing youngsters i n 未来
Her 報告（する）／憶測, which?含むs 32 推薦s to 精密検査する NHS gender services, 公式文書，認めるs: 'The reality is that we have no good 証拠 on the long-称する，呼ぶ／期間／用語 結果s of 介入s to manage gender-関係のある 苦しめる.'
The 推薦s 含む:
- 分配するing gender services across NHS paediatric services, rather than pooling them at a small number of 献身的な clinics
- 'Holistic' 査定／評価s for children 捜し出すing gender care, 含むing 審査 for neurodevelopmental 条件s such as autism, and a mental health 査定／評価
- Separate 治療 pathways for prepubescent children and their families so parents can talk about how to support their child in a 'balanced and 非，不，無-judgemental way'?
- 供給するing 独立した・無所属 services for those who wish to detransition, 公式文書，認めるing that they may not wish to engage with the same specialists as before
- The 創造 of an NHS 研究 programme looking at the 結果s for those who 現在の to gender services
- 'Extreme 警告を与える' over 供給するing masculinising or feminising hormones to the over-16s - with 指導／手引 示唆するing these should not be given until the age of 18
Dr Cass' 熟考する／考慮する was?（売買）手数料，委託（する）／委員会／権限d nearly four years ago as 関心s were raised about the Tavistock Gender 身元 開発 Service (GIDS), which has since been の近くにd 負かす／撃墜する and is 存在 取って代わるd with two 地域の clinics.
The clinic had been 始める，決める up 供給するing psychotherapeutic services to those 尋問 their gender 身元 but had, the 報告（する）／憶測 said, 移行d to 定める／命ずるing a greater number of hormonal 麻薬s as part of that 治療.???
の中で the most high-profile of detransitioning people is Keira Bell, who was 定める／命ずるd puberty blockers as a 十代の少年少女 as she 移行d from 女性（の） to male, を受けるing a 二塁打 mastectomy at 20.
However, she later regretted her 移行, arguing it happened at a time of poor mental health, and took the Tavistock clinic to 法廷，裁判所.?
But the 事例／患者 saw the 法廷，裁判所 of 控訴，上告 支配する that children under 16 can take puberty blockers without parental 同意 供給するd that clinicians are 満足させるd they are 'Gillick competent' - 円熟した enough to understand what is 存在 提案するd.
NHS England has since said it will no longer routinely 定める／命ずる puberty blockers to children unless they are part of a 臨床の 裁判，公判.
The 報告（する）／憶測 was also （売買）手数料，委託（する）／委員会／権限d because of the greater number of people 捜し出すing gender-断言するing care on the NHS.?
She has 主張するd the review was 'not about defining what it means to be trans, nor is it about 土台を崩すing the 有効性，効力 of trans 身元s, challenging the 権利 of people to 表明する themselves, or rolling 支援する on people's 権利s to healthcare'.
A 広報担当者 for Bayswater, a group that supports parents of trans children, said the Cass 報告（する）／憶測 'repr esents a sea change in the 治療 of trans-identified children and young people'.?
総理大臣 Rishi Sunak welcomed the 報告（する）／憶測 and called for 'extreme 警告を与える' in 扱う／治療するing youngsters in the 未来.
Asked about the Cass 報告（する）／憶測 on LBC, the PM said: 'The Cass 報告（する）／憶測 rightly 向こうずねs a スポットライト that we need to 演習 extreme 警告を与える on these 問題／発行するs.?
'These things are not 中立の 行為／法令／行動するs. We do not know the long 称する，呼ぶ／期間／用語 影響s.?
'I think it (the 報告（する）／憶測) is 概して in 協定 with the direction of travel of the 政府.?
'It is not 権利 kids are 支配するd to さまざまな different things. We should 行為／法令／行動する 慎重に.'
Tory 大臣 Laura Farris (pictured) said there would be a '根底となる change of direction' in children's gender services に引き続いて the 出版（物） of the Cass 報告（する）／憶測
影をつくる／尾行する home 長官 Yvette Cooper (pictured) said 労働 受託するd all of the 報告（する）／憶測's 推薦s, 追加するing that children had been '不正に let 負かす／撃墜する'
犠牲者s and 保護（する）／緊急輸入制限ing 大臣 Laura Farris said there would be a '根底となる change of direction' as a result of the Cass Review's final 報告（する）／憶測.
She told Sky News Breakfast: 'We began the work on changing it after her 暫定的な 報告（する）／憶測 was published, but I think you can 推定する／予想する to see a 根底となる change of direction that comes out of this.'
Ms Farris 追加するd: 'We are going to have 地域の support centres across the UK so that a child who is 尋問 their gender will be given a holistic 一括 of support.
'And not just funnelled 負かす／撃墜する an irreversible pathway where they may find that they reach adulthood and then, a bit like Keira Bell, wonder how on earth they were ever 許すd to take those steps.'
影をつくる／尾行する home 長官 Yvette Cooper said children had been '不正に let 負かす／撃墜する', 追加するing that 労働 受託するd all of the 報告（する）／憶測's 推薦s.
The 労働 MP for Normanton, Pontefract and Castleford told Sky News Breakfast: 'The 報告（する）／憶測 is very （疑いを）晴らす that children and young people have been 不正に let 負かす／撃墜する and have been receiving 治療 that's not based on 証拠.
'So I think the Cass Review is really important - we welcome it, 労働 受託するs all of its 推薦s.
'I think they should be 器具／実施するd now, as 速く as possible, and we would like to work with the 政府 on doing that.'
Asked about children receiving puberty blockers, Ms Cooper said it is 'very troubling'.
But Robbie de Santos, director of （選挙などの）運動をするs and human 権利s at LGBTQ+ 権利s organisation Stonewall, had a mixed 返答.
'What is important, above all, is that trans and gender-diverse children get the 質 healthcare that they need and deserve,' he said.
'The Cass Review can play a 決定的な 役割 in 達成するing this 目的（とする） if its 推薦s are 器具／実施するd 適切に.
'Many 推薦s could make a 肯定的な 衝撃 ? such as 拡大するing the 準備／条項 of healthcare by moving away from a 選び出す／独身 国家の service に向かって a 一連の 地域の centres while recognising that there are many different 治療 pathways that trans young people might take.
'But without 予定 care, training or その上の capacity in the system, others could lead to new 障壁s that 妨げる children and yo ung people from 接近ing the care they need and deserve.'
Trans 青年 support charity Mermaids, 一方／合間, said the '現在の system is failing trans 青年' and called for the NHS to 'resist 圧力s from those who 捜し出す to 限界 接近 to healthcare'.
Instead, it said, the health service should '行為／法令／行動する 緊急に to 供給する gender services which are timely, supportive and holistic'.??
The charity 追加するd: 'We are pleased the 発言する／表明するs and experiences of trans young people appear to have been heard and 尊敬（する）・点d, and we welcome Dr Cass’ calls for trans children and young people, and their families, to be "扱う／治療するd with compassion and 尊敬（する）・点".'
From troubled childhoods to 影響（力）s at school... how young people come under so much 圧力
By Alex 区, social 事件／事情／状勢s 特派員 for the Daily Mail
The 独立した・無所属 review of gender services for children and young people was （売買）手数料，委託（する）／委員会／権限d nearly four years ago.
An 暫定的な 報告（する）／憶測 was produced by Dr Hilary Cass, who led the review, in February 2022. She has now published her final findings.
At nearly 400 pages, the review 診察するd the challenges 直面するing NHS England's gender services for children and young people and made more than 30 推薦s.
These are some of the 重要な 主題s Dr Cass's 報告（する）／憶測 演説（する）／住所d:
有毒な 審議?
In her foreword to the review, Dr Cass 警告するd 'the 有毒性 of the 審議 is exceptional'.
She 報告（する）／憶測d 存在 criticised for engaging with all 味方するs of the 審議, which she 述べるd as s o vicious 'professionals are so afraid to 率直に discuss their 見解（をとる）s'.
Dr Cass said while there was little reliable 証拠 on trans healthcare, 'results of 熟考する／考慮するs are 誇張するd or misrepresented by people on all 味方するs of the 審議'.
She 問題／発行するd a 決起大会／結集させるing cry to clinicians that 'we have to 削減（する） through the noise and polarisation' to 供給する trans children with the same 基準 of care as others.
The 388-page Cass Review was published today after four years of speaking to specialists and reviewing the NHS's services for transgender children
Detransitioned woman Keira Bell speaking outside the 王室の 法廷，裁判所s of 司法（官） in 2020. She 最初 won her 事例／患者 against the Tavistock clinic before it was overturned on 控訴，上告
Schools
Dr Cass could only make 推薦s for NHS England, with classrooms outside of her remit.
But the review sought to lay the 基礎 for 政府 to introduce clearer 指導基準s on social 移行ing in schools.
Dr Cass said 'the importance of what happens in school cannot be over-概算の', in a 隠すd 言及／関連 to 最近の 非，不，無-statutory 指導／手引.
The systematic review 設立する there was no （疑いを）晴らす 証拠 social 移行 had a 肯定的な or 消極的な 衝撃 on a child's mental health.
But it 設立する those who socially 移行d 'at an earlier age' or before seeing a 医療の professional 'were more likely to proceed to a 医療の pathway'.
It also 問題／発行するd a 警告 to those 捜し出すing to 除外する parents, 明言する／公表するing they 'should be 活発に 伴う／関わるd in 決定／判定勝ち（する） making unless there are strong grounds to believe that this may put the child or young person at 危険'.
私的な clinics?
The r eview 設立する that young people had been driven to 私的な providers after sitting on the NHS waiting 名簿（に載せる）／表（にあげる）.
焦点（を合わせる） groups told Dr Cass they felt there was a '軍隊d choice' to use 私的な clinics because NHS 準備／条項 took too long to 接近. Dr Cass also said she was 関心d about the use of unregulated 医薬s by 'providers that are not 規制するd within the UK'.
She had been told GPs were 関心d they had been 'pressurised to 定める／命ずる hormones after these have been 始めるd by 私的な providers'.
But the review 結論するd GPs should not 'be 推定する／予想するd to enter into a 株d care 協定 [with a] provider, 特に if that 私的な provider is 事実上の／代理 outside NHS 指導／手引'.
Dr Cass recommended a 'follow-through service' for 17 to 25-year-olds to 保護する 十代の少年少女s '落ちるing off a cliff 辛勝する／優位' in care when they 攻撃する，衝突する 17
Dr Cass said: 'にもかかわらず the best 意向s of everyone with a 火刑／賭ける in this コンビナート／複合体 問題／発行する, the 有毒性 of the 審議 is exceptional' (在庫／株 Image)
世代 Z
A large 量 of work went into understanding the 特徴 of trans children and young people.
The review 設立する 世代 Z and some younger Millennials had different beliefs about the fluidity of gender compared with older 世代s.
It 特記する／引用するd a US 調査する which showed Gen Z adults were the first 世代 to 答える／応じる negatively to the 声明 'there are only two genders'.
The 調査する 設立する the 態度s had changed quickly ? within a six-month period in 2020.
Dr Cass's foreword also 言及／関連d those who identified as 非，不，無-binary ? people who do not identify as 排他的に male or 女性（の） ? 述べるing it as 'the fastest growing group identifying under the trans umbrella'.
Traumatic experiences
The systematic review 設立する there was little 研究 on '逆の childhood experiences', but the 熟考する／考慮するs they did find showed high 率s の中で children referred to gender services.
They 設立する between 11 to 67 per cent had 苦しむd 連合させるd neglect or 乱用; 15-20 per cent had been 肉体的に 乱用d; 5-19 per cent had been sexually 乱用d; and 14 per cent had been emotionally 乱用d.
Traumatic experiences to family members were also a 与える／捧げるing factor, with maternal mental illness or 実体 乱用 特記する／引用するd in between 53 per cent and 49 per cent of 事例／患者s.
Paternal mental illness or 実体 乱用 was 設立する to 存在する in 38 per cent of 事例／患者s. （危険などに）さらす to 国内の 暴力／激しさ was 現在の in between 23 to 25 per cent of 事例／患者s and death or 永久の hospitalisation of a parent in 8 per cent to 19 per cent of 事例／患者s.
While the data had 制限s, a review of the first 124 事例／患者s at the NHS Gender 身元 開発 Service (Gids) 設立する more than a ４半期/4分の1 of all referrals had spent some time in care.
Nearly half of all referrals had experienced living with only one parent.
De-移行ing?
One of Dr Cass's 推薦s was that individuals thinking about de-移行ing ? stopping or 逆転するing a gender 移行 ? should be cared for by a separate service.
She 公式文書，認めるd NHS England should recognise 'they may not wish to re-engage with the services whose care they were 以前 under'.
The 推薦 was 知らせるd by experiences of people who told the review they regretted 移行ing.
It 設立する they may 'be hesitant to engage with the gender services that supported them through their 初期の 移行'.
