If you have been following the controversies on care for so-called transgender children, you have likely heard that the UK has, along with most European countries, reversed course on the medicalization of gender confusion in children. 

Even the Dutch, who invented the "Dutch Protocol" that normalized the use of puberty blockers, hormones, and surgery to "treat" people who think they are transgender, are abandoning the practice. They have all done so because the evidence isn't there that this helps, and there is lots of evidence piling up that these "treatments" have devastating consequences for children, including a doubling of suicide rates. 

Oops. Who could have predicted that? (Raises hand). 

WPATH, the World Professional Association of Transgender Healthcare, is under tremendous strain as the House of Cards is falling everywhere outside the United States, and they are regrouping and firing back at their critics both as an organization and through their allies. 

One shot across the bow was just released--an attack on the Cass Review that has led Britain to reverse course, and the response is a doozy.  

WPATH (@wpath) hits back at the Cass Review (@thecassreview) (and by extension NHS England) through its journal, the International Journal of Transgender Health.

"The Cass Review: Cis-supremacy in the UK’s approach to healthcare for trans children."

Haven't read the piece in…

— Leor Sapir (@LeorSapir) March 14, 2024

I am not going to take you through their farrago of lies and distortions because the response is self-refuting in the first few paragraphs. It is those that bear study, because they tell you everything you need to know about how WPATH conceives science works. Once you understand these paragraphs, you will be convinced that these people are dangerously insane. 

First things first: Cal Horton, a professor for the Centre for Diversity, Research, Policy and Practice, Oxford Brookes University, Oxford, UK, is writing a critical review of the Cass Review. The Cass Review was commissioned by the British government to look into allegations that the Tavistock Clinic, which has since been closed, was engaged in horrific practices that were resulting in harm to kids referred there for gender care. 

The charge given to Hilary Cass was to review all the evidence on "gender-affirming" treatment and make recommendations based on the best science available. Cass' resume is impressive:

Dr Hilary Cass was appointed by NHS England and NHS Improvement to chair the Independent Review of Gender Identity Services for children and young people in late 2020.

A former President of the Royal College of Paediatrics and Child Health from 2012-2015, Dr Cass recently finished a term as Chair of the British Academy of Childhood Disability (2017-2020).  

Although retired from clinical practice, she remains an honorary Consultant Paediatrician at Evelina London Children’s Hospital, Guy’s & St Thomas’s NHS Foundation Trust, where she was also previously Director of Education and Workforce.  

There is little reason to believe that Cass went in with an ideological agenda, both because the NHS had more than enough reason to hope that they would not be responsible for committing massive harm to patients and because her work mirrors that coming out of all European research in the past few years. There is little daylight between the findings, many of which were developed by people who were originally advocates of medicalizing gender care. 

The Cass Review has led to a 180 degree reversal in British policies, and of course WPATH is rightly freaked out about this. 

Now, let's examine Cal Horton's "takedown" of the Cass Review and explain why it would be laughably silly if it were so disturbingly revealing about how WPATH does "science."

The part I want to focus on is the "Methodology" section, which tells you everything you need to know:

Qualitative analysis

The dataset was uploaded into NVivo software and analyzed utilizing broad and unstructured inductive coding, combining qualitative document analysis (Bowen, Citation2009; Mackieson et al., Citation2019) with a critical review methodology. A critical review is inherently and intentionally subjective (Grant & Booth, Citation2009), bringing a reviewer’s perspective and positionality into analysis and reflection on a body of work (Paré et al., Citation2015; Temple Newhook et al., Citation2018). I approached this analysis as a non-binary researcher, as a parent of a trans child, and with experience as a parent-service user of children’s gender services in the UK. My approach to this topic is informed by a commitment to trans emancipatory research (Noel, Citation2016), acknowledging that trans lives are equal to cis lives, and being attentive to cisnormativity or pathologization of gender diversity. In the initial inductive coding content was reviewed and categorized into themes, drawing upon my theoretical and personal knowledge of trans healthcare, highlighting content that provided insight into the Cass Review’s approach to trans children’s healthcare. Initial categories were distilled into four broad themes (see Table 2), that correspond to the four key themes of the results section. For each broad theme, a thematic research question (see Table 2) was selected, with the data then taken through a second round of qualitative analysis framed by those research questions, looking for evidence and insight from the dataset to enrich and expand understanding of Cass Review approaches. This second-round of analysis applied deductive reflexive thematic analysis (Braun & Clarke, Citation2019), seeking data-driven answers to the four research questions, utilizing Cass Review data to enrich and expand understanding of the Cass Review’s approach to trans children’s healthcare.

Did you catch that? Horton acknowledges up front that his approach assumes the results, and works backward from there. There is nothing objective about the approach; it is about expressing the "reviewers perspective and positionality into analysis and reflection on a body of work..." 

Shockingly, Horton concludes that all that scientific data is BS, because, well, it contradicts his lived experience and desires as a nonbinary person and parent of a trans child. 

The work is "trans emancipatory," which is just another way of saying, "I begin with the conclusion, so screw that objective evidence."

This is exactly what critical theory is: reframe everything in terms of the preconceived conclusions of the writer, and define every disagreement as deriving solely from bad intentions. 

The entire point of the Cass Review was to bring objective science to the table, and the alphabet ideology critique is that objective science is oppressive. 

"My approach to this topic is informed by a commitment to trans emancipatory research (Noel, Citation2016), acknowledging that trans lives are equal to cis lives, and being attentive to cisnormativity or pathologization of gender diversity."

It really is that simple. Commitment, not objectivity. 

Everything else is noise and slander.