So, after years of gaslighting and cancellations, what has been going on in those NHS gender clinics is now staring the great and good in the face. The question now is, how was this ever allowed to happen?

The review points to some of the more immediate reasons. Namely, the shoddiness of the evidence base for various treatments combined with the conspiracy of silence around this. Shockingly, Dr Cass says her research was actually ‘thwarted by a lack of cooperation from the adult gender services’. ‘I do think it was coordinated’, she tells the Guardian. ‘It seemed to me to be ideologically driven.’

But there is a deeper question here too – not just for the health service but for the media, academia and polite society. These cruel goings-on in the NHS have been an open secret for literally decades. And yet only today, with Cass’s report, is it being properly digested.