Journalist who spent years investigating Tavistock clinic hails bombshell report that dismantles NHS's transgender treatment model - as she warns 'we've known for years this is a population of vulnerable young people'

A journalist who has spent years reporting on NHS transgender services for children has questioned why it 'has taken so long' for the services to be scrutinised after the publication of a landmark report on their treatments.

Hannah Barnes, a prolific reporter on NHS gender services, has praised the Cass Report, which concluded young people were being set on paths of irreversible change without substantial medical evidence to support their treatment. 

She said the report is an 'incredibly thorough' piece of work examining how the service treats young people seeking gender-affirming care, adding that society owed its author, Dr Hilary Cass, a 'huge debt of gratitude'.

Leading paediatrician Dr Cass concluded there was a 'lack of high-quality research' on the effects of giving puberty blockers to transgender children.

The journalist, has reported extensively on gender services for the likes of BBC Newsnight, The Guardian and is currently associate editor at the New Statesman, self-described as the UK's 'leading progressive political and cultural magazine'.

Ms Barnes told Good Morning Britain's Ed Balls and Kate Garraway of the report: 'It's incredibly thorough - I think society owes Dr Hilary Cass and her team a huge debt of gratitude 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 tackle this. We've known this is a very vulnerable population of young people for many years.

'We've known the evidence base is weak and severely lacking for very many years. What has been recommended today is the right pathway - you take a young person and you treat them as an individual, as a whole being.'

The 388-page Cass Report concluded that the rationale for suppressing puberty in young children 'remains unclear', with 'weak evidence' on the impact such treatments have on children.

Dr Cass found that a medical pathway would not be the best way to manage questions about gender 'for most young people' without also addressing other concerns such as mental health or neurodivergent conditions such as autism. 

She used the review to hit out at all sides of the debate over how best to treat children seeking gender-affirming care, noting that the discussions had become exceptionally 'toxic'.

Dr Cass said she had been criticised by both those advocating for transgender healthcare and those whom she said 'urge(d) more caution' - and accused all parties of 'exaggerat(ing) or misrepresent(ing)' studies to support their own views.

In remarks seemingly addressed to those on all sides of the discussion, she added: 'There are few other areas of healthcare where professionals are so afraid to openly discuss their views, where people are vilified on social media, and where name-calling echoes the worst bullying behaviour. This must stop.

'Polarisation and stifling of debate do nothing to help the young people caught in the middle of a stormy social discourse, and in the long run will also hamper the research that is essential to finding the best way of supporting them to thrive.'

Her report, which includes 32 recommendations to overhaul NHS gender services, notes: 'The reality is that we have no good evidence on the long-term outcomes of interventions to manage gender-related distress.'

The recommendations include:

• Distributing gender services across NHS paediatric services, rather than pooling them at a small number of dedicated clinics
• 'Holistic' assessments for children seeking gender care, including screening for neurodevelopmental conditions such as autism, and a mental health assessment
• Separate treatment pathways for prepubescent children and their families so parents can talk about how to support their child in a 'balanced and non-judgemental way' 
• Providing independent services for those who wish to detransition, noting that they may not wish to engage with the same specialists as before
• The creation of an NHS research programme looking at the outcomes for those who present to gender services
• 'Extreme caution' over providing masculinising or feminising hormones to the over-16s - with guidance suggesting these should not be given until the age of 18

Dr Cass' study was commissioned nearly four years ago as concerns were raised about the Tavistock Gender Identity Development Service (GIDS), which has since been closed down and is being replaced with two regional clinics.

The clinic had been set up providing psychotherapeutic services to those questioning their gender identity but had, the report said, transitioned to prescribing a greater number of hormonal drugs as part of that treatment. 

The report was also commissioned because of the greater number of people seeking gender-affirming care on the NHS. 

She has insisted the review was 'not about defining what it means to be trans, nor is it about undermining the validity of trans identities, challenging the right of people to express themselves, or rolling back on people’s rights to healthcare'.

A spokesman for Bayswater, a group that supports parents of trans children, said the Cass Report 'represents a sea change in the treatment of trans-identified children and young people'. 

Prime Minister Rishi Sunak welcomed the report and called for 'extreme caution' in treating youngsters in the future.

Asked about the Cass report on LBC, the PM said: 'The Cass report rightly shines a spotlight that we need to exercise extreme caution on these issues. 

'These things are not neutral acts. We do not know the long term effects. 

'I think it's (the report) is broadly in agreement with the direction of travel of the government. 

'It is not right kids are subjected to various different things. We should act cautiously.'

But Robbie de Santos, director of campaigns and human rights at LGBTQ+ rights organisation Stonewall, had a mixed response.

'What is important, above all, is that trans and gender-diverse children get the quality healthcare that they need and deserve,' he said.

'The Cass Review can play a vital role in achieving this aim if its recommendations are implemented properly.

'Many recommendations could make a positive impact – such as expanding the provision of healthcare by moving away from a single national service towards a series of regional centres while recognising that there are many different treatment pathways that trans young people might take.

'But without due care, training or further capacity in the system, others could lead to new barriers that prevent children and young people from accessing the care they need and deserve.'