I'm the doctor whose landmark report got puberty blockers banned - here is why ... trends now
The British doctor whose landmark report got puberty blockers restricted in the UK has urged similar caution be taken in the US, in her first American interview.
Dr Hilary Cass' 400-page report, which took more than three years to complete, found the evidence for using the drugs on transgender children was of 'poor quality' and 'not reliable.'
The findings resulted in the UK's National Health Service (NHS) restricting hormone drugs for people under 18, an outcome that has made Dr Cass the subject of viscous bullying - leaving her too scared to use public transportation.
Now, in her first discussion of the report on an American platform, Dr Cass is urging doctors to allow transgender children to go through their natural puberty to 'leave their options open.'
Dr Cass received major backlash, previously saying she has been the recipient of online bullying and threats, adding she cannot even use public transportation anymore because she is being threatened over her report
She highlighted the irreversible effects of puberty blockers in some patients, suggested other stressors could be causing children's gender anxiety and highlighted the many unknown side effects of starting the drugs too young.
Speaking on the On Point podcast, Dr Cass said: 'The more we can let young people go through their typical puberty, and work out their identity and leave their options open as long as possible, the more likely it is that they will make the best possible decision.'
Because a wrong decision could mean permanent change, especially for young girls taking male hormones, which can cause irreversible voice dropping and facial hair growth within months.
However, Dr Cass added: 'It's really important to say that there may be a group of young people who do have early gender incongruence for whom this might be the right treatment,' such as young boys who would experience irreversible changes of male puberty.
America has been accused of falling behind other countries when it comes to gender-affirming care.
In the UK, Sweden, France, Australia and the Netherlands, puberty blockers are restricted from use in minors, but in the US there are no age limits.
Puberty blockers were originally developed to suppress the hormones of minors who started puberty too early, but in the US they are prescribed off-label for people who seek to transition genders.
Dr Cass, former president of the Royal College of Pediatrics and Child Health, Britain's premier body for pediatricians, was commissioned by the NHS in 2020 to investigate whether it is medically sound to provide gender-confused children with puberty blockers and cross-sex hormones
Advocates say they are life-saving for a suicide-prone group, but critics say puberty blockers taken too young are dangerous, and suggest therapy and counseling instead.
Dr Cass said: 'Just giving hormones without supporting people is not helpful. An adult trans person said to me the other day, "If you just get the hormones, that does not make years of dysphoria go away, and you need some therapeutic support, as well."'
She continued: 'Somehow, we've got locked into puberty blockers as the totemic treatment that young people feel that if they don't get on that pathway, if they don't get onto puberty blockers, they're not going to get onto a medical pathway [to transition].'
While there are many different ways in which doctors can address gender anxiety in children that don't involve drugs, Dr Cass said 'we've somehow stopped short of trying those just because puberty blockers have become so widely believed to be effective.'
She added she has spoken with people in the trans community who said they wish they knew when they were younger there are more options and more ways of expressing identity than just taking a medical approach.
'So a lot of what the focus of our review has been on is saying what do we do to help these young people to thrive, and how do we give them the widest range of options that also don't foreclose for them,' the doctor said.
Keeping options open is a major point Dr Cass stressed.
She gave an example of adolescent girls, who are more at risk for self harm, depression and suicidal ideation.
While going through puberty, they may feel distress over the changes in their bodies, leading them to question their identity: 'And then you go on puberty blockers.
'That may absolutely be the right decision, but conversely, you have very little experience of your own puberty and probably very little basis on which you might change your mind because you feel good on your testosterone.
'We have absolutely
