In a Dáil debate that took place on Wednesday, October 16, Green Party TD Neasa Hourican asked the Irish government to confirm that no health, clinical or social policy-making would be informed by the Cass Review, urging the HSE to pause its own review of the report.

The review in question was authored by Dr Hillary Cass, who was commissioned by the former Conservative UK government to examine the provision of gender-affirming care in England. The result is a 400-page report including 32 recommendations, some of which have been heavily criticised by trans activists and healthcare specialists.

In particular, Cass’ study led to a temporary block being placed on prescribing puberty blockers to under-18s in the UK, a move which sparked widespread outrage. The Cass Review has also faced significant criticism from international medical bodies, including the British Medical Association and the World Association for Transgender Health (WPATH).

Earlier this year, in light of the HSE considering the Cass Review in developing a national model of care for young Irish people, ​​136 academics from more than 20 universities and colleges across Ireland signed an open letter outlining “serious concerns” with how the review was conducted.

During Wednesday’s debate, TD Neasa Hourican criticised the Irish government’s decision to conduct its own review of the Cass report. “The report is highly politicised, junk science,” she said. “It is driven by the UK’s culture wars and should be allowed nowhere near policymaking in Ireland.”

Expanding on the reasons why the review should be dropped, Hourican cited the fact that the Cass Review “does not follow established standards for evaluating evidence or evidence quality” and that it “contravenes standard practice in scientific evaluations of medical research”. She added, “In any other field of medicine, this practice would be deemed unacceptable and harmful to patients.”

Hourican also mentioned an independent review of the Cass report, which described it as “pseudo-scientific and subjective”. This review found several issues with the methodology employed in the Cass report, including conducting focus groups with healthcare workers of varying background. “It is not clear what expertise these individuals had but 34% of them admitted that their understanding of gender-questioning children came from the media,” the TD mentioned.

“The Cass review levies unsupported assertions about gender identity, gender dysphoria, standard practice and the safety of gender affirming medical treatments. It also repeats claims that have been disproved by sound evidence,” Hourican said.

Responding to the TD during the debate was Minister of State at the Department of Social Protection Emer Higgins, who spoke on behalf of Minister for Health Stephen Donnelly. According to the Minister, the review of the Cass report will be undertaken by an expert clinical group and it will be “independent of the HSE planned update of the clinical Model of Care for Gender Healthcare.”

Further focusing on the HSE’s plan to develop a new model of trans healthcare, the Minister said that it “will be informed by the best evidence-based clinical care” and will “incorporate input from healthcare professionals, patient advocates and those with lived experience.”

Higgins added, “Minister Donnelly is strongly of the view that we cannot have a situation where a model of care is being developed for a group of people who are not involved and whose voices are not heard. I can assure you that the Minister and the HSE are anxious to ensure that all stakeholders are heard as part of this process.”

This comes after the HSE has been criticised by several community groups for its failure to consult with trans organisations in their plans to develop a new model of trans healthcare.

Further expanding on the flaws of the Cass Review, TD Neasa Hourican cited a report that shows “a significant amount of the political activity we saw in the UK around this issue is funded by foreign entities, including Russia. The intention is to do exactly what the Cass review is helping to do, which is create a culture war rallying point rooted in fear and marginalising vulnerable groups.”

Minister Emer Higgins concluded by saying that she was taking on board the “valid and interesting points” raised by TD Hourican and that she would refer them back to Minister Donnelly.