Over 130 Irish academics sign open letter criticising Cass Review on transgender healthcare

Following the publication of the Cass Review, Irish academics are calling on the HSE to adopt a more balanced approach to trans healthcare.

Image: Michael Tubi via Shutterstock

A group of leading Irish academics have published an open letter calling on the government and the HSE to improve healthcare for trans young people in light of the publication of the Cass Review. 

The letter posted online on Friday, April 19, was signed by 136 academics from more than 20 universities and colleges across Ireland, in disciplines ranging from psychology to philosophy, nursing to law, and many more.

It was prompted by the final report from Dr Hilary Cass, published last week, as part of an “Independent Review of Gender Identity Services for Children and Young People” carried out in the UK. 

The review was first commissioned by NHS England in 2020 and has since been the subject of much debate, especially over the resultant closure of the Tavistock Clinic and the suspension of puberty blockers.

The latest jurisdiction to fall foul of the review’s findings was Scotland after it was reported yesterday that the Glasgow-based Sandyford clinic – the country’s only clinic offering gender-affirming healthcare to young trans people – would also be pausing the prescription of puberty blockers and cross-sex hormones.

In the letter published by the academics, they state, “We believe Irish trans young people are not receiving the quality of care they deserve. We wish to highlight the risk of this situation being worsened should Irish authorities uncritically rely on the Cass Review to inform their model of care for trans young people in Ireland.”

They continue, “We call for the vision of Trans Healthcare Action who seek ‘an Ireland where trans and gender diverse people can access gender-affirming healthcare within our local communities through an informed consent model’ and ‘an end to the current outdated gatekeeping model practised in Ireland’ to be implemented across services for young people and adults.”


The letter goes on to highlight that there is currently no gender identity service available to young people in Ireland, which they describe makes “our state an outlier within the EU.”

In light of the HSE considering the Cass Review in developing a national model of care for young people, the academics outline “serious concerns” with how the review was conducted which the letter says should “raise doubts about the wisdom of implementing its recommendations.”

It goes on to forensically analyse the review’s methodology, including citing three contradictory reports and several instances of breaching best practices. It also lists no less than five leading international health organisations that support gender-affirming healthcare for young people.

In the open letter criticising the Cass Review, the academics outline the current political climate and the escalating far-right sentiment in Ireland and globally. They suggest that the review “implicitly endorses a socially conservative and demonstrably harmful ideology in relation to gender” and point out “that ‘the UK is considered a hostile country for trans people especially for trans children’.”

They also cite Amnesty International’s statement that the Cass Review is “being weaponised by people who revel in spreading disinformation and myths about healthcare for trans young people”. 

The letter concludes by summarising the current failings of the Irish system and calls on the government and the HSE to consider a more reasoned assessment, saying, “If we are to decide what the care of our children looks like on our own terms, that means critiquing, deconstructing and rejecting the colonial nature of the transphobic rhetoric that has shaped the responses of those who have championed the Cass Review.” 

It continues, “Instead, we should (be) embracing and supporting trans, non-binary and gender diverse people in our communities by establishing access to gender identity services within primary care that are based on the principles of bodily autonomy, self-determination, and informed consent and these services, as with any health service, should be continually researched and improved according to the latest evidence.”


The full letter can be read here.

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