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Original Twitter thread by Christina Buttons


One-month recap since the final Cass Report: More European countries have restricted youth medical transitions, with others heading in that direction—in stark contrast to U.S. medical bodies, which have doubled down on medical pathways for minors.

The Global Response to the Cass Review: More European Countries Restrict Youth Transition While US-based Medical Organizations Double Down A guide to the debate on youth medical transition, where the U.S. departs from a growing international consensus.

In response to the Cass Review, Wales and Scotland have halted new prescriptions of puberty blockers for minors under 18. Additionally, in Scotland, cross-sex hormones will not be available to those under 18.

Germany has emerged as the latest country to take steps towards placing restrictions on youth transition. Earlier this week, the German Medical Assembly passed a resolution that calls for the restriction of medical interventions to research settings.

In Belgium, a new report in a prestigious medical journal has physicians advocating for significant reforms in the treatment protocols for youth with gender dysphoria, where hormones are considered a last resort and used only in strict research settings.

Prior to the release of the final Cass Report, debate had been growing in the Netherlands. On February 15, 2024, the Dutch Parliament ordered an investigation into the physical and mental health outcomes of children who have been prescribed puberty blockers.

In Ireland, the Health Service Executive announced the development of a new clinical program for gender healthcare, scheduled over the next two years. They also stated that the final report for the Cass Review will be included as part of this process.

The United Nations Special Rapporteur on violence against women and girls, Reem Alsalem (@UNSRVAW), issued a statement declaring that the Review’s recommendations are essential for protecting children, especially girls, from harm.

The European Society of Child and Adolescent Psychiatry (ESCAP), representing 36 societies worldwide, issued a policy statement advising against “experimental and unnecessarily invasive treatments” with unproven effects for gender-distressed youth.

These responses stand in stark contrast to WPATH, a body modification advocacy org, which emailed a statement to its subscribers in response to the Cass Review, criticizing it as “harmful” and “rooted in a false premise” that youth can be helped without “medical pathways.” See images here.

In response to the Cass Review, US medical organizations, the American Academy of Pediatrics (AAP) and the Endocrine Society (ES), issued statements doubling down on their endorsement of medical interventions for minors and blaming “politics” for spreading “misinformation.” See images here.

In a recent @nytimes  interview, Dr. Hilary Cass responded to statements from the AAP and ES, saying their insistence that “the evidence is good” is “misleading the public.” The president of the AAP denied this claim. See images here.

WPATH, AAP, and ES continue to mislead the public by claiming that gender-affirming care adheres to the principles of evidence-based medicine. Their recommendations rely on circular referencing of each other’s guidelines, known as a citation cartel.

My latest report provides a recap of new developments in the month since the Cass Review was published. Paying subscribers have access to a detailed overview of all significant updates on youth medical transition in recent years, organized by country.