FIRST READING: Canadian Paediatric Society vows to continue prescribing puberty-blockers

22 hours ago 9

The Society dismissed groundbreaking U.K. findings that puberty-blockers stand on 'remarkably weak' evidence

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Published Oct 17, 2024  •  Last updated 6 minutes ago  •  4 minute read

CPS logoThe Canadian Paediatric Society logo. Photo by X.com/CanPaedSociety

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The Canadian Paediatric Society has explicitly reaffirmed its policy of prescribing puberty blockers to children despite the conclusions of the Cass Review, a comprehensive U.K. report finding that the whole practice stands on “remarkably weak evidence.”

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In a letter published last week in Paediatrics & Child Health, the society said the Cass Review has no lessons for Canada, and they would be sticking with their prior policy of “affirming” children with gender dysphoria.

As per a detailed position statement first published last year, the Canadian Paediatric Society advocates an “affirmation approach” for minors who “identify with a gender other than the sex assigned to them at birth.”

Paediatricians are told to immediately affirm preferred names and pronouns in gender dysphoric patients, and to provide information about “gender-affirming medical interventions” including hormone treatments and drugs to block puberty.

As per Canadian Paediatric Society’s recent letter, this approach “remains unaltered by the publication of the Cass Review.”

The letter was in response to an Oct. 7 petition by four Canadian paediatricians urging the society to take heed of the Cass Review, given that it concerns a British medical system whose approach to gender care was almost identical to that of Canada.

British doctors, like Canadian doctors, had similarly been advised to pursue an “affirmation” approach that prioritized medical interventions for youth with gender dysphoria.

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The Cass Review, led by renowned British paediatrician Hilary Cass, concluded that this approach was premised on little more than “ideology.” “The reality is we have no good evidence on the long-term outcomes of interventions to manage gender-related distress,” wrote Cass.

In addition, Cass found that potentially irreversible therapies were being prescribed to outsized numbers of neurodivergent British youth whose feelings of gender dysphoria were likely temporary.

“The current evidence base suggests that children who present with gender incongruence at a young age are most likely to desist before puberty, although for a small number the incongruence will persist,” reads the review.

Gender dysphoria in children list Excerpt from “An affirming approach to caring for transgender and gender-diverse youth.” These are listed as the markers of gender dysphoria in children. Photo by Canadian Paediatric Society

Notably, the Cass Reviews’ findings were broadly accepted across the British political spectrum. Although the review was commissioned under a Conservative government, the new Labour government of Prime Minister Keir Starmer accepted its conclusions and pledged to continue implementing its recommendations, which includes a ban on the sale and supply of “puberty-blocking hormones.”

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The four Canadian paediatricians who authored the Oct. 7 letter urged the Canadian Paediatric Society to discard its “affirmation approach” for a “cautious approach,” in which psychotherapy is the main treatment for gender dysphoric youth, with “puberty blockers and hormones limited to the context of research.”

The letter called the Cass Review the “most thorough review of gender-affirming treatments in young people conducted to date” and the “new international standard of care.” “It carefully considered the meteoric rise of young people presenting with gender distress … (and) the socio-cultural and developmental contexts that may contribute to trans-identification,” it read.

The Canadian Paediatric Society’s response was to effectively dismissed the Cass Review as a viable work of scholarship, and to assert that the affirmation approach in Canada is not comparable to the affirmation approach once practised in the U.K.

The Cass Review, which capped off a four-year inquiry, was called “a critique, authored by a single individual.” The society added, “the model of gender-affirming care in Canada differs in many ways from the approach that had been in place in the U.K.”

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