The Cass Review:
Will activism hinder its implementation?
Dr Carole Sherwood
Acknowledgements
Save Mental Health is indebted to several colleagues for their invaluable help in collating and making sense of the information revealed on both Free Speech Nation on GB News and in this article.
With thanks to: Peter Jenkins, Mary Garner, Lucy Beney and James Esses of Thoughtful Therapists; David Pilgrim and Pat Harvey of BPS Watch; Val Thomas of Critical Therapy Antidote; Shelley Charlesworth of Transgender Trend; Bayswater Support Group; Tamara Sears; @STILLTish; and Dr P @psychgirl
When the final report of the Cass Review was published on 10th April 2024, many of us hoped this would be a turning point. After the scandal that led to the closure of the Tavistock GIDS clinic, at last it seemed that children and young people with gender-related distress would finally receive the high quality, evidence-based care they need and deserve.
At the time her report was published, Dr Hilary Cass noted that: “some professional organisations have ducked their responsibility in ensuring that everyone working in this field treated these young people as they would any other”. She called on these organisations to “Come together to provide leadership and guidance” to ensure that the report’s recommendations could be implemented.
It is nearly three months on from the Review’s publication. How have the professional therapeutic organisations responded? Are they providing the required leadership and guidance?
Let’s look first of all at the British Association for Counselling and Psychotherapy (BACP). To date this organisation, with over 50,000 members, has produced no public or in-house response to the Cass Review – not on their website, not in emails to members, nor in their journal Therapy Today. They have, though, continued to review several books on gender identity and one on polyamory and refused to remove a blog by a school counsellor who advocates gender affirming care.
One of BACP’s members wrote to a senior manager in the organisation asking why they had not responded to the Review. She was told that the findings of the Cass Review were “primarily about medical pathways and interventions” and that its members “have no role in either”. Where counselling was mentioned in the report, the BACP claimed that “the focus is on provision of fertility counselling, delivered by NHS professionals trained in this area”.
These statements are simply not true. As the Clinical Advisory Network on Sex and Gender points out in their summary of the report:
“Psycho-social support is recommended as the first line of treatment.”
Why is a major professional therapeutic organisation, whose membership comprises counsellors and psychotherapists, so dismissive of a report that recommends psycho-social support as the first line of treatment? Their members provide psychotherapeutic support. This is their job. It’s as though the BACP has turned its back on Dr Cass’s Review with a shrug and said, ‘nothing to see here’.
Worse than this, as mentioned above, the BACP continues to produce content promoting gender-identity ideology. James Esses recently revealed in his Substack, that the BACP’s latest edition of its quarterly magazine for practitioners who work for children, titled Children, Young People, & Families, appears to be “nothing more than a manual in trans ideological indoctrination.”
While the BACP is failing miserably to respond to the Cass Review, is the British Psychological Society (BPS), with more than 65,000 members, doing any better? On the day that the Cass Review final report was published, it was greeted by the BPS’s President-Elect with a glowing commendation. In a response published on the BPS website he called it a “thorough and sensitive review”. There was praise for Dr Cass and agreement with her call to end the “deeply concerning public bullying and vilification of professionals working in this challenging area”.
While the President-Elect was gushing about the Cass Review, the Chair of the BPS Sexualities section, Dr Rob Agnew, took a different stance. He announced on his social media account that its publication was a “Bad day for trans youth” This is a man who described the NHS’s decision to stop prescribing puberty blockers to children and young people as “bigotry” and likened gender critical therapists to “misogynists” and “incels”. You can read more about the Chair of BPS Sexualities Section on our website here where Dr P (@psychgirl on X) gives an insightful and frank commentary.
Questioned about the discrepancy in responses between their President-Elect and the Chair of BPS Sexualities Section, a BPS spokesperson replied: “in an organisation of more than 60,000 people, there will be some who hold different opinions.” Yet the “different opinions” being voiced in this case happen to be from the Chair of the Section that holds responsibility for the area of work most affected by the Cass Review’s recommendations.
The problem facing the BPS is not one of a single dissenting voice in a senior position. There are several other senior clinicians, closely associated with the BPS, who advocate for gender identity ideology. This became clear when the BPS Guidelines for Psychologists working with Gender, Sexuality and Relationship Diversity were published in 2019. These guidelines were widely criticised for being ideologically-driven and for enforcing a gender-affirming approach to care. The Chair of the Working Group was Dr Christina Richards.
David Pilgrim, of BPS Watch puts it well:
“The guidelines resemble no other professional practice documents. Of six members who produced these under Richard’s control, two have forced the BPS to remove their names in professional embarrassment. Patients were to be called ‘sluts’ if they so wanted it and BDSM and other variants of ‘kink’ were a part of a de-repressive future to be celebrated by psychologists as being essentially non-pathological.”
Despite the criticism, the BPS declared that it was confident in these guidelines because they had been developed by “experts working in the field”. These experts were strongly influenced by the now discredited World Professional Association for Transgender Health (WPATH) which has been accused of “widespread medical practice on children and vulnerable adults.” (See the WPATH files by Mia Hughes).
One of the experts in which the BPS places such confidence is the previously mentioned Dr Christina Richards. Dr Richards is a transwoman who in 2019 placed an advert for the Adult Gender Identity Clinic, at the Tavistock and Portman NHS Foundation Trust stating: “Bigots and exploitative theoreticians need not apply!”
Dr Richards is also notorious for declaring that the debate about puberty blockers is ‘shut’ and for claiming that a variety of sadomasochistic sexual practices are “sexualities.” See David Pilgrim’s account Cass, Columbo and the BPS for full details of the gender idealogues working within the BPS who continue to wield influence.
Last week the long-awaited revision to the BPS Guidelines was finally published. BPS Watch has now scrutinised them and their verdict is that, while the previous ideological zeal has been toned down, and references to gender affirming care and reclaimed language such as slut removed, the guidelines continue to use unscientific terminology including assigned male/female at birth and make contested assumptions, with no scientific evidence to support them. The Working Group now comprises clinicians who are all advocates of gender identity ideology and their Guidelines cite WPATH Standards of Care (8) which declare Eunuch to be a gender. So it seems that the BPS has some serious work to do before it can get its house in order sufficiently to provide leadership and guidance to its members regarding the Cass Review.
Finally, we come to the UK Council for Psychotherapy (UKCP) – a smaller professional body of 11,000 members, that has been under attack since November last year from a group of UK activists called Therapists against Conversion Therapy and Transphobia (TACTT).
Following the publication of the interim Cass Review report and the Maya Forstater ruling on gender critical beliefs being protected by law, the UKCP made a statement recognising the rights of its psychotherapists and counsellors, under the Equality Act 2010, to hold gender critical beliefs and practice exploratory therapy. The statement also made it clear that “Exploratory therapy should not in any circumstances be confused with conversion therapy, which seeks to change or deny a person’s sexual orientation and/or gender identity.” TACTT reacted with fury to the UKCP’s statement and wrote an open letter, suggesting that gender critical therapists were not competent to work with gender questioning clients and may cause them harm.
While the UKCP managed to fend off TACTT’s criticism on this occasion, the activist group has attacked again and delivered a more serious blow. Just prior to the publication of the Cass Review final report in April, the UKCP issued another statement, this time announcing that they were withdrawing their signature from the Memorandum of Understanding (MoU) on Conversion Therapy. The MoU is a policy document, signed by more than 25 health, counselling and psychotherapy organisations including the BACP and BPS. Its aim is to end the practice of conversion therapy in the UK, although there is very little evidence of such practice. (See Transgender Trend’s report on the activists behind the MoU.)
In its current form, the MoU makes no distinction between adults and children. This is a problem because children’s needs differ over the course of their development and a young child may not have the ability or capacity to consent to treatment. The UKCP made the decision to remove its signature from the MoU policy document, citing concerns about the safety and welfare of children and young people. They also expressed fears that the inclusion of children in the MoU could be construed as a ‘ban’ on therapists exploring the reasons a child or young person is questioning their gender, something Dr Cass has said is “essential”.
In response to the UKCP’s withdrawal from the MoU, the activist group TACTT mounted a petition calling for a vote of no confidence in the UKCP’s Chair and Board of Trustees. It gathered enough signatories to force an election in which members can vote to remove the Board. The UKCP’s Chair, Dr Christian Buckland, accused TACTT of mounting a ‘coup’ and said “As Chair, I will not allow the UKCP to be bullied into turning a blind eye to the safety of children”. However, shortly after making this statement, he resigned, handing over to his deputy.
The UKCP’s voting process started on 20 June and ends on 3 July. If UKCP members vote to remove the Board of Trustees, this will serve as a warning to all the other professional bodies that are signatories to the MoU. This would be a disastrous result. Activists should not be allowed to dictate policy, set standards or use bullying tactics in order to get what they want, especially where children’s welfare is concerned.
We now find ourselves in the situation where the Cass Review’s recommendation for psychotherapists and psychologists to explore all the factors contributing to a gender questioning child’s distress may be viewed, by some, as ‘conversion therapy’. As clinical psychologist Dr Anna Hutchinson explains in her article for the Daily Telegraph:
“This is because some activists argue that anything other than self-diagnosis and the provision of gender-affirming care (including medical affirmation) for children and young people is a type of conversion therapy that should be banned”.
Where does this leave the main professional organisations tasked with implementing the Cass Review who are either signatories to the MoU and in thrall to activists, or have withdrawn from the MoU and are under attack from them? It is hard to imagine a resolution without strong leadership, a determination to replace the current MoU, and resist activist pressure.
To add to this complex situation, Dr Hutchinson warns of “political pressures to enact a conversion therapy ban” which Seen in Journalism reports may be coming from the Coalition Against Conversion Therapy who originally drafted the MoU and are currently advising the Labour Party.
In her article, Dr Hutchinson states that “We cannot both implement Cass and accede to these campaigners demands”. She urges all political parties calling for a law banning conversion therapy to ensure that they are “well-informed” in order to “best help younger people”. The BACP and BPS would do well to heed her warnings. The future of thousands of young people awaiting care for gender-related distress depends upon it.
Further Reading and viewing:
Jenkins, P. (2021) Through the looking glass: Making sense of the MOU Part 1 and Part 2, Critical Therapy Antidote
Peter Jenkins and Tamara Sears: UKCP’s Stand on Conversion and Exploratory Therapy
Shelley Charlesworth, Transgender Trend : Captured! The Full Story Behind The Memorandum of Understanding on Conversion Therapy : How UK professional counselling bodies were hijacked by an unaccountable activist network
Mia Hughes, Environmental Progress 4 March 2024: The WPATH Files: Pseudoscientific, Surgical and Hormonal Experiments on Children, Adolescents and Vulnerable Adults