Fri 29 Sep 2023 (updated: Thu 5 Oct 2023 , 18:49 ) — 3 min

Endocrinologist Donal O’Shea, who used to lead Ireland’s National Gender Service (NGS) reported to Irish national radio show Newstalk that Hilary Cass, leader of the Independent Cass Review, has endorsed the Irish NGS model as the “gold standard for how it should be done”.

In response to a request for comment a representative for the Cass Review said:

"The Review is looking at how gender services for children and young people in England should be organised and delivered in future. The remit does not stretch to adult services and we have not reviewed such services either in the UK or elsewhere.

We have met with services across the UK and internationally to look at how they operate but we have not declared on any model beyond that described in the interim report and subsequent letter to NHS England."

Ireland’s National Gender Service was last year ranked the “worst in Europe” by TGEU’s Trans Health Map. With this in mind, the revelation of Cass’ support for the Irish NGS is deeply concer future of trans healthcare in England and Wales. Among other things the Irish service has imposed bizarre and draconian requirements on patients like requiring adult patients to bring their parents to appointments. It has also come under criticism for its use of unnecessary and inappropriate “barrage of personal questions” as part of diagnosis. These can include such things as how patients “pick up men” and other probing questions which patients described as “voyeuristic” about their sex lives and which have no obvious relation to their gender identity.

The Cass review was initially triggered after the Bell v Tavistock (2020) ruling. However, while Bell v Tavistock was overturned in 2021, the Cass Review has continued, gathering growing criticism over explicit bias against trans experiences in defining how trans health reforms should happen, as well as hiring clinicians associated with the “Gender exploratory therapy” model. The gender exploratory model as yet has no real evidence base and has been likened in academic writing to conversion therapy approaches.

In the interview for Newstalk, O’Shea says

"That is, correct. Hilary Cass came over, met with our clinical team, looked at how we do it in the adult service. And said, this is, the gold standard for how it should be done. We're contributing to her expert review panel on on the design and delivery of care. We have repeatedly said to the HSE they need to stop sending our children and young people to affirming services, because we will see more of the disasters that we saw coming back from Tavistock."

The Cass Review have attempted to present a public face of balance and impartiality, albeit an impartiality which deliberately discriminated against trans people participating in the oversight panel on the basis this would constitute a risk of bias. These recent revelations from O’Shea are perhaps the first really strong evidence of an ideological bias in the Cass Review specifically against gender affirmation for young people.

This article was updated on 5th October 2023 to include comment from a representative of the Cass Review