The Cass Review has laid bare a systemic lack of robust clinical evidence supporting the so-called “gender-affirming model” of care for children. Unlike the politically charged narratives that have dominated the debate, this comprehensive review puts the welfare of children first—prioritising medical knowledge, ethical practice, and reason over ideology.
Puberty Blockers: An Unproven Experiment on Children
Puberty is one of the most critical phases of human development—physically, emotionally, and psychologically. Yet, in gender clinics across Australia, this natural process is increasingly treated as a disorder to be halted with puberty blockers, cross-sex hormones, and, in some cases, surgery.
Advocates claim puberty suppression “gives children time to think.” But the Cass Review shows the opposite: most young people who start puberty blockers proceed to hormones, with some undergoing irreversible surgeries—becoming lifelong medical patients.
Crucially, the Review found “insufficient or inconsistent evidence about the effect of puberty suppression on psychological or psychosocial well-being, cognitive development, cardiometabolic risk, or fertility” (Cass Review, p. 32).
Moreover, the Review warns that “although a diagnosis of gender dysphoria is needed for initiating medical treatment, we don’t have evidence that this dysphoria will continue into adulthood or that medical intervention is the best option” (p. 29).
A 2024 longitudinal study following adolescents from age 11 to 26 found that gender non-conformity often declines in early adulthood and is strongly linked to same-sex attraction (Rawee et al., 2024; Cass Review, p. 118). Historical research—such as the original Dutch protocol study (de Vries et al., 2011b)—found that up to 89% of young people presenting with gender dysphoria were same-sex attracted.
The Role of Schools and Social Media
While the Cass Review found no conclusive evidence that social transition directly improves or worsens long-term outcomes, it observed that social transition is often linked to increased gender distress.
Parents reported instances of schools socially transitioning children without parental consent—an alarming practice when parental guidance is vital for safeguarding. The Review warns that bypassing parents leaves children vulnerable to online influencers, activists, and predatory behaviours from strangers with no personal knowledge of the child’s needs.
Silencing Debate Harms Children
For too long, open discussion has been stifled by claims that questioning the gender-affirming model constitutes “hate speech.” This censorship erodes scientific transparency. History is clear: no society that silences dissent is on the right side of progress.
The Redefinition of “Conversion Therapy”
Once understood as coercive attempts to change a person’s sexual orientation (“pray the gay away”), the term conversion therapy has been quietly redefined in some circles to include simply supporting a child to remain in their natal sex.
This is an Orwellian way of twisting language that has escaped scrutiny, until now.
Groups that make no distinction between psychological therapy and conversion therapy, without realising that the intent of psychological intervention is not about telling children and younger people who they are, but to work with them and to help them explore their concerns, with the goal to alleviate any distress.
This conflation ignores the fact that legitimate psychological therapy—endorsed in the Cass Review—is exploratory, not coercive. Its aim is to help young people process distress, explore underlying causes, and develop resilience without rushing to irreversible interventions.
Time for Action, Not Another Review
The Cass Review examined not only the evidence base but also major guidelines, including those from WPATH, the Endocrinology Society, and the Royal Children’s Hospital Melbourne—finding serious shortcomings in assessment and diagnostic standards.
We do not need another inquiry. We need to act.
It is time to implement the Cass Review’s recommendations and return to a holistic, child-centred approach—one that safeguards young people, prioritises their long-term wellbeing, and ensures that medical intervention is a last resort, not the first.
by Dr. Elizabeth Caballero (retired GP)