Hilary Cass to be unleashed on Northern Ireland trans healthcare

For almost six years, a panel met regularly and fought to build NHS trans healthcare in Northern Ireland after being commissioned by then-Northern Ireland Health Minister Robin Swann to review gender services here. It was a long, slow process, but one that had tried to centre trans people and their families. It only finished in April.

They made recommendations that they hoped would be followed. They won’t be.

In response, the current Health Minister Mike Nesbitt allocated just over £800,000 to fund a new service that now seems set to focus on conversion therapy practices that they call “psychological and psychiatric support”.

As Scott Cuthbertson, CEO of the Rainbow Project said, “Gender Identity Services in Northern Ireland have been almost completely non-functional for most of the past decade.” They look set to stay that way.

The backlash to the funding was immediate. The News Letter’s David Thompson and Adam Kula wrote and published 17 anti-trans articles in a week, mostly attacking the funding, including on a number of front pages. The TUV’s Jim Allister, and Timothy Gaston, along with members of Nesbitt’s own Ulster Unionist Party, all piled in, joined, of course, by the DUP. Parties that pretend to be allies of the trans community – Sinn Féin, Alliance and the SDLP – said little and, as usual, did even less.

A month after announcing the funding, Nesbitt confirmed something else to the surprise of everybody: yet another review of gender services in Northern Ireland. This one, however, will be conducted by Hilary Cass.

At first glance, it looks like Nesbitt, desperate to shore up his position as Health Minister and party leader, has cobbled this together quickly. As Alexa Moore, Policy Campaigns and Communications Manager at Rainbow said, it’s a “way to kick the can down the road”. It will also please multiple parties while only hurting people no-one in power cares about. Win-win for the bigots and their enablers.

“Trans people and their families poured their heart and souls into the local review of Gender Identity Services, commissioned by the Department and led by the Strategic Planning and Partnership Group,” Moore said.

“This announcement of yet another review, rather than getting on with the job of providing fit-for-purpose gender affirming care will be devastating to all those who gave so much of themselves over the past 6 years. Trans people here deserve better than a Minister who, once again, wants to kick the can down the road rather than delivering meaningful improvements to their lives.”

The hand of Wes Streeting and the rest of the UK government is also obvious. These are, after all, the same people determined to strip healthcare from every trans person in Britain. This is not hyperbole. Please stop telling us that it is.

They have already removed healthcare from under-18s, with the UK also pressuring Northern Ireland into criminalising parents who support their children by seeking globally recognised best practice treatment – puberty blockers and hormones – abroad. When I met with the NI Justice Minister at the start of the year, she assured me that Nesbitt had no plans to go after these families. Eight months later, she is made to look a complete fool once again just as he has caved to pressure from Westminster and his fellow Unionists to sacrifice trans people on the culture war altar again.

Best practice in the UK no longer exists for trans people. Where doctors are sworn to do no harm, many are now actively finding ways to inflict it on us. Their own ideological beliefs, which have been encouraged to fester over the past decade, now have the unwavering support of not only the media but the government, too.

Cass was picked from a pool of one by Kemi Badenoch to lead her review of children’s services in England. She has no experience in trans healthcare and produced a report savaged by the international medical community, and dismantled in 11 peer-reviews. As the Rainbow Project said in their statement about her appointment, “The Cass Review, which examined children and adolescent gender identity services in Britain, has been criticised by peer reviewed studies in multiple countries including Ireland, Canada, the United States, Australia, New Zealand and others around the world.”

If you’re being extremely generous, you could at least say Cass has a background in paediatrics. Now, according to Nesbitt, her bastardised review into trans children somehow makes her “eminently qualified” to run a review of all gender services in Northern Ireland that will begin as soon as November. It’s amazing how fast they can move when they are stripping healthcare away from trans people. It shows the slowness of government bureaucracy for the myth that it is.

It is obvious what this is: a handpicked appointment designed, once again, to produce a report whose conclusions are already written. The pages simply need to be filled in. The goal is the same as trans people have been saying for years, to strip healthcare from every trans person in the UK.

There is no medical justification for this. The evidence is overwhelming: hormones and surgery work. Unlike almost any other treatment for any other ‘condition’, they deliver transformative, measurable outcomes. We are happier.

Perhaps that’s why they hate us so.

In Northern Ireland, the failings of a system that barely exists are being used as the excuse for a review that will push conversion therapy over actual care, just as we see with children’s services in England. Nesbitt has already said that the funding he approved will be directed towards that purpose. “Whilst understandably much of the focus of her [Cass’s] report centred on the recommendation on puberty blockers – which Northern Ireland rightly adopted – she also came to other important conclusions,” he said.

“In finding that most young people experiencing gender-related distress would not benefit from a medical pathway she instead called for a much stronger focus across the UK on psychological support, as well as a more holistic approach to care.

“That is exactly what I want Northern Ireland to be delivering.

“Much of the previously approved £806,000 business case for the new Lifespan Gender Service is to invest in new and additional psychological and psychiatric support, as well as a greater multi-disciplinary approach. From my reading of the Cass Review that is exactly the direction of travel she has recommended.”

That is not what the money was meant to be for and you can see clearly that Nesbitt has already decided what Cass’s review should find.

It is all so absolutely shameless.