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Why is the NHS still following WPATH regulations?

'It's as if the Cass Report never happened.' Credit: Getty

October 17, 2024 - 10:00am

It’s as if the Cass Report never happened. Six months on, an NHS trust is advertising for a clinical psychologist who will offer support to young people “on the gender affirming medical pathway”. That’s exactly what Cass warned against, pointing out that no one knows which children will persist with a trans identity as they get older. The risks involved in prescribing cross-sex hormones to young people who will almost certainly change their minds are obvious.

Not to Nottinghamshire NHS Healthcare Trust, it seems. The job advertised involves working with children as young as 11 who are waiting for or have already been prescribed puberty blockers by the NHS, a treatment for which Cass found no clinical evidence. Even more astonishingly, the job specification insists that the successful applicant should “practice in a gender affirming manner in line with WPATH SOC 8”.

The uninitiated may not immediately realise how big a red flag that is. The impenetrable initials stand for the World Professional Association for Transgender Health and version 8 of its treatment recommendations. It was widely regarded as the leading authority on the subject until earlier this year, when leaked files revealed that ideology had long ago trumped best practice.

The files demonstrate that the organisation “is neither scientific nor advocating for ethical medical care”, according to a highly critical report. It claims that WPATH is a proselytising organisation which promotes dubious medical practices, “including hormonal and surgical experimentation on minors and vulnerable adults”.

Back in April, Health Secretary Wes Streeting said he wanted the Cass Review to be a “watershed moment” for NHS gender services. “We just can’t have this free-for-all when people decide when they are or aren’t going to cooperate with an NHS England review,” he said.

Yet that seems to be what’s happening if an NHS trust thinks it’s acceptable to publish a word salad of fashionable terms, clearly belonging to an era that predates Cass. The job advert also has a section on the trust’s “Equality and Diversity principles”, a phrase that strikes fear into anyone who believes in genuine equality — the old-fashioned kind that doesn’t prioritise airy-fairy notions about gender over everything else, that is.

You might think that doctors, of all people, should have been more resistant to pseudo-science, given its capacity to do permanent damage to vulnerable patients. But that’s to underestimate the influence of a determined bunch of “queer theorists” and trans activists. They were quietly working away, characterising nonsensical ideas as progressive, long before most of us had even begun to grasp what was going on.

The extent of institutional capture was confirmed when the BMA initially rejected the findings of the Cass Report, plunging the doctors’ union into a hugely damaging row with many of its own members. It was a warning of how much pushback is needed. A good start would be for Government ministers to tell public bodies to leave Stonewall’s Diversity Champions Scheme, of which Nottinghamshire Healthcare Trust is a proud member.

What we’re seeing now is the long tail of gender ideology, lighting up the sky before fading into obscurity. Too many people, however, are still dazzled by its pyrotechnics.


Joan Smith is a novelist and columnist. She was previously Chair of the Mayor of London’s Violence Against Women and Girls Board. Her book Unfortunately, She Was A Nymphomaniac: A New History of Rome’s Imperial Women will be published in November 2024.

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2 plus 2 equals 4
2 plus 2 equals 4
1 month ago

What we’re seeing now is the long tail of gender ideology, lighting up the sky before fading into obscurity. Too many people, however, are still dazzled by its pyrotechnics.

Unfortunately I think this is overly-optimistic from Joan Smith. This is a forever war.
Just as “the price of liberty is eternal vigilance”, so will be the price of defending vulnerable children and women’s rights from the insanity of the trans idealogues.

Robert
Robert
1 month ago

I think you’re right. All those who think we have reached ‘peak woke’ are deluding themselves. I live in the US and I read that a lot. No. This stuff is deeply ingrained in the people running the various organizations of government, schools, universities (including, now, medical and law schools), accrediting boards, etc. It’s not going anywhere.

David Morley
David Morley
1 month ago
Reply to  Robert

And we do seem to have developed an odd habit of identifying “woke” with trans. They are not the same – woke is far wider in its reach – and I doubt it is going away anytime soon.

Not only that, some of those feminists now opposing trans were once considered part of the woke phenomena, and attacked for it by people like Milo Y.

What short memories we have.

Evan Heneghan
Evan Heneghan
1 month ago

If you think the transgender madness is really passing you’re a more optimistic person than I.

Talia Perkins
Talia Perkins
1 month ago
Reply to  Evan Heneghan

You are in a deep part of it, of course you can’t see the edges of the cult you are in.

Tyler Durden
Tyler Durden
1 month ago

Of course a socialist state bureaucracy is going to enthuse about modern Californian transhumanism. Modern socialism is nothing but identity politics.

Talia Perkins
Talia Perkins
1 month ago
Reply to  Tyler Durden

“modern Californian transhumanism”
Has nothing you can even colorably argue to do with it.

David Morley
David Morley
1 month ago
Reply to  Tyler Durden

You’re just bundling together disparate things you don’t like. Transhumanism is far more likely to be pushed forward by competition and consumerism within a capitalist economy. While many modern socialists are a bit anti technology.

Mona Malnorowski
Mona Malnorowski
1 month ago

This is doubly depressing for me as I live close to Nottingham. Between this, a hopelessly inept City Council, the sorry state of the police force and the fiasco involving Trent College pastor Bernard Randall (link below) there aren’t many local institutions left I have any faith in. So far I’ve never had to go up before a judge but I can’t see my chances being great there either.
https://www.spiked-online.com/2023/12/04/i-was-sacked-as-a-school-chaplain-for-my-christian-beliefs/

Lancashire Lad
Lancashire Lad
1 month ago

Following closely on from yesterday’s article by MH which included reference to the dropping of the Robin Hood symbol by Nottinghamshire BS (could stand for bullshit) from its logo, has the Nottingham area suddenly become a hotbed for this kind of nonsense?

UnHerd Reader
UnHerd Reader
1 month ago
Reply to  Lancashire Lad

But Robin Hood was a socialist!!!

Rob N
Rob N
1 month ago
Reply to  UnHerd Reader

No he wasn’t. He stole from the thieving, taxing rich elite to return the money to the robbe and oppressed. He was a libertarian.

William Cameron
William Cameron
1 month ago

I was in Nottingham City hospital yesterday. It felt very odd. Rainbow signs everywhere . But not adequate parking. Reception didn’t work / but lots of diversity messages.

Saul D
Saul D
1 month ago

With the flags I always get the feeling that institutions are saying “we support all these minority groups … but not you”.
And why flags for these groups, why not mothers, or the elderly, or people with disabilities? What about alcoholics, the depressed, victims of crime, people with parking tickets, people who failed their GCSEs? And in particular, how about all those people with more legs than average – they really need a voice…

Talia Perkins
Talia Perkins
1 month ago
Reply to  Saul D

“With the flags I always get the feeling that institutions are saying “we support all these minority groups … but not you”.”

&

“And why flags for these groups, why not mothers, or the elderly, or people with disabilities? What about alcoholics, the depressed, victims of crime, people with parking tickets, people who failed their GCSEs? And in particular, how about all those people with more legs than average – they really need a voice…”

They are not denied a “voice”. <– They are either not abused in law or policy (people with parking tickets are in fact criminal in some fashion if they have not been “framed”).

Those flags are in defiance of people like you and those commonly here at The Herd, who think the people those flags are for deserve to be abused in law and policy.

You instead do deserve to feel the hurt you excuselessly want to inflict on other poeple.

~ I don’t wear Pride logos to tell you whom is in my bed. I wear Pride so the family across the street knows they are safe with me despite you. So the couple at the restaurant knows they are not alone. So gender nonconforming children know I’m not judging them for it. I wear Pride because you want them to hide and be afraid. ~

Saul D
Saul D
1 month ago
Reply to  Talia Perkins

You wearing a pride flag is great. It’s the group that you identify with. Please, do wear the flag with pride.
But why should government organisations also wave your flag? It leaves the impression that you are privileged in the public’s eyes. Why is something special about promoting people based on sexuality, over say supporting working mothers, or disability rights, or the challenges of age, or addiction, or mental health, or victims of legal injustice, or failures of education.The state should be secular.
More pointedly, I reject your attempt to abuse me with words like “you instead do deserve to feel hurt…” where you both misunderstand the point that is being made, and attempt to imply thoughts that I do not have. Treat people fairly as people not some invented hate figure stereotype.

Talia Perkins
Talia Perkins
1 month ago
Reply to  Saul D

“But why should government organisations also wave your flag?”

Because government should advocate for the protection of systematically abused people’s rights.

“It leaves the impression that you are privileged in the public’s eyes.”

Only to people who want to do that abuse, and want to pretend that this not what that is about.

“The state should be secular.”

What religion do you pretend is involved?

“I reject your attempt to abuse me with words like “you instead do deserve to feel hurt”

I have no reason to respect you at all. You have no legitimate complaint to make.

Talia Perkins
Talia Perkins
1 month ago

For one thing, Cass is herself still giving interviews to the effect that youth should be permitted medical transition, and not coincidentally per WPATH.

https://www.bbc.co.uk/programmes/m0023q2z

For another, because the NHS is not generally comprised of child abusing psychopaths — unlike the ranks and file of the gender critical — they will not, possibly not until force is used, permit the youth in their care to be abused in the manner the gender critical desire.

David Morley
David Morley
1 month ago

 “We just can’t have this free-for-all when people decide when they are or aren’t going to cooperate with an NHS England review,” he said.

This is perhaps the back story to this. Powerful professionals, in the NHS do not expect to be told what to do. Not by managers, and not by the elected government. So far as they are concerned, they are the experts, and they should be left to “get on with the job”.

Talia Perkins
Talia Perkins
1 month ago
Reply to  David Morley

When that review is obvious fraud done for political purposes, and, is interpreted by some to command what is in fact an atrocity — which is how the gender critical view the Cass Review and what they command — there will be precious few doctors who help commit the atrocity willingly.

B Emery
B Emery
1 month ago
Reply to  Talia Perkins

It is atrocious that hormonal and surgical experimentation on minors and vulnerable adults is happening in Britain.
It is atrocious that you will hide behind concerns for peoples rights to justify experimentation on children and young adults.

Talia Perkins
Talia Perkins
1 month ago
Reply to  B Emery

It is not experimentation, child abusing liar.

Your love of abusing some children is atrocious.

B Emery
B Emery
1 month ago
Reply to  Talia Perkins

Deflection.

Hiding behind insults is no better.
I’ve been called worse. Try harder.

It is medical experimentation. How else did you trial the treatments?

Talia Perkins
Talia Perkins
1 month ago
Reply to  B Emery

The only deflection is yours to claim it — I responded directly to your lies.
Setting bones is not experimentation, it is medicine and that even if every break is different.
Gender affirming care stopped being experimental beginning over 40 years ago and was that no longer now over 30 years ago. The accuracy of it’s use proves that, which a regret rate under 1%.
You are a child abuser, you want to force girls to have beards and deep voices and you want to force boys to have breasts and periods.

Derek Smith
Derek Smith
1 month ago
Reply to  Talia Perkins

What is a girl, Talia?

B Emery
B Emery
1 month ago
Reply to  Derek Smith

*America opens its latest gender identity dictionary*

Talia Perkins
Talia Perkins
1 month ago
Reply to  B Emery

No imbecile, looks at all available facts and applies logic and examples from history. What you can not or will not do, because you are a child abusing bigot.

B Emery
B Emery
1 month ago
Reply to  Talia Perkins

I quite like your combative style.
I will try to do that.
Would you like a thesaurus of insults?
I think you may have called me a child abuser at least three times. Could try some variety.

Talia Perkins
Talia Perkins
1 month ago
Reply to  B Emery

No, because you are child abuser. It is not insult, it is only accuracy in description.

B Emery
B Emery
1 month ago
Reply to  Talia Perkins

You over use the word imbecile and bigot too, are you sure don’t need a thesaurus?

Talia Perkins
Talia Perkins
1 month ago
Reply to  B Emery

They are fulsome to the issue, why should I use other?

Talia Perkins
Talia Perkins
1 month ago
Reply to  Derek Smith

Imbecile, a young human whose gender has developed more than 50% in a feminine manner. That is the correct answer until and unless we begin to categorize people into a third, middle sex. Doing so would be a mistake because there are only two directions in which someone may sexually dimorphize.

B Emery
B Emery
1 month ago
Reply to  Talia Perkins

‘You are a child abuser, you want to force girls to have beards and deep voices and you want to force boys to have breasts and periods.’

OK then. So you saying that Nature is forcing humans to have beards and breasts they don’t want.
I can’t actually force boys and girls to do that myself.
I have no problem with transgender people, but I don’t think we should be introducing children to these types of medicines and treatments, don’t you think it would be better to give them more time to understand themselves, before they make such a big decision?

Talia Perkins
Talia Perkins
1 month ago
Reply to  B Emery

“I can’t actually force boys and girls to do that myself.”

Child abuser, you can and are advocating for that to be law and policy.

“I have no problem with transgender people”

You just lied. You then say you want to force onto transgender people when they are children, exactly the misery I accuse you of wanting for them.

“don’t you think it would be better to give them more time to understand themselves, before they make such a big decision?”

Only if there were evidence that under current protocols mistakes were commonly made, and they are not so made. The applicable statistic is that less than 1% of people who transition medically regret it.

B Emery
B Emery
1 month ago
Reply to  Talia Perkins

Do you think you could make one post without accusing people of child abuse.
Dont you think you may want to consider the person you are talking to.
Do you have some some sort of source for your 1%?
Have these procedures and medications been used for long enough to assess the long term impact on people? What is the longest case study that’s been done? As in are you sure that none of these medications have long term side effects?

‘Child abuser, you can and are advocating for that to be law and policy.’

No. You want more laws and policy. I advocate less law and policy. The state is enormous enough, without adding more law and more policy.

Talia Perkins
Talia Perkins
1 month ago
Reply to  B Emery

“Do you think you could make one post without accusing people of child abuse.”

Only to those not advocating for child abuse to be law and policy, and you are doing that. You have made it perfectly clear you are a great fan of abusing some children.

That’s all only on you.

“Do you have some some sort of source for your 1%?”

Of course child abuser, I have cited it here many, many times.You want to claim something else, go cite it so I debunk it.

“You want more laws and policy.”

No liar, I do not. You are the one who did so here, “I don’t think we should be introducing children to these types of medicines and treatments”.

B Emery
B Emery
1 month ago
Reply to  Talia Perkins

If you are really concerned about transgender rights, providing sensible answers/ sources to a person legitimately trying to understand your position better might be more helpful than shouting child abuse at them.
You may well have shared the information before, I’m afraid I missed it.
How are the treatments regulated then if there is no regulations/ laws/ government policies in place. Are you saying this is completely unregulated?

Talia Perkins
Talia Perkins
1 month ago
Reply to  B Emery

I am providing sensible answers. You are too deliberately uneducated to care.

The consequence of, “I don’t think we should be introducing children to these types of medicines and treatments”, is an abused child, and, far more of them than the application of current WPATH standards of care to the matter.

“How are the treatments regulated then if there is no regulations/ laws/ government policies in place. Are you saying this is completely unregulated?” <– Other than that changed and additional and far more intrusive laws and policies must be emplaced and enforced to enact your preference, what you have just asked has no bearing on it.

This link to a list of links is a beginning.

https://taliaperkinssspace.quora.com/People-are-born-transgender-they-are-not-mentally-ill-it-is-no-paraphilia-it-is-a-physical-birth-defect-no-more-a-men

John Tyler
John Tyler
1 month ago

Simple answer to headline question: because they think they know better than anyone else. Ideology trumps science and good sense yet again.

Talia Perkins
Talia Perkins
1 month ago
Reply to  John Tyler

And yet, there is no such ideology — and in fact they do know better. They actually care about their patients and facts, and you care your feelings.

UnHerd Reader
UnHerd Reader
1 month ago

The people who run the hospital easily research the drug Lupron (different brands do the same thing), a puberty blocker. Check out the 10,000+ reports of adverse side effects to the FDA. Women who used it for precocious puberty and endometriosis (and some men for prostate cancer) have suffered tooth loss, hair loss, brain fog every day, osteoporosis, joint pain so extreme that a person is wheelchair bound and on opioid painkillers, and other side effects. Check out the forums where women and men discuss how the blocker has destroyed their lives. Check it out trans fanatics. And you want to give it to children?

Talia Perkins
Talia Perkins
1 month ago
Reply to  UnHerd Reader

The way I know you are not really any physician is lies you tell like this:

Check out the 10,000+ reports of adverse side effects to the FDA. Women who used it for precocious puberty and endometriosis (and some men for prostate cancer) have suffered tooth loss, hair loss, brain fog every day, osteoporosis, joint pain so extreme that a person is wheelchair bound and on opioid painkillers, and other side effects.

An actual physician would not conflate adverse effects to be side effects known to be caused by the drugs, as for youth those adverse effects do not occur in the youthful population taking them above the baseline rate either when youth or later as adults. You would take note that some “side effects” reported for youth are actually suppressed by puberty blockers to a degree, which would be expected given their mechanism of action, such as pseudo tumor cerebri.

Adults taking puberty blockers for the uses cases in adults have side effects — none are known to occur in youth. It is deceit or incompetence for you to conflate them.

You are a fraud and incompetent as a physician, and we both know it.

UnHerd Reader
UnHerd Reader
1 month ago
Reply to  UnHerd Reader

I should also add the threat to women’s rights. This is why I read British media. Except a few conservative outlets, there is basically no news about women’s rights or transing children. The New York Times has covered trans children three times. What is interesting are the comments for each story. The Times has a large readership of liberals, yet 95 percent are firmly against transitioning children. An article about Lia Thomas, the trans identified male college swimmer, had a lot of commenters. Ninety-nine percent of them were against men in women’s sports. American media outlets, again conservative outlets, are overall ignoring these important trends.

Talia Perkins
Talia Perkins
1 month ago
Reply to  UnHerd Reader

“I should also add the threat to women’s rights.”

None exist.

“Ninety-nine percent of them were against men in women’s sports.”

Which has nothing to do with it — as Lia Thomas is not a man, and, has been on HRT for quite a long time. She has never “dominated” any event.

https://www.independent.co.uk/news/world/americas/lia-thomas-trans-swimmer-ron-desantis-b2091218.html

UnHerd Reader
UnHerd Reader
1 month ago
Reply to  Talia Perkins

oh dear, we got a deluded trans activist here, spouting pseudo science and saying patently absurd things as ‘Lia Thomas is not a man’ — I think you’ll find his DNA and p***s suggest otherwise — and ‘she has never dominated any event’ — except UPenn’s womens 500-yard freestyle. And, goodness, no threat to women’s rights exist, except of course the right to single-sex spaces, enshrined in law.

Talia Perkins
Talia Perkins
1 month ago
Reply to  UnHerd Reader

Lia Thomas was always in the top of her rankings in that event. The idea she should never win it is ludicrous. You can not change her times or rankings, and HRT plainly removed all masculine advantage from her. It was 5th place, not 1st place, in which she tied Riley Gaines, you can’t change that either.

You are an incompetent physician or simply a fraud in claiming you are a physician, or would acknowledge the implications to all the exceptions to “single sex”.

You are the activist, a fraudulent physician out to abuse children whom you hate.

B Emery
B Emery
1 month ago
Reply to  Talia Perkins

“I should also add the threat to women’s rights.”

None exist.’

Apart from women having to share changing rooms and toilets with men. Men in womens prisons. Are you really saying that there is absolutely no risk to women in these situations.

For someone who is clearly very passionate about transgender rights, your disregard for children’s and women’s rights is rather ironic.

Talia Perkins
Talia Perkins
1 month ago
Reply to  B Emery

“Apart from women having to share changing rooms and toilets with men.”

Which has nothing to do wit it — it only your delusion.

I have no such disregard. What you pretend is real is not.

B Emery
B Emery
1 month ago
Reply to  Talia Perkins

That is a really bad deflection.

Who can say what is real and what is not.

‘If there is existence, there must have been non – existence. And if there was a time when nothing existed, then there must have been a time before that – when even nothing did not exist. Suddenly, when nothing came into existence, could one really say whether it belonged to the category of existence or of non – existence? Even the very words I have just uttered – I cannot say whether they have really been uttered or not’ – Chuang Tzu

Talia Perkins
Talia Perkins
1 month ago
Reply to  B Emery

“Who can say what is real and what is not.”

That is deflection.

You are here only to be a child abusing liar and sophist.

B Emery
B Emery
1 month ago
Reply to  Talia Perkins

Well it’s very hard to have a sensible conversation with you if you are going to deflect, I thought I’d show you what a better deflection looks like.

‘I am whatever it is you say I am’ – Eminem.

Talia Perkins
Talia Perkins
1 month ago
Reply to  B Emery

You are the only one deflecting here.

Guy Austin
Guy Austin
1 month ago
Reply to  Talia Perkins

Talia. Are you by any chance related to Titania McGrath?

Talia Perkins
Talia Perkins
1 month ago
Reply to  Guy Austin

No, but you are plainly a child abuser as Andrew Doyle is.

Talia Perkins
Talia Perkins
1 month ago
Reply to  UnHerd Reader

Will you ever have any fact laden, substantive reply?

Jake Raven
Jake Raven
1 month ago

The Kneeler could not define a woman and his party are in thrall to trans ideology, so don’t expect the Cass report recommendations to be taken seriously by this bunch of socialist retards.

Talia Perkins
Talia Perkins
1 month ago

“It’s as if the Cass Report never happened.”
It is now and was in design, only cherry picking fraud writ very large.