In an interview to be broadcast on Sunday, she said there was a “lack of realism about what transition would really mean and how hard it would be” – pointing to “quite intensive medical treatments” and “sometimes quite brutal surgeries”.<\/p>\n
She added: “There are a tiny number of people who will never be comfortable with their biological sex, with the gender associated with their biological sex.<\/p>\n
“And for them, a medical pathway is the only way they’re going to live their life comfortably. And we don’t understand why that is, but we have to try and help those people thrive as much as the young people who are going to grow out of this.”<\/p>\n
The review was commissioned after concerns about the treatment of growing numbers of children and young people with worries about their gender, particularly at the Tavistock Clinic in London<\/p>\n
When asked how many children with distress about their gender would experience that same distress into adulthood, Cass said it was impossible to assess precisely, but it would be a “really tiny number”.<\/p>\n
The paediatrician added: “When the clinic started, there were about 50 children a year in the UK, and then by the time I started my review it had shot up to 3,500 a year. <\/p>\n
“We tried very hard to find out from the Tavistock what happened to the ones who didn’t go on medical pathway. They just didn’t follow them up and they didn’t have that data. <\/p>\n
“So that’s one chunk of children who don’t go on a medical pathway, then there are all the ones that me and parents and teachers will tell you about who go through two or three years of gender questioning and then desist.” <\/p>\n
Asked if children had been let down by an adult-led debate, Cass said “absolutely”, adding they “were also caught up in all the issues about single-sex spaces and sports and safe areas for women which were actually not to do with the children but they were somehow part of a football within it”.<\/p>\n
“That’s a real shame that children have been weaponised.”<\/p>\n
The vast majority of people in the middle of the debate were silent while the “people at the extremes” and rhetoric in the media had been “frightening for young people,” the clinician said.<\/p>\n
She added that some activists for trans rights had been “so strident that it’s made it more difficult for trans people themselves who are just trying to live under the radar”, while equally people who had taken the view no-one should ever transition had “similarly made it difficult”.<\/p>\n