British Medical Association no longer opposes Cass Review – apart from puberty blockers ban

Doctors from the British Medical Association (BMA) have said that the medical body no longer opposes the Cass review, but believes that clinicians should still be able to prescribe puberty blockers.

BMA doctors had previously criticised the controversial report into gender medicine by Dr Hilary Cass, with the body voting to “oppose the implementation” of the review in July 2024 and declaring its recommendations “unsubstantiated”.

In a statement published at the time, the BMA said that it had “been critical of proposals to ban the prescribing of puberty blockers to children and young people with gender dysphoria, calling instead for more research to help form a solid evidence base for children’s care.”

On 6 May, however, the BMA published a new critique of the Cass review written by 12 union members.

Chair of the BMA’s board of science and the new report’s lead author, Professor David Strain, told The Times that Dr Cass “has been vindicated in the way she approached the data”, and went on to praise her approach.

Professor Strain also said that he couldn’t highlight a single recommendation of the 32 included in the Cass report that the BMA opposed.

‘To have a political decision affecting the way we prescribe is wrong’

“She approached an area of significant uncertainty with that prime rule of medicine, of ‘first, do no harm,’” he said.

However, the BMA are “continuing to oppose a ban on puberty blockers”, for reasons including “a threat to the autonomy of a doctor”. They said: “We spend decades training on how to use drugs, and to have a political decision affecting the way we prescribe is wrong.”

Strain said specialists should be able to prescribe the drugs, but they should not be “freely available”.

When the Cass review was first published in 2024, it was criticised by clinicians, academics, charities and health bodies which work with trans people. Some expressed “great concern”, and others labelled it “deeply flawed” and claimed it had relied on a “selective and inconsistent use of evidence”.

A government-prescribed review into puberty blockers and their effects was supposed to begin earlier this year but has been paused.

NHS England’s PATHWAYS trial was put on hold in February after the Medicines and Healthcare products Regulatory Agency (MHRA) voiced concerns regarding its methodology.

Headed by King’s College London (KCL), the £10million study, which is set to analyse the effects of puberty suppressants on transgender adolescents, was commissioned after health secretary Wes Streeting indefinitely extended a ban on new prescriptions for the medication.

As a result, there is currently no way for trans youths in the UK to get hold of puberty blockers. The medication is also regularly prescribed to cisgender children to treat issues such as precocious puberty.

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