Cass Review author calls for ‘holistic’ child care

Green MSP Gillian Mackay cited concerns that the review suggested a gender transition was the “worst outcome” for young people.

Dr Cass said a medical transition was a really important option for people who were going to have a long-term trans identity. “And one from which many people do benefit.”

But she warned the “risk” of starting that transition at a point when someone is still in the process of development is you give treatment to wrong person.

“The reason that is a negative outcome is because medical transition does not come without costs in terms of effect on sexual function, fertility, knowns and unknowns about long-term bone health risk, the limitations of surgery.

“All those costs which are well worthwhile if you have a long-term, stable trans identity but it’s a high cost to pay if, in the longer term, you don’t.”

She said picking the “sweet point” where medical professionals have a high level of certainty they are giving the treatment to the right people is “very important”.

A Scottish government spokesperson said: “The Cass Review is a comprehensive and valid scientific document. In line with NHS England – for whom the report was commissioned – we are considering all of the recommendations.

“A multi-disciplinary clinical team within the office of the chief medical officer in the Scottish government – including people with paediatric, pharmacy and scientific expertise – is leading this work.

“The chief medical officer will provide a written update to parliament on the outcome of that clinical consideration process before the summer recess.”