Trans group expresses ‘great concern’ over Cass-style review into adult gender services

Charities and experts have expressed concern over the announcement of a review into adult gender clinics by NHS England.

The review, to be led by NHS North West medical director Dr David Levy, was announced by NHS England earlier this week.

In a letter to paediatric expert and the author of the Cass Report, Dr Hilary Cass, NHS England’s medical director for specialised services, Professor James Palmer, and its acting director of specialised commissioning, John Stewart, said the Levy Review will provide “an important way of exploring the broader concerns and issues with adult services”.

The letter went on to say: “The programme of reviews will be led by Dr David Levy and will carefully consider experiences, feedback and outcomes from clinicians and patients, past and present.”

The suggestion that NHS England should review its adult gender services was made by Dr Cass as part of her 32 recommendations in how best to update youth gender clinics in England.

The Cass Report was criticised by health experts and the trans community, with several people calling it of “poor quality” and guilty of a “selective and inconsistent use of evidence”.

Trans activism group TransActual expressed “great concern” about the Levy Review.

“We are concerned that the focus will be on the legitimacy and efficacy of medication instead of improving healthcare and reducing waiting lists for consenting adults,” the not-for-profit organisation said.

“We are also concerned that the lived experience of tens of thousands of people, and the wealth of international evidence and best practice, will be ignored.”

What is the Levy Review?

The Levy Review will analyse the way in which adult gender clinics are run in England.

It will use information gathered from the Cass Report about adult gender services, to make recommendations on how to improve the way in which trans healthcare is delivered.

According to the letter written by the NHS England directors, it will assess the quality and stability of each of England’s nine gender identity clinics (GICs) – those in the devolved nations will not be covered – and consider whether the “existing service model” is still appropriate.

A panel of medical experts, headed by Dr Levy, will look into various aspects of each GIC, including effectiveness, safety and patient experience, and consider personal accounts of how patients received care. The first on-site visits will begin next month.

The findings of the review – which, at the time of reporting, does not have a definitive end date – will “inform an updated adult gender service specification” which will then be considered and potentially implemented by NHS England.

TransActual, have asked for clarification on why Dr Levy has been chosen to head the review and what makes him qualified to conduct it.

“Once again, we have a review that the service users have not asked for, which risks being manipulated by the same bigoted actors within the NHS, media and parliament, into a further attack on a level of service provision that is already unfit for purpose,” TransActual claimed.

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