Talk:Cass Review

sources for consideration

• Vinter, Robyn (11 April 2024). "Trans children in England worse off now than four years ago, says psychologist". The Guardian.
• "The Guardian view on the Cass report: rising numbers of gender distressed young people need help". The Guardian. 11 April 2024.
• Barnes, Hannah (10 April 2024). "The Cass review into children's gender care should shame us all". New Statesman.
• "The Observer view on the Cass review: children were catastrophically failed by the medical profession". The Observer. 14 April 2024.
• "RCPCH responds to publication of the final report from the Cass Review". RCPCH.
• "Cass Review 'should mark a watershed moment' – charity chief". The Shropshire Star. 9 April 2024.
• Hansford, Amelia (10 April 2024). "Cass report urges 'caution' in prescribing puberty blockers to trans youth". PinkNews.
• Dyer, Clare (9 April 2024). "Guidelines on gender related treatment flouted standards and overlooked poor evidence, finds Cass review". BMJ: q820. doi:10.1136/bmj.q820.
• Abbasi, Kamran (11 April 2024). "The Cass review: an opportunity to unite behind evidence informed care in gender medicine". BMJ: q837. doi:10.1136/bmj.q837.
• Abbasi, Kamran (9 April 2024). ""Medication is binary, but gender expressions are often not"—the Hilary Cass interview". BMJ: q794. doi:10.1136/bmj.q794.
• Cass, Hilary (9 April 2024). "Gender medicine for children and young people is built on shaky foundations. Here is how we strengthen services". BMJ. 385: q814. doi:10.1136/bmj.q814. ISSN 1756-1833.
• "Evidence for puberty blockers and hormone treatment for gender transition wholly inadequate". BMJ.
• Penna, Dominic (16 April 2024). "Chris Whitty: Debate around transgender issues 'too vitriolic'". The Daily Telegraph.
• Reed, Erin. "Why Hilary Cass' NHS report is wrong about trans health care". The Advocate.
• "Gender care review: Children 'let down' by research amid 'exceptionally toxic' debate". ITV News.
• "Hilary Cass: Ideology on all sides directed gender care of children". ITV News.
• Horton, Cal (14 March 2024). "The Cass Review: Cis-supremacy in the UK's approach to healthcare for trans children". International Journal of Transgender Health: 1–25. doi:10.1080/26895269.2024.2328249.
• "Gender Identity Service Series". Archives of Disease in Childhood.
• Thornton, Jacqui (April 2024). "Cass Review calls for reformed gender identity services". The Lancet. 403 (10436): 1529. doi:10.1016/s0140-6736(24)00808-0.
• Ghorayshi, Azeen (2024-05-13). "Hilary Cass Says U.S. Doctors Are 'Out of Date' on Youth Gender Medicine". The New York Times. ISSN 0362-4331. Retrieved 2024-05-14.
• Grijseels, D. M. (8 June 2024). "Biological and psychosocial evidence in the Cass Review: a critical commentary". International Journal of Transgender Health. doi:10.1080/26895269.2024.2362304.
• Horton, Cal; Pearce, Ruth (7 August 2024). "The U.K.'s Cass Review Badly Fails Trans Children". Scientific American. Retrieved 13 August 2024.
• Polgreen, Lydia (13 August 2024). "The Strange Report Fueling the War on Trans Kids". New York Times. Retrieved 13 August 2024.
• Budge, Stephanie L.; Abreu, Roberto L.; Flinn, Ryan E.; Donahue, Kelly L.; Estevez, Rebekah; Olezeski, Christy L.; Bernacki, Jessica M.; Barr, Sebastian; Bettergarcia, Jay; Sprott, Richard A.; Allen, Brittany J. (28 September 2024). "Gender Affirming Care Is Evidence Based for Transgender and Gender-Diverse Youth". Journal of Adolescent Health. doi:10.1016/j.jadohealth.2024.09.009. ISSN 1054-139X.

Criticism in lede

i am not okay with this revert, why did you unilaterally overturn consensus? Editing-dude144 (talk) 16:29, 14 October 2026 (UTC)

Seems to be a consensus that the lede needs revising. I propose inserting the phrase "heavily criticized" into the first sentence so that it reads

The Independent Review of Gender Identity Services for Children and Young People (commonly referred to as the Cass Review) is a heavily criticized independent review commissioned in 2020.

Or would people prefer to describe it as controversial? HenrikHolen (talk) 16:37, 16 October 2026 (UTC)

the criticisms are clearly relevant to the subject. Cass review is extremely controversial and hasn't been adopted outside of the United Kingdom WP:DUE & MOS:OPEN : The Cass Review's notoriety and importance is completely linked to its controversial nature. It would not be discussed if it wasn't controversial By not including its controversial nature, we are illustrating an inaccurate depiction of the report and a non-descriptive lede. This report, factually is controversial but moreover, the Cass Review as a subject is inextricably linked to its criticisms and backlash. Editing-dude144 (talk) 16:36, 14 October 2026 (UTC)

I think that we should, at the very least, acknowledge that it is controversial early on in the lead. Huge sections of the article are devoted to critiques of it, so at an absolute bare minimum it's inappropriate (and fails to adequately summarize the body) to omit how controversial it is. --Aquillion (talk) 18:28, 14 October 2026 (UTC)

Agreed I think the best way to do so, would be to add this terminology back in link to commit

I need to wait 24hr before doing so Editing-dude144 (talk) 20:40, 14 October 2026 (UTC)

I agree, and I think the best way to do that would be to add a qualifier in the first paragraph HenrikHolen (talk) 00:33, 15 October 2026 (UTC)

agreed, let's give it 24hrs for any conflicting responses then establish consensus. Editing-dude144 (talk) 14:09, 15 October 2026 (UTC)

Agreed Snokalok2 (talk) 15:58, 15 October 2026 (UTC)

Hi Snokalok, I just reverted your revert for a couple of reasons. 1) as @Partofthemachine noted, the text is not supported by the linked sources. We can't use a press release by WPATH for this statement (even if we could use a press release, WPATH is not independent from the Cass Review) and The National article, which is mostly just quoting others, does not state this. 2) The sentence is duplicative as the lead already states "Medical organisations outside the UK, international medical organisations, and other countries' clinical practice guidelines have criticised its methodology, findings, and recommendations. PositivelyUncertain (talk) 19:38, 15 October 2026 (UTC)

this should be moved to a new thread, you both are violating the BRD requirements on this page Editing-dude144 (talk) 20:44, 15 October 2026 (UTC)

it is normal and expected for the lead to state things that are stated in the body of the article. It's actually required Wikipedia:Manual of Style/Lead section. Edit: ah you're claiming that it duplicates info in the lead. I think that wording minimizes the international response. The way it's worded now is extremely wordy and vague. Per Wikipedia:Manual of Style/Lead section and WP:UNDUE, I think the more concise wording is much better. Is there any specific reasoning that you prefer listing out each part of the global response in the lead? That is more fitting for the body.

We can use WPATH as it is a reliable source and medical organization Wikipedia:Reliable sources

Similarly, secondary sources are actually encouraged so your comment on the national also does not violate Wikipedia:Reliable sources.

I understand hesitation at the number of sources for this comment. We can add in more reliable sources if you want. Additionally please cite the style guidelines when making your arguments. I am not really sure what the basis for your removal and reverts are. Editing-dude144 (talk) 20:54, 15 October 2026 (UTC)

You are currently blocked from the article for edit warring...please don't lecture about BRD when I have made one revert and took it to talk. Also, before sending a CT notice to somebody it's common practice to check that they received it before. If you had checked you would see that I am well aware this is a CT PositivelyUncertain (talk) 05:12, 16 October 2026 (UTC)

take it to my talk page Editing-dude144 (talk) 15:03, 16 October 2026 (UTC)

And as I said, it’s in the lede - meaning we don’t need any citation so long as the body supports it - which it does. If you prefer, I can simply delete the citation altogether and leave it empty. Snokalok2 (talk) 21:44, 15 October 2026 (UTC)

Yeah, the body lists numerous countries and medical orgs outside of the UK criticizing the reports findings. Yet the main adoption of this review was within the UK and in Trump's politically charged report. This is not Wikipedia:Undue weight (sources) because that has legitimately been the international medical response.

Other users are welcome to add more reliable sources and summaries if they think the article is missing some part of the international response. Editing-dude144 (talk) 21:57, 15 October 2026 (UTC)

Why do we need this sentence and the sentence I quoted above as it repeats the same information, just the second one (the one you re-added) lacks precision? And you re-added it as-is without looking into the issues POTM pointed out.

In terms of the number of med orgs around the globe, the number that criticized/rejected the review is a drop in the bucket. The sentence in question makes it seem like most of the medical community rejected Cass when that is not the case. The lack of precision misrepresents the wider response. PositivelyUncertain (talk) 05:07, 16 October 2026 (UTC)

It’s really not a drop in the bucket, it’s more or less the entire first world plus a little but of the second (Poland) Snokalok2 (talk) 07:00, 16 October 2026 (UTC)

It is not a drop in the bucket, and the article already illustrates that. The first line in global medical receptions says "Professional organisations and transgender health providers have widely criticised the review's findings." And goes on to list 11 different countries who's medical communities rejected the review. Not a single other country had a medical community that accepted the cass review in that section. If you believe there's something missing from that section, you are welcome to add it in.

It is not WP:UNDUE or a violation of WP:NPOV to describe this as controversial. One could even argue that "debunked" would not violate WP:NPOV as it stands. Editing-dude144 (talk) 14:56, 16 October 2026 (UTC)

I agree with everyone else who says that most of the medical community *did* reject Cass. Loki (talk) 16:23, 16 October 2026 (UTC)

I could have sworn we had an RfC that found the CASS review to be a WP:FRINGE source largely on that basis. But, of course, it involves the medical care of trans people so we need to have unlimited numbers of debates about this piece of bad science and worse politics. Simonm223 (talk) 16:25, 16 October 2026 (UTC)

As I recall, the actual thread found SEGM and Gender Exploratory Therapy to be fringe, as well as GAC to be good science; and Cass advocates Gender Exploratory Therapy in place of GAC as a conclusion to the Cass Review - but the RFC didn't actually say the Cass Review itself is fringe. Snokalok2 (talk) 17:36, 16 October 2026 (UTC)

If the Cass Review is a non-MEDRS-compliant source that advocates for a WP:FRINGE position I don't think it's a stretch to say that it's a fringe source. Simonm223 (talk) 19:13, 16 October 2026 (UTC)

The Cass Review is not fringe and I'm not sure why you bring up MEDRS because nobody on this page is trying to use it for medical claims. That said, the systematic reviews conducted under the Cass Review do meet MEDRS PositivelyUncertain (talk) 20:41, 16 October 2026 (UTC)

Cass absolutely promotes fringe theories.

From WP:FRINGE states "fringe theory is used in a broad sense to describe an idea that departs significantly from the prevailing views or mainstream views in its particular field."

The prevailing medical opinion (which I believe is distinct from the political/governmental reactions) is that puberty blockers have already been established to be safe, already are prescribed to minors, and treat gender dysphoria. The idea that puberty blockers would somehow be worse for trans youth than cisgender youth doesnt hold much weight.

This study, “These Laws Will Be Devastating”: Provider Perspectives on Legislation Banning Gender-Affirming Care for Transgender Adolescents states "Providers of gender-affirming care overwhelmingly opposed legislation that bans gender-affirming care for TGDY citing the severe consequences to the health and well-being of TGDY along with the need to practice evidence-based medicine without fear."

The US Endocrine Society similarly objects to puberty blocker bans.

So does the American Academy of Pediatrics

The SFEDP (French Society of Pediatric Endocrinology and Diabetology) commissioned their own study and firmly rejected the "wait and see" approach for GAC in minors.

The Australian Medical Association also firmly stands by the prescription of puberty blockers.

The Canadian Pediatrics Association also supports puberty blockers

(This is all on top of what is already in the article.)

Cass Review promotes WP:Fringe theories, so in my book that makes it a fringe source. Editing-dude144 (talk) 20:08, 18 October 2026 (UTC)

Do we have any sources that say most of the medical community rejected the review? PositivelyUncertain (talk) 19:56, 16 October 2026 (UTC)

heres one but see my response here for more sources to synthesize: Talk:Cass Review#c-Editing-dude144-20261018200800-PositivelyUncertain-20261016204100 Editing-dude144 (talk) 20:12, 18 October 2026 (UTC)

That source is about US state bans and restrictions and was published in 2021 (Cass came out in 2024). PositivelyUncertain (talk) 21:04, 18 October 2026 (UTC)

I don't think your comment is correctly understanding Wikipedia policy. Quoting WP:MEDORG is very standard. Could you expand on why you think Cass and WPATH are not independent. HenrikHolen (talk) 00:22, 16 October 2026 (UTC)

It's a press release from an organization that is heavily discussed and criticized in the Cass Review meaning it's not independent. At most, the press release can be used to describe WPATHs own response, not the response of the broader medical community. PositivelyUncertain (talk) 05:00, 16 October 2026 (UTC)

Whelp it's a moot point anyway. I just read over the press release and nowhere does it say that the international medical community criticized the review. PositivelyUncertain (talk) 05:20, 16 October 2026 (UTC)

Cass criticizing WPATH is not an impartiality issue. It might be a WP:NOMANDY question, but that only applies to statements Cass made about WPATH specifically; it does not apply to the whole review. Saying the international community has criticized it is a fair summary of text which appears, and is sourced, in the body per WP:LEAD HenrikHolen (talk) 13:52, 16 October 2026 (UTC)

If a distinguished astronomer is criticized by a publication claiming stars are fake we don't say the distinguished astronomer is non-independent of the fake-stars publication. Simonm223 (talk) 20:08, 16 October 2026 (UTC)

Part of the review included a BMJ published study focused on how so many medical body guidelines included interventions that lacked an evidence base. The study found these guidelines were all based on WPATH and endocrine society standards and the review argues that a vulnerable population has been or could be harmed by these guidelines. A WPATH self-published press release replying to the review is not independent and any statements used from the press release need to be attributed.

But regardless, nowhere in that doc or the other cited doc does it state that the review was widely criticized by the international medical community. Would you mind deleting those two references while the sentence is discussed? PositivelyUncertain (talk) 20:35, 16 October 2026 (UTC)

ILGA is one of the largest stakeholder groups and as such is due. As for the quotation of Ruth Pearce, the expert opinions of professionals who are regularly cited in reputable journals is explicitly listed as a permissible use of WP:SELFPUB. Further, you are trying to scrutinize the sources ILGA used. That is WP:SYNTH; we base our assessment of sources on the reputation of the publisher, we do not investigate "the sources of sources". HenrikHolen (talk) 22:29, 16 October 2026 (UTC)

Right in the ILGA document it states it's a quote from her blog. How is that investigating the source of sources? And how is a brief mention of Cass in a statement about school policy due for inclusion in this document? I did not remove any of the language only the cite. PositivelyUncertain (talk) 23:22, 16 October 2026 (UTC)

If ILGA uses her blog as a source it doesn't suddenly become a blog. This isn't how sourcing works. Simonm223 (talk) 09:56, 17 October 2026 (UTC)

It does when it's a direct quote from the blog. PositivelyUncertain (talk) 15:09, 17 October 2026 (UTC)

I've split this section from the one above, not sure why this was started as a reply to a month's old thread. InfernoHues (talk) 14:45, 16 October 2026 (UTC)

Sources for statement

From what I can tell, the sentence It has been widely criticized by the international medical community in the lead is based off the first sentence in the Cass Review#Global medical reception section: Professional organisations and transgender health providers have widely criticised the review's findings. That sentence has two sources:

• Xian et al states exactly that Professional organizations and transgender health providers have widely criticized the Review’s findings (I'll reword so not a direct copy), which doesn't mention the international medical community. Additionally it is a passing mention without any analysis of the international response, just a quick statement which brings up questions of WP:DUE.
• The ILGA statement is in response to UK changes to school guidance policies. The statement includes a bullet-point that the updated guidance uses the Cass Review as evidence and then goes on to quote a blog, stating As stated by healthcare activist and feminist researcher Dr Ruth Pearce in an article titled “What’s wrong with the Cass Review? A round-up of commentary and evidence” (2024), the Cass Review “has been extensively criticised by trans community organisations, medical practitioners, plus scholars working in fields including transgender medicine, epidemiology, neuroscience, psychology, women’s studies, feminist theory, and gender studies”. We use this source (a direct quote from a blog) 2 times for the statement that the review was heavily criticized. With that consideration I am going to boldly remove those two cites.
• Additionally, we use the ILGA statement to state The International Lesbian, Gay, Bisexual, Trans and Intersex Association (ILGA), international LGBTQ student organisation IGLYO, and Transgender Europe released a joint statement which criticised the Cass Review's "poor and inconsistent use of evidence, pathologising approaches, and exclusion of service users and trans healthcare experts. ILGA and Transgender Europe also raised concerns about "pathologizing approaches" and the use of language like "gender questioning" to refer to transgender youth. How can we quote this source so extensively when the statement itself is not about Cass and their only mention of Cass is two sentences? The current language makes it sound like the ILGA is responding directly to the review and its not.

With those points in mind, I have two questions:

1. Does the Xian et al citation support the statement that the review was widely criticized by the international medical community?
2. Should we remove the paragraph about ILGA's response to the Cass Review? — Preceding unsigned comment added by PositivelyUncertain (talk • contribs) 22:02, 16 October 2026 (UTC)

1. I don't see much of a difference between "professional organizations and transgender health providers" and "the international medical community", but if you think there is one, then I have no issue with a rewording.

2. The reason we have declare some sources unreliable is because as editors we don't have the ability to decide which blogs are reliable and which aren't. A reliable source does have that ability, and so it's fine for them to cite blogs. Like HenrikHolen says above, we shouldn't be investigating the sources of the sources.

3. There's also this I just found , which says "The Cass Review is one of the most critiqued healthcare policy processes in recent history, condemned by healthcare, academic, and lived-experience experts from around the world for methodological, conceptual, interpretative, evidential, and epistemological failings." While that isn't a WP:MEDRS, it wouldn't be used here for biomedical information. InfernoHues (talk) 22:45, 16 October 2026 (UTC)

linking this response because I think its relevant here too. The expert opinions in the field at hand (pediatrics, endocrinology, and transgender healthcare) have overwhelmingly rejected the cass reviews suggestions that gender affirming care is not rooted in science and Cass Review's presentation as an evidence based review. Talk:Cass Review#c-Editing-dude144-20261018200800-PositivelyUncertain-20261016204100

Provider Perspectives on Legislation Banning Gender-Affirming Care for Transgender Adolescents

American Academy of Pediatrics

SFEDP (French Society of Pediatric Endocrinology and Diabetology)

Australian Medical Association

Canadian Pediatrics Association

In fact, any study that supports for gender affirming care for minors that came out shortly after updates on the Cass Review could very well be in response to it. Especially if the organization it originates from is in an English speaking country, the UK itself, or a neighbor of the UK Editing-dude144 (talk) 20:50, 18 October 2026 (UTC)

Blanket restores and reverts

please remember that reverts without discussion are reserved for specific scenarios such as vandalism.

https://en.wikipedia.org/wiki/Wikipedia:Revert_only_when_necessary Editing-dude144 (talk) 16:09, 14 October 2026 (UTC)

please archive this, I didn't know what I was talking about Editing-dude144 (talk) 21:35, 15 October 2026 (UTC)

Undue weight given to support of cass review

Wikipedia:Neutral point of view there's a huge amount of weight being given to supporters of the cass review, but extremely little weight given to the overwhelming global response to the Cass review.

As stated in another topic, we don't even mention this backlash until 3 paragraph in. I propose that we amend the lede to include that the study is controversial in the first line

is an a controversial independent review commissioned in 2020 by NHS England and NHS Improvement[1]

Additionally, the lede paragraph on criticism is sorely lacking. It fails to mention widespread global panning of the review, which is again not assigning enough weight. We focus exclusively on lgbt aligned groups rather than describing the full scope of disagreement in the global medical community

I will work on rewriting the 3rd paragraph to abide by style guidelines. Editing-dude144 (talk) 16:52, 14 October 2026 (UTC)

Lede is far too long

i struggle to see the importance of including the following text in the lead. It seems better suited for an "Impact Section". Let's move this to a new section and summarize it in a shorter format.

"The Gender Identity Development Service (GIDS) at the Tavistock and Portman NHS Foundation Trust was closed in March 2024 and replaced in April with two new services, which are intended to be the first of eight regional centres.[4] In August, the pathway by which patients are referred to gender clinics was revised and a review of adult services commissioned.[5] In September, the Scottish government accepted the findings of a multidisciplinary team that NHS Scotland had set up to consider how the Cass Review's recommendations could best apply there.[6] In England a delayed clinical trial into puberty blockers was planned for 2025,[7][8] but was later delayed to 2026 due to ethics concerns about the original trial design.[9][10]" Editing-dude144 (talk) 17:08, 14 October 2026 (UTC)

I agree. I've checked that all this content is covered in the appropriate sections so I will boldly delete. HenrikHolen (talk) 17:45, 14 October 2026 (UTC)

sounds good to me, I think we should leave in the bit about puberty blockers and potentially something on the requested trial being postponed. Those feel relevant to the review articles lead Editing-dude144 (talk) 17:48, 14 October 2026 (UTC)

This is a 9,000 word article with 10 sections, I do not think 4 paragraphs is too long. That said, I agree that the language quoted above should be moved to the body. PositivelyUncertain (talk) 19:46, 15 October 2026 (UTC)

I don't think removing mention of criticism from the lead is due when the justification is just shortening it. That seems very non-neutral to me. Simonm223 (talk) 14:02, 16 October 2026 (UTC)

I absolutely agree criticism should be in the lead. I only made the above to say that I agree. PositivelyUncertain (talk) 19:52, 16 October 2026 (UTC)

I don't think it should be removed entirely from the lead. As it stands, a huge chunk of this article is devoted to criticism. That should be addressed in the lede. Additionally, another talk thread recently agreed on adding this paragraph in. I don't think we should overturn that consensus because the paragraph isn't concise enough. Let's focus on making it more concise, but retaining the information. Editing-dude144 (talk) 14:40, 16 October 2026 (UTC)

Ignoring Onus & Gaming 0RR

I've gotta say, I'm pretty disturbed at how it has been so quickly decided that not only does "It has been widely criticized by the international medical community" get to stay in the lead, but it now gets to be in the first paragraph of the lead. Here is the timeline:

• 10/14/26 (2 days ago) - @Editing-dude144 adds the sentence to the article .
• - It gets removed by @Partofthemachine for not being supported sources (EDIT: neither of the linked sources discusses the international medical response)
• - @Snokalok2 restores with lead follows body and the body is overwhelmingly supported. Doesn't matter whether we have reliable sources that specifically say this; instead what matters is the article is chock full of criticism
• - I revert, referring to my talk page comment as rationale
• - @Simon223 restores the comment without addressing any sourcing concerns, stating it "seems non neutral to remove".
• - @LokiTheLiar has now decided the brand new sentence is so vital that it belongs in the first paragraph.

Remember - this was added to the article 2 days ago! The WP:ONUS for inclusion falls on those who want to add the contested content. However, the editors who have restored are not trying to find sources that verify this sentence or actually discuss the issue with the sentence. Instead, it's one editor after another reverting on a 0RR page. What is the rationale for keeping the sentence? It's the WP:LEAD and sources don't need to be included in the lead . Or the editors personal opinion that "it's more or less the entire first world" that criticized the review and our own article lists "11 different countries who's medical communities rejected teh review" .

This is not inline with the spirit of why this article needs 0RR and, because I am currently the lone voice, editors apparently don't feel the need to follow the BRD cycle nor standard verifiability policies and is exactly the type of battleground behavior that lead to WP:ARBTRANS. We can do better.

Interestingly enough, a very similar conversation happened on talk just a year ago . @WhatamIdoing made some excellent points and I encourage you all to read them over. In the meantime, I highly suggest somebody remove the sentence so we can follow the spirit of the BRD cycle. PositivelyUncertain (talk) 01:55, 17 October 2026 (UTC)

Pinging Simonm223, as there was a typo in the original post. InfernoHues (talk) 02:01, 17 October 2026 (UTC)

• I mean, the flip side of WP:ONUS is WP:STONEWALL. If you really are currently the lone voice, you should consider the possibility that a consensus does exist for the change, or at least that one is developing to the point where you consider suggesting compromises and should perhaps accept that a version you dislike may stay in place at least temporarily until one is accepted or consensus changes again. If you think the discussion isn't representative there's also noticeboards or RFCs to call in more voices, but again, the goal is to keep things moving forwards; doing those things accomplishes that, while invoking ONUS itself rarely does. In any case (while I recognize the irony of saying this in a big post about process) discussing the article content and going with what a rough consensus on talk supports until / unless it shifts seems more productive than endlessly debating process. Quick nose-counts are not the be-all and end-all of consensus, to be sure, but we avoid stonewalling and keep things moving forwards by recognizing and accepting broad consensuses and working with them (or around them, if you think there are issues with them that need to be addressed but are in the minority.) --Aquillion (talk) 03:35, 17 October 2026 (UTC)

  Or maybe you could actually address the points I made? You know - the problem of editors restoring language without even considering the edit summary for why it was removed? The repeated restoration of a sentence that had 2 cites - neither of which verified the content? Then when that pointed out the argument is that cites don't matter because it's the lead? Maybe you could try doing that instead of rushing to the defense of the people you agree with? But no, instead you just continue with the BATTLEGROUND behavior that pushes editors away from this page.

  As for compromise - and something I've already pointed out - the lead already states Medical organisations outside the UK, international medical organisations, and other countries' clinical practice guidelines have criticised its methodology, findings, and recommendations. PositivelyUncertain (talk) 04:00, 17 October 2026 (UTC)

  As the most recent actor here: I did consider the previous edit summaries, I just disagreed with them. There are way more than 2 cites for that claim; in fact one of the current supporting citations for that claim is a bundle of six, and it's only one of the supporting citations.

  So after that the issue is WP:WEIGHT and, at least in my view, the opposition is prevalent enough that we'd run into serious WP:NPOV issues by not clearly stating the views of the Cass Review are not widely accepted by the medical community at large. Loki (talk) 04:36, 17 October 2026 (UTC)

  The bundle of six - you mean the blog post that we don't cite but is quoted in the ILGA statement? But hey as long as it's critical of Cass, yes, blogs are RSs. PositivelyUncertain (talk) 04:52, 17 October 2026 (UTC)

  I apologize for the last two sentences. You are being even keeled and not BATTLEGROUND but there is very much an us vs them mentality and any edit that any edits perceived as positive or non-critical of the review is going to lead to arguing with a like-minded group of editors who are very adamant that Cass has been thoroughly debunked and discredited.PositivelyUncertain (talk) 04:42, 17 October 2026 (UTC)

  Several of the editors who watch this page have really read a huge amount about this subject over the last couple of years. They have a good general grasp of what sources are out there. Hopefully we'll eventually get books about this instead of press releases and the occasional newspaper article. WhatamIdoing (talk) 06:40, 17 October 2026 (UTC)

  Frankly it's remarkably non-neutral to say the WPATH criticism somehow doesn't count because of "independence". I am seeing WP:STONEWALLING here more than "gaming 0RR" (AKA multiple editors disagreeing with one editor.) Simonm223 (talk) 09:54, 17 October 2026 (UTC)

  Simply put the claim of failed verification depends on a specious "source of the source" argument to disqualify reliable sources. Considering this is supporting hiding the fact that mainstream health agencies treat the Cass Review as a WP:FRINGE publication with dangerous recommendations supporting what is effectively conversion therapy, we absolutely should not hide the criticism especially on such patently flimsy pretexts. Simonm223 (talk) 10:05, 17 October 2026 (UTC)

  The Cass Review is not FRINGE. That's just your opinion and does nothing to actually advance this conversation. PositivelyUncertain (talk) 15:11, 17 October 2026 (UTC)

  Actually a publication that advocates for conversion therapy is, in fact, WP:FRINGE. And a person disagreeing with weak arguments is not WP:BATTLEGROUND. Simonm223 (talk) 15:18, 17 October 2026 (UTC)

  How is calling the Cass Review FRINGE at all relevant to this conversation? Am I trying to source the Cass Review? Nope - just talking about the international medical response. PositivelyUncertain (talk) 15:22, 17 October 2026 (UTC)

  Fine let's say a WPATH press release responding to Cass is independent. Now please review the WPATH source and tell me where it says the report was widely criticized? But no, you'd rather just jump in without looking at the sources. That is BATTLEGROUND. PositivelyUncertain (talk) 15:14, 17 October 2026 (UTC)

  wait who was claiming wpath isnt relevant cuz of independence concerns fho? User:Bluethricecreamman (Talk·Contribs) 15:26, 17 October 2026 (UTC)

  Simonm223 (talk) 15:29, 17 October 2026 (UTC)

  thank you for clarification User:Bluethricecreamman (Talk·Contribs) 01:55, 18 October 2026 (UTC)

  This was my rationale here and I'm willing to accept I was wrong PositivelyUncertain (talk) 15:42, 17 October 2026 (UTC)

What it is

Since I was pinged, I glanced over the page, and I see that one of the main problems has persisted. The problem is: We're doing a bad job of educating people about what the "Cass Review" actually is.

For example, I see multiple comments above about whether the "international medical community" has "adopted" the Cass Review. Why is that relevant? The Cass Review is a collection of information and recommendations that is specific to the operation of the UK National Health Service in England and Wales.

Recommendation #1 in the final report (page 28 in the PDF) is:

• "Given the complexity of this population, these services must operate to the same standards as other services seeing children and young people with complex presentations and/or additional risk factors. There should be a nominated medical practitioner (paediatrician/child psychiatrist) who takes overall clinical responsibility for patient safety within the service."

How exactly could another country "adopt" or "reject" that? Are we expecting other countries to say things like "Nope, I reject your evil report! Trans kids should not be treated the same as other kids with comparable medical needs, and someone should not be taking responsibility for their health care!" or "Yes, you're right! We're going to implement our own underfunded, centrally controlled, single-payer healthcare system so that we can do the same thing you're doing!"

We say "It has been widely criticized by the international medical community" and that various people in countries unaffected by it have "criticised its methodology, findings, and recommendations", but is that really true? Did anybody criticize this recommendation?

The lead is four paragraphs (~280 words) long. At the end of it, readers know that a lot of non-UK organizations are critical of it. They still don't know that the report has no effect outside the UK (so these non-UK providers are not affected by it directly), and, in fact, they're only critical of a fraction of the recommendations. We need to be clearer about what it is so that people will understand why there's a gap between the acceptance in the UK and the panicked response from the US. Step #1 is "it's a report that made some recommendations such as X and Y". After they know what the report said, we can proceed on to the bits about critics being mad about/scared of the puberty blocker trial (←just one out of many recommendations). WhatamIdoing (talk) 03:32, 17 October 2026 (UTC)

I agree there was a lot of stuff in the report and that almost all the coverage, except for the initial British reaction, has mostly been to a handful of the most controversial sections of the report. What I disagree with is the idea that this is inappropriate. Wikipedia covers things based on their weight in the sources. The sources talk about one section of the report a lot and most of the other sections much less. So, we should talk about that one section a lot, and less about the other sections. The one section that everyone mentions is the controversial parts, so we talk about the controversy a lot. None of this is wrong or even surprising.

In fact, I think it's frankly much more informative to a reader to say "the Cass Review was a British government report that was controversial because it claimed X and Y and recommended Z" than it would be to give exhaustive detail about everything that's in the report. If the reader wants to know everything in the report they can read it. We're here to give an encyclopedic summary, and right now that summary needs to include that the claims made in the report are quite controversial. Loki (talk) 04:56, 17 October 2026 (UTC)

Yes, it does seem like a bit of a "your honor, look at all the people my client didn't stab" argument. If one part of a report is particularly shocking and controversial, it's to be expected that that would get most of the coverage; and it's normal for our article to primarily focus on that. --Aquillion (talk) 05:04, 17 October 2026 (UTC)

I like the idea of "was controversial because it claimed X and Y and recommended Z", or even "Its claims X and Y and its recommendation to Z was controversial". I don't like the unqualified "was controversial", which falsely implies that the whole thing is controversial. When one part of a report is particularly shocking, we should be clear that it's specifically the one part that is so shocking. "The international medical community particularly criticized its approach to puberty blockers" would IMO be a big improvement. WhatamIdoing (talk) 06:01, 17 October 2026 (UTC)

i think attributing a single reason to why it's controversial isn't quite proven, and will probably result in more edit warring.

I prefer to keep it concise without interpetation. Cass Review is quite literally controversial, for different reasons.

The endocrine society said "Banning evidence-based medical care based on misinformation takes away the ability of parents and patients to make informed decisions."

WPATH said "[the review was] rooted in the false premise that non-medical alternatives to care will result in less adolescent distress"

RANZCP said "assessment and treatment should be patient centred, evidence-informed and responsive to and supportive of the child or young person's needs"

these are all unique reasons. Summarizing it as one reason, risks being WP:UNDUE

It is far easier for us to say it was controversial, rejected by the global medical community and leave it at that. The body can go into the various reasons of why it's controversial Editing-dude144 (talk) 15:29, 17 October 2026 (UTC)

i think attributing a single reason to why it's controversial isn't quite proven - well, it will certainly require a lot of hammering out, but it's a reasonable way to move forwards and seems like something everyone might agree on if we can find the right thing(s). Worth digging through a bunch of sources and producing a table of what they focus on controversy-wise, at least. Then we can try to figure out if we can come up with a concise summary of the main points for the lead. (It might also point to stuff that needs more coverage in the body.) --Aquillion (talk) 17:42, 17 October 2026 (UTC)

I think the main critiques I've seen in this article and elsewhere are

a) that the Review was not based on firm evidence, ignored existing evidence, or had faulty logic BAGISUS Endocrine Society WPATH Response to Cass pdf Yale Response Association of the Scientific Medical Societies in Germany Aneta Gawlik-Stazyk et al

b) the Review was either invalid, inapplicable Australian Medical Association US Endocrine Society

c) the Review was a politically driven report used to block access to gender affirming care US Endocrine SocietyWPATH Response to Cass pdfYale Response

d) delaying the patients access to hormones fails to meet expected standards of care US Endocrine SocietyWPATH Response to Cass pdf SFEDP (French Society of Pediatric Endocrinology and Diabetology)

e) Criticisms on the Cass Review's repeated use of the term exponential growth, when the growth was not exponential at allAssociation of the Scientific Medical Societies in Germany

f) Cass Review ignored patient perspectives WPATH Response to Cass pdf Aneta Gawlik-Starzyk et al

g) Cass herself was not qualified to conduct the review Aneta Gawlik-Starzyk et al

The above is not comprehensive, but a start Editing-dude144 (talk) 01:21, 19 October 2026 (UTC)

I think that list combines major points with less important ones. It looks like (a), (c), and (d) are the more common complaints.

The math question of "exponential" caught my eye. The Cass final report says on page 22 that the exponential growth began in 2014, and on page 26 says that the exponential growth phase happened (only) over the course of five years. https://web.archive.org/web/20250722165053/https://tavistockandportman.nhs.uk/about-us/freedom-of-information/responses/gids-referrals-by-year-and-by-sex-assigned-at-birth-saab/ gives the numbers per year. Just for fun, I plugged those five years' numbers into an online curve fitting calculator, and the best-looking fit for 2014–2019 was y=108 + 499.2143x + 111.2143x² - 21x³ and the best fit if you shift one year back (because it's not clear whether "2014" refers to 2013–2014 or to 2014–2015) is y=794.6 + -724.2143x + 434.0357x² - 43.75x³. These are both cubic equations (i.e., the last exponent is 3 instead of 2), and therefore it's cubic growth. You can fit an exponential curve to this, but the cubic one is a better fit. The logarithmic option was the worst fit of the usual options.

But mostly what I wanted to say about that is that the words exponential growth aren't always used to describe a mathematically exponential growth. See, e.g., Wiktionary's third definition: "Characterised by a very rapid rate of change, especially increase". Or Merriam-Webster's: "especially: characterized by or being an extremely rapid increase (as in size or extent)". The (German) source in (c) cites two non-peer-reviewed, self-published preprints which interpret exponential as exclusively a mathematical term, which I don't think is reasonable in the context of a document written for (IMO) bureaucrats, politicians, and the general public. The underlying sources even assumed certain unstated limits on the formula. If the exponent y in x^y is 0 < y < 1, then you can have a true exponential curve that is pretty close to a straight, flat line. You can have mathematically exponential growth without having much growth at all, but I think that the Cass Review used this term to mean "very rapid increase" rather than "my curve fitting software said an exponential formula was better than the other options'.

Anyway, I had fun looking at the numbers behind this complaint, but we really should focus on the most common complaints. There appear to be three of those. WhatamIdoing (talk) 02:47, 19 October 2026 (UTC)

right, "exponential" not always used in the mathematic sense colloquially, but using it repeatedly in what is supposed to be a scientific document is irresponsible and undermines credibility especially because a core claim of the Cass Report is that # of referrals grew too fast.

I think there are many more sources that echo the complaints of excluding patient and transgender viewpoints and complaints about dishonest usage of scientific and mathematical terms. Editing-dude144 (talk) 13:35, 19 October 2026 (UTC)

I agree with this. The Cass Review did cause controversy and that was a defining characteristic of the aftermath and should be in the lead and body (which it is). Being more specific would be helpful to readers. PositivelyUncertain (talk) 15:50, 17 October 2026 (UTC)

I think i agree with WAID about inclusion about last part. Much of the findings of cass report are in context of NHS yes, but also in context of broader UK politicsl environment (perceived or real). We should be clear that this is an NHS finding, and neither overstate it as some international rec nor understate its implications for gender affirming care including as possible precendent (emphasis on possible, not yet impleyanywhere else yet) User:Bluethricecreamman (Talk·Contribs) 16:53, 17 October 2026 (UTC)

I want to echo this: "this is an NHS finding, and neither overstate it as some international rec". Readers should be told in the lead (maybe in the first paragraph) that this is supposed to be limited to England and Wales, even if politicians elsewhere are pointing to it as precedent for puberty blocker bans. WhatamIdoing (talk) 23:51, 17 October 2026 (UTC)

Trying to assume WP:Goodfaith here, but the globally medical community section contains plenty of criticisms of the review.

The review has had impacts outside of the UK, and is being propped up as a scientific study by people outside of the UK. As evidenced by Donald Trump's incorporation of the review into his executive order.

The part of the review you quoted is just a tiny part of the review and is not noteworthy. It feels more like a preamble than a legitimate conclusion of the review. The scope of the contents and impact of the review is far wider than what you quoted. Editing-dude144 (talk) 15:36, 17 October 2026 (UTC)

Yes, as I clearly indicated, that is only Recommendation #1. There are 32 of them.

I don't think we have a list anywhere, so I'll post a longer reply with all 32 later. WhatamIdoing (talk) 23:59, 17 October 2026 (UTC)

Comparison of the 32 recommendations and responses

#	Cass Reivew recommendation	AusPath	US anti-trans
1	Given the complexity of this population, these services must operate to the same standards as other services seeing children and young people with complex presentations and/or additional risk factors. There should be a nominated medical practitioner (paediatrician/child psychiatrist) who takes overall clinical responsibility for patient safety within the service.	Agrees (already doing this)	Silence
2	Clinicians should apply the assessment framework developed by the Review's Clinical Expert Group, to ensure children/young people referred to NHS gender services receive a holistic assessment of their needs to inform an individualised care plan. This should include screening for neurodevelopmental conditions, including autism spectrum disorder, and a mental health assessment. The framework should be kept under review and evolve to reflect emerging evidence.	Doing their own version (should apply the Australian framework)	Silence? Mixed views?
3	Standard evidence based psychological and psychopharmacological treatment approaches should be used to support the management of the associated distress and cooccurring conditions. This should include support for parents/carers and siblings as appropriate	Agrees (has always done this)	Agrees only if it delays and denies gender care
4	When families/carers are making decisions about social transition of pre-pubertal children, services should ensure that they can be seen as early as possible by a clinical professional with relevant experience.	Agrees only if it's optional help ("can be seen", not "should be")	Agrees only if it delays and denies gender care
5	NHS England, working with DHSC (Department of Health and Social Care) should direct the gender clinics to participate in the data linkage study within the lifetime of the current statutory instrument. NHS England’s Research Oversight Board should take responsibility for interpreting the findings of the research.	Agrees (already doing the equivalent)	Silence, or hoping it provides support for desistance claims
6	The evidence base underpinning medical and non-medical interventions in this clinical area must be improved. Following our earlier recommendation to establish a puberty blocker trial, which has been taken forward by NHS England, we further recommend a full programme of research be established. This should look at the characteristics, interventions and outcomes of every young person presenting to the NHS gender services. The puberty blocker trial should be part of a programme of research which also evaluates outcomes of psychosocial interventions and masculinising/feminising hormones. Consent should routinely be sought for all children and young people for enrolment in a research study with follow-up into adulthood.	Agrees that research is good. Disagree with research that withholds medication. Disagree if non-participation prevents access to medication.	Agrees only if it would withhold medications (would loathe, e.g., a placebo-controlled randomized trial that provided PBs for everyone and early access to gender-affirming hormones for half).
7	Long-standing gender incongruence should be an essential pre-requisite for medical treatment but is only one aspect of deciding whether a medical pathway is the right option for an individual.	Agrees with individualized care. Disagree with "long-standing"	Agrees because it could delay and deny treatment
8	NHS England should review the policy on masculinising/feminising hormones. The option to provide masculinising/feminising hormones from age 16 is available, but the Review would recommend extreme caution. There should be a clear clinical rationale for providing hormones at this stage rather than waiting until an individual reaches 18.	Disagree (too few will get GAH)	Disagree (too many will get GAH)
9	Every case considered for medical treatment should be discussed at a national Multi Disciplinary Team (MDT) hosted by the National Provider Collaborative replacing the Multi Professional Review Group (MPRG).	Agrees with MDTs Disagree (prefers local committees for Australia)	Silence (but would hate any national committee)
10	All children should be offered fertility counselling and preservation prior to going onto a medical pathway.	Agrees (already doing this; wants more funding)	Silence
11	NHS England and service providers should work to develop the regional multi-site service networks as soon as possible. This could be based on a lead provider model, where NHS England delegates commissioning responsibility to the regional services to subcontract locally to providers in their region.	Agrees (already decentralized)	Silence (already decentralized)
12	The National Provider Collaborative should be established without delay.	Agrees (already doing this)	Silence
13	To increase the available workforce and maintain a broader clinical lens, joint contracts should be utilised to support staff to work across the network and across different services.	Irrelevant	Silence
14	NHS England, through its Workforce Training and Education function, must ensure requirements for this service area are built into overall workforce planning for adolescent services.	Agrees (already doing this)	Silence
15	NHS England should commission a lead organisation to establish a consortium of relevant professional bodies to: develop a competency framework, identify gaps in professional training programmes, develop a suite of training materials to supplement professional competencies, appropriate to their clinical field and level. This should include a module on the holistic assessment framework and approach to formulation and care planning.	Agrees (already doing this; wants more funding)	Silence
16	The National Provider Collaborative should coordinate development of evidence-based information and resources for young people, parents and carers. Consideration should be given as to whether this should be a centrally hosted NHS online resource.	Agrees (already doing this; wants more funding)	Silence
17	A core national data set should be defined for both specialist and designated local specialist services.	Agrees (already started this; wants more funding)	Silence
18	The national infrastructure should be put in place to manage data collection and audit and this should be used use this to drive continuous quality improvement and research in an active learning environment.	Agrees	Silence
19	NHS England and the National Institute for Health and Care Research (NIHR) should ensure that the academic and administrative infrastructure to support a programme of clinically based research is embedded into the regional centres.	Agrees	Silence (but only wants research that will produce the Right™ Answer)
20	A unified research strategy should be established across the Regional Centres, co-ordinated through the National Provider Collaborative and the Research Oversight Group, so that all data collected are utilised to best effect and for sufficient numbers of individuals to be meaningful.	Agrees (wants more funding)	Silence
21	To ensure that services are operating to the highest standards of evidence the National Institute for Health and Care Research (NIHR) should commission a living systematic review to inform the evolving clinical approach.	Agrees (wants more funding)	Silence
22	Within each regional network, a separate pathway should be established for pre-pubertal children and their families. Providers should ensure that pre-pubertal children and their parents/carers are prioritised for early discussion with a professional with relevant experience.	Doing their own version (wants more funding)	Silence (but only wants professionals with the Right™ View to help these families)
23	NHS England should establish follow-through services for 17-25-year-olds at each of the Regional Centres, either by extending the range of the regional children and young people’s service or through linked services, to ensure continuity of care and support at a potentially vulnerable stage in their journey. This will also allow clinical, and research follow up data to be collected.	Doing their own version (wants more funding)	Silence
24	Given that the changing demographic presenting to children and young people’s services is reflected in a change of presentations to adult services, NHS England should consider bringing forward any planned update of the adult service specification and review the model of care and operating procedures.	Irrelevant	Silence
25	NHS England should ensure there is provision for people considering detransition, recognising that they may not wish to reengage with the services whose care they were previously under.	Agrees (already doing this, but thinks the political stuff is overblown)	Weirdly obsessed with desistance
26	The Department of Health and Social Care and NHS England should consider the implications of private healthcare on any future requests to the NHS for treatment, monitoring and/or involvement in research. This needs to be clearly communicated to patients and private providers.	Agrees (already doing this)	Silence
27	The Department of Health and Social Care should work with the General Pharmaceutical Council to define the dispensing responsibilities of pharmacists of private prescriptions and consider other statutory solutions that would prevent inappropriate overseas prescribing.	Irrelevant	Silence, or would agree if it could block access to medication-based treatment
28	The NHS and the Department of Health and Social Care needs to review the process and circumstances of changing NHS numbers and find solutions to address the clinical and research implications.	Irrelevant	Silence
29	NHS England should develop an implementation plan with clear milestones towards the future clinical and service model. This should have board level oversight and be developed collaboratively with those responsible for the health of children and young people more generally to support greater integration to meet the wide-ranging needs of complex adolescents.	Agrees and wants trans teens and families officially involved	Silence
30	NHS England should establish robust and comprehensive contract management and audit processes and requirements around the collection of data for the provision of these services. These should be adhered to by the providers responsible for delivering these services for children and young people	Irrelevant	Silence
31	Professional bodies must come together to provide leadership and guidance on the clinical management of this population taking account of the findings of this report.	Agrees (trans specialist groups should lead)	Silence (but trans specialist groups should be excluded)
32	Wider guidance applicable to all NHS services should be developed to support providers and commissioners to ensure that innovation is encouraged but that there is appropriate scrutiny and clinical governance to avoid incremental creep of practice in the absence of evidence.	Agrees (and SOC-8 would solve this problem)	Silence

By my count, AusPATH and Transcend Australia said they:

• Disagree with part or all of four (12.5%)
• Irrelevant to five (15.6%), and
•  Agree mostly with the remaining 23 (71.9%).

The four that I marked as disagreeing were:

• Recommendation #6 on randomized controlled clinical trials for puberty blockers,
• Recommendation #7 on the minimum age for gender-affirming hormones (they disagree with the pre-Cass rules, too),
• Recommendation #8 on requiring "a clear clinical rationale" for 16- and 17-year olds to get gender-affirming hormones, and
• Recommendation #9 on having a centralized national committee instead of doing the same thing within each local clinic.

I identified the "irrelevant" ones by looking for words such as "is not relevant in the Australian context" and "does not apply to the Australian context". In other all cases, if the specifics were irrelevant, they provided some comment about how they agree, disagree, or are doing something similar or better, and I recorded those as agreeing or disagreeing.

My guesses for the US anti-trans lobby are just uncited guesses, but as you can see, I don't think that very many of them care much about things like "who takes overall clinical responsibility" or whether there is "an implementation plan with clear milestones" or which agency has to "ensure that the academic and administrative infrastructure...is embedded into the regional centres".

To go back to the comment that prompted this long reply, it is true that "The scope of the contents and impact of the review is far wider than" just the first recommendation, but the key point is that the non-UK "impact of the review" is largely constrained to a small fraction of "The scope of the contents". People outside the UK don't care about ~80% of the recommendations. They only care about recommendations that support or deny access to medications.

WhatamIdoing (talk) 01:44, 18 October 2026 (UTC)

For rec 2, i think US anti trans lobby definitely has used the framing of mental illness and neurodivergence (and conflation between the two to transgender identity) as part of their attacks on trans care User:Bluethricecreamman (Talk·Contribs) 02:14, 18 October 2026 (UTC)

I don't think that's derived from the Cass Review, though, since that was happening decades ago, and was especially happening when the Rapid-onset gender dysphoria controversy was in the news (i.e., in the years before the Cass Review was commissioned). I just checked Google News to see what anyone was saying about the Cass Review; it gave me a page of LGBT media and UK newspapers, most of which were talking about the BMA's report. WhatamIdoing (talk) 05:04, 18 October 2026 (UTC)

Ive thought a bit more about this as sell, wouldnt it be synth to state that these orgs are critical of only a portion of it? We could state they criticize Cass report for suggesting x y z, instead of saying they criticize a portion of it, ofc. User:Bluethricecreamman (Talk·Contribs) 02:17, 18 October 2026 (UTC)

No, because we actually have sources. It's already in the article, in fact: "criticised the review or parts of the review". We just need more attention to this. I think an appropriate change could be:

"It has been widely criticized by the international medical community" → "Parts of it have been widely criticized by the international medical community, especially _____" (with editors filling in the blank with whatever they find most appropriate). WhatamIdoing (talk) 05:07, 18 October 2026 (UTC)

At this point, the criticism has changed a bit too from purely theoretical policy based to how the report has practically played out. The infrastructure required to support trans kid as required by recommendations from review were never built out, such that lede should state cass review may have practically had a deleterious effect on gender affirming care. Indeed the final impact is essentially massive restriction on yourh gender affirming care, justified as part of the process of implementation of this review, as well as having providing some fodder for broader international politics ?User:Bluethricecreamman (Talk·Contribs) 02:21, 18 October 2026 (UTC)

i think that's a good point and it would add a lot to the article to highlight the difference between the report's recommendations and its implementation. That's something Cass has complained about herself. Editing-dude144 (talk) 02:45, 18 October 2026 (UTC)

Some of the newer sources differentiate between the review and the implementation, e.g.,

• Coombes, Rebecca (2026-05-06). "Puberty blockers: BMA critique vindicates Cass review but questions government "overreach"". BMJ. 393: s876. doi:10.1136/bmj.s876. ISSN 1756-1833.
• Collington, Faefyx. "Major British medical group reverses course & embraces controversial guidance on trans health care". LGBTQ Nation.
• Palmer, Poppy-Jay St (2026-05-07). "British Medical Association no longer opposes Cass Review". PinkNews.

WhatamIdoing (talk) 05:18, 18 October 2026 (UTC)

Yes, others have said it better, but the inefficiency may be the point. User:Bluethricecreamman (Talk·Contribs) 05:47, 18 October 2026 (UTC)

That does seem to be one of the major categories of complaints about the Cass review, that it was politically charged and designed to target GAC for minors. See point c) in this response https://en.wikipedia.org/wiki/Talk:Cass_Review#c-Editing-dude144-20261019012100-Aquillion-20261017174200 Editing-dude144 (talk) 16:20, 19 October 2026 (UTC)

To quote Aquillion above, this strikes me as a "your honor, look at all the people my client didn't stab" argument. Yeah, the review did make many other recommendations that were uncontroversial. To the extent this is worth mentioning, it's worth mentioning maybe as an aside, "While many of the report's recommendations were uncontroversial, ..." The large majority of the sources focus on the recommendations, and even more so the claims, that were controversial. Loki (talk) 21:12, 18 October 2026 (UTC)

I understand that. From where I sit, "widely criticized" sounds like "Your honor, the prosecution intends to prove that they committed crimes. Oh, you wanted to know which crimes? Everything they do is a crime, your honor."

I realize that some sources have engaged in this kind of black-and-white, for-us-or-against-us thinking. Immediate outrage brings the clicks, and nuance and detail often doesn't. But the better sources aren't engaged in binary thinking, and Wikipedia shouldn't, either. I think this article should look more like the 21-page briefing from AusPATH and Transcend than it does right now. WhatamIdoing (talk) 22:09, 18 October 2026 (UTC)

BAGIS in the lead

The third paragraph says: "The review made 32 recommendations across all aspects of service provision, which were welcomed by UK medical organisations such as the British Psychological Society and the Royal College of Psychiatrists, though some such as the British Association of Gender Identity Specialists criticised the review or parts of the review".

So far, BAGIS has said:

• April 2024 (when the final report was published): "On first glance, BAGIS Council are deeply troubled by some of the content of the Cass Review and the potential impact thereof. We will be considering this lengthy document carefully, and in detail, before offering a comprehensive response to its recommendations and before making any relevant observations regarding the process that has underpinned them."
• In the 2.5 years since then: Nothing.

I don't think we should be naming them in the lead as an example of criticism if they never got around to publishing that long-promised "comprehensive response". WhatamIdoing (talk) 04:10, 17 October 2026 (UTC)

I don't think this makes any sense, for two reasons:

1. Just because they don't mention Cass by name in their other statements doesn't mean their other statements since then are "nothing". E.g. take this response to a proposal originally made by the Cass Review.
2. Even if BAGIS actually hadn't said anything else, that doesn't mean they didn't say anything on April 2024. A source is a source. If it says they're going to write more, and then don't, the information in the first source is still there and we can still use it.

Loki (talk) 04:42, 17 October 2026 (UTC)

1. They promised "a comprehensive response". They haven't published one. They have published just three (3) statements in the 2.5 years since then. Only one of those has any connection to the Cass Review, and they cite the Cass Review favorably in that statement, as supporting their view.
2. The original BAGIS statement says almost nothing. It spends 72 words sending people to appropriate crisis support services, and 54 words promising a future response, which has not appeared yet.

I'm not saying that it shouldn't be in the article (though it's just a self-published primary source), but I don't think it should be in the lead. Let's not call out an organization for saying "something" in the lead, especially if that could result in a reader looking up the response and discovering that they've failed to follow up. That makes BAGIS look bad, and it makes Wikipedia look bad because a single self-published primary source that says almost nothing is WP:UNDUE. The lead should be naming a group that actually wrote their "comprehensive response" instead of merely promising one and failing to follow up. WhatamIdoing (talk) 06:10, 17 October 2026 (UTC)

1 of those responses is objecting to the puberty blocker ban, which was a recommendation of the cass review. Link

Could you link the one that you're referring to? I can't seem to find any that welcome the cass review. Editing-dude144 (talk) 04:17, 18 October 2026 (UTC)

That's the only statement they've made that is at all related to the Cass Review, but I think you may have misread the source. The point of that source is that a full puberty blocker ban was not recommended by the Cass Review. That's the meaning of their sentence "we note that this [approach to using puberty blockers and gender-affirming hormones] was affirmed by the Taylor Review and the recommendations in the Cass Review that derive from it." The Cass final report said "the Review would recommend extreme caution. There should be a clear clinical rationale for providing hormones" to under-18s. The Cass final report did not say "Dear politicians, please impose a total ban on all under-18s, with no exceptions whatsoever no matter how strong the clinical rationale is in any individual case". WhatamIdoing (talk) 04:50, 18 October 2026 (UTC)

The Final Report version of Cass said of puberty blockers "In summary, there seems to be a very narrow indication for the use of puberty blockers in birth-registered males as the start of a medical transition pathway in order to stop irreversible pubertal changes. Other indications remain unproven at this time." This was the final point of the summary on puberty blockers.

Puberty blockers are not hormones.

I also want to suggest that a British based organization like BAGIS has a particular reason for criticizing the contents of the report without naming it. The field it oversees, the grant money it relies on for research all comes from a government that has aggressively pushed adoption of measures arguably even more extreme than what the Cass Review initially advocated for.Editing-dude144 (talk) 21:03, 18 October 2026 (UTC)

I can imagine that a British-based organization like BAGIS could have reasons for criticizing the contents of the report without naming it. However, I've seen nothing that could be interpreted that way. They've made three statements:

1. "BAGIS statement on proposed changes to the NHS constitution", which neither states nor implies anything about the Cass Review.
2. "BAGIS statement on the Supreme Court ruling on the definition of women April 2024", which neither states nor implies anything about the Cass Review.
3. "BAGIS response to the suspension of prescribing for under 18s in the UK", which says Cass agrees with them and not with the government's proposal.

If your argument is that they're not criticizing the Cass Review because they're cowards who won't speak up for fear of losing funding, then I suppose that's a POV you can adopt, but it can't help us, because Wikipedia needs sources. An editor saying that there would be sources except the source is too scared to say anything doesn't exempt us from the requirement that every single source be WP:Published.

If your argument is that they have criticized the Cass Review, only without using Cass's name, then you need to point to exact sources and exact wording. You need to be telling us to look at an exact source, and explain why a reasonable editor might think that "_____" in https://www.example.com/exact-page is a secret code phrase for "we disagree with the Cass Review" even though it doesn't mention the Cass Review. It's entirely possible that such a thing happens (e.g., "The final report that dominated yesterday's news"), but you've got to show it, and not just speculate about it. WhatamIdoing (talk) 22:23, 18 October 2026 (UTC)

I think this may be a moot argument because I found their comprehensive report. It was in a medical journal instead of their press release webpage.

Rapid Response: Medical institutions should not unquestioningly accept the conclusions and recommendations of the Cass Review Details Bagis' complaints that the Cass Review is not based on firm evidence.

"We respond to the views expressed by McCartney regarding the Cass Review,(1) and advise against unquestioning medical acceptance of the Review’s conclusions and recommendations.(2)"

"The Review is flawed in its presentation of evidence(4,5) and here are a number of unreferenced claims where suppositions are presented as fact."

Now that we have a better source, I recommend citing this or both BAGIS' initial statement and the above. Editing-dude144 (talk) 23:35, 18 October 2026 (UTC)

Thanks, that's great! I'm so glad you found this. I suggest using the stronger source throughout. The closer we can get to a MEDRS-style source, the less likely it is that someone will challenge it entirely later. WhatamIdoing (talk) 00:00, 19 October 2026 (UTC)

The BMJ "rapid responses" are just letters to the editor, but at least they're not self-published, and this one provides more information about the group's POV. WhatamIdoing (talk) 00:03, 19 October 2026 (UTC)

I definitely agree that if we have a published article in a major medical journal from BAGIS, that obviously takes precedence over a press release. Loki (talk) 00:10, 19 October 2026 (UTC)

That does not mandate removal of the WPATH source.Simonm223 (talk) 00:14, 19 October 2026 (UTC)

I believe the question is whether it could replace:

• "Position & Process Statements: Initial BAGIS statement on the Cass Review". BAGIS. Archived from the original on 16 January 2025. Retrieved 21 December 2024.

and not the WPATH source in the first paragraph of Cass Review#Response from LGBTQ health bodies in the UK.

Loki, the "Rapid Responses" tab on that article says: "Rapid responses are electronic comments to the editor....Rapid responses are not indexed in PubMed and they are not journal articles. The BMJ reserves the right to remove responses which are being wilfully misrepresented as published articles". I think this Rapid Response letter is at least ten times better than the brief thing on their own website, but we should be careful not to claim that it's "a published article in a major medical journal from BAGIS". WhatamIdoing (talk) 01:22, 19 October 2026 (UTC)

Worth considering when structuring the lead

Saw this on WP:NPOV. I have no interest in getting stuck in with the underlying issues here, (especially considering the history of this page and related ones) but from the perspective of an average reader who doesn't have knowledge of the source material, it feels like there is redundancy and a lack of flow in putting "It has been widely criticized by the international medical community." at the end of the first paragraph, and then essentially repeating that later in the lead, after an intervening, unrelated paragraph.

NPOV is a priority of course, but it is also worth trying to avoid (not necessarily by simply reverting back to the status quo) this sort of redundancy and choppyness in a lead of this size, –Maltazarian ^{ᚾparley$\lor$investigateᛅ} 21:41, 20 October 2026 (UTC)

Agreed - not only is the sentence duplicative, "widely" is a weasel word and "international medical community" is far too imprecise. Did ophthalmologists, nephrologists, and dermatologists all band together to criticize it? That sentence should be removed and reworded in line with WhatamIdoing's notes here. Astaire (talk) 15:12, 22 October 2026 (UTC)

Generally the medical community refers to subject matter experts, so dermatology isnt exactly relevant to the subject.

Or are you seriously suggesting that someone will assume that dermatologists, specifically, criticized the review? Editing-dude144 (talk) 19:43, 22 October 2026 (UTC)

The phrasing "international medical community" is both vague and inapt here. It could mean global bodies like the World Health Organization, none of which seem to have commented on the review, or - yes - it could mean international organizations of subject matter specialists. Look at Category:International medical associations and you'll see that most of them are organized around a particular medical specialty. The criticisms we have in the article are from national and sub-national bodies from roughly a dozen countries, which have weight but do not together make up an "international community". Astaire (talk) 22:14, 22 October 2026 (UTC)

WPATH: World Professional Association for Transgender Health

Do you view Transgender Healthcare as an invalid specialty? I think that is the root of our disagreement. You view the international experts as something less than what they rightfully are.

You do not have a Wikipedia:CRYSTALBALL and you can't just reject WPATH and transgender health experts because you disagree with them. Editing-dude144 (talk) 15:13, 28 October 2026 (UTC)

Thank you for looking at this! I agree that it's redundant and imprecise. I just removed it and hopefully it won't be restored without discussion. PositivelyUncertain (talk) 17:44, 22 October 2026 (UTC)

Whelp - @Snokalok2 reverted me . Snokalok - the onus for inclusion is on those adding the language. There are reasonable objections to this sentence and instead of trying to resolve objections you are WP:GAMING 0RR to keep in contested language that was only added last week and has been contested since. This isn't long-standing and you should self-revert. PositivelyUncertain (talk) 18:09, 22 October 2026 (UTC)

suggest that PositivelyUncertain is stonewalling on the issue Wikipedia:STONEWALL Editing-dude144 (talk) 19:45, 22 October 2026 (UTC)

Please tell me how it's STONEWALLING to voice reasonable, policy-based objections to a new sentence added to the lead? I have listed my objections - it's redundant, lacks specificity, and the sourcing is weak. It would be great if those issues could actually be discussed but I've been mostly shouting into a void (except for when I questioned using WPATH as a source for this sentence - that got a whole lot of response but didnt address any of my concerns).

Whats more boggling is I have repeatedly stated that I agree criticism of the review belongs in the lead. I also agree that the report was controversial. There is so much room for compromise but why would anyone compromise when "consensus" (aka a bunch of like minded editors who believe Cass was full of inaccuracies and is only respected by right-wing politicians) is on your side? PositivelyUncertain (talk) 20:24, 22 October 2026 (UTC)

I suggest that you read WP:STONEWALLING: opposition to a proposed change without (a) stating a substantive rationale based in policy, guidelines and conventions or (b) participating in good-faith discussion. Neither of those apply here. Astaire (talk) 22:08, 22 October 2026 (UTC)

"POV pushing"

@HenrikHolen @Simonm223: POV pushing is defined as the aggressive presentation of a particular point of view in an article. Adding the words "heavily criticized" to the first sentence, and then reverting to add them back in —even before we define what the subject is, as though it is the most important thing readers need to know—is POV pushing.

@Simonm223, please undo your revert. Per MOS:LEAD, MOS:FIRST, and MOS:CONTROVERSIAL, we require a rock-solid body of sourcing to justify adding "heavily criticized" in this manner. Recent coverage of the review (e.g. ) does not treat the criticism as an essential, defining element of the review. It does not belong in the first sentence. Astaire (talk) 15:39, 22 October 2026 (UTC)

Pretty much every major evidence-based medicine group criticized this little bit of political grandstanding. I will not be undoing that revert - as far as I know I have not violated any policies and I do think excluding that the Cass Review faced heavy criticism is a serious NPOV violation. And a WP:FRINGE one to boot. Simonm223 (talk) 15:44, 22 October 2026 (UTC)

While I agree that this should be mentioned somewhere in the first paragraph, I think having both "heavily criticized" and "widely criticized" in the first couple sentences is a bit redundant. I'd suggest changing the first one to "controversial," which is pretty obviously true, no matter your opinion on the report itself. InfernoHues (talk) 15:49, 22 October 2026 (UTC)

Yeah i think i agree with this. The main point of criticism are cery much real with cass review was inclusion exclusion criteria for many of the studies (trans kids are such a small segment of population anyways that having a large enough sample size to power studies to meet cass review criteria was always gonna be difficult) and the suggestion to prevent all puberty blockers for gender dysmorphia. At same time its a bit too much go start off with that User:Bluethricecreamman (Talk·Contribs) 15:57, 22 October 2026 (UTC)

My principal concern is that we should be really clear when dealing with WP:FRINGE medical claims such as support for conversion therapy that we immediately identify these as fringe. I understand the concern about repetition but would prefer to retain the first instance and remove the second. Simonm223 (talk) 16:17, 22 October 2026 (UTC)

Simon, I posted a table with all 32 recommendations above. I wonder if you could give me a list of the recommendations that amount to a "medical claim". I assume that, e.g., you would say that #5, which is about whether Government Agency 1 should tell Government Agency 2 to do something with the structure of their database, is not a "medical claim". WhatamIdoing (talk) 17:21, 22 October 2026 (UTC)

someone could agree with 32/32 of the conclusions and still criticize Cass Review for its evidence handling, politicized nature, inaccurate presentation of evidence, etc etc.

The fact that we're ranking "how much of a criticism is a criticism" is kind of proof that the report was widely criticized Editing-dude144 (talk) 18:53, 22 October 2026 (UTC)

actually its a good point, yes. So now the opponent of "criticized" in the lead presented the case that quite numerous med orgs agree with Cass conclusions. But not to the Cass methodology etc. ComfyLemur (talk) 19:07, 22 October 2026 (UTC)

excluding that the Cass Review faced heavy criticism is a serious NPOV violation Perhaps if we were talking about excluding it from the entire page, or even the lead, but we are talking about the first sentence. Not even the first sentence, but the very first thing that people read.

If you cannot present evidence that the "heavy criticism" is a defining characteristic of the subject that is widely used by reliable sources as an essential descriptor, then you need to undo your revert. Astaire (talk) 15:54, 22 October 2026 (UTC)

No, it's a WP:FRINGE document. That needs to be immediately stated. Simonm223 (talk) 16:18, 22 October 2026 (UTC)

That is your opinion and has not been established either by consensus on this page, or by any sources you have provided. Please revert. Astaire (talk) 16:22, 22 October 2026 (UTC)

Are you trying to contend that conversion therapy is not a WP:FRINGE pseudoscientific treatment??? Simonm223 (talk) 16:27, 22 October 2026 (UTC)

If someone ever equates "cautious in treatment" with "conversion therapy is not a WP:FRINGE pseudoscientific treatment???" it gives a serious ground to dismiss any further points. Its a very bad discussion style, pls correct it ComfyLemur (talk) 16:48, 22 October 2026 (UTC)

Please see WP:CIVIL and WP:AGF.

The review itself opposes conversion therapy: no LGBTQ+ group should be subjected to conversion practice (p. 150)

Hilary Cass has spoken against conversion therapy: Conversion therapy is a wholly unacceptable practice which is not supported by any clinical professional bodies.

And nothing in this article - even the various criticisms - suggests that the review is promoting conversion therapy.

You are justifying the insertion of this language in the first sentence based on your own interpretation, not backed up by any WP:MEDRS source. This is WP:POVPUSH behavior. Astaire (talk) 17:00, 22 October 2026 (UTC)

There's a real-world disagreement about what constitutes "conversion therapy".

There is something called Gender exploratory therapy that is considered conversion therapy, because the only thing the GET therapist wants to explore is why you're not trans after all. So when the Cass final report says things like:

• "There are mixed views on what young people want and need; for example, young people have told us they need space and time to explore, but also that questioning feels intrusive."
• "The intent of psychosocial intervention is not to change the person’s perception of who they are, but to work with them to explore their concerns and experiences and help alleviate their distress regardless of whether or not the young person subsequently proceeds on a medical pathway."
• "Clinicians along the pathway should remain open and explore the patient’s experience and the range of support and treatment options that may best address their identified needs."

then some people seem to react to this use of the word explore as if it's a dog whistle that means "Please implement the exact form of conversion therapy recommended by anti-trans groups such as the Gender Exploratory Therapy Association, which is now called Therapy First".

Separately, for some people, the idea that medications aren't promptly offered to all trans youth is conversion therapy. In this POV, anything that delays access to medication is a rejection of their identity and therefore a type of conversion therapy. "Let's spend a year in psychotherapy talking about what's going on before we think about medications" is, in in their view, either conversion therapy or close enough to conversion therapy that it doesn't make any difference.

The end result is that even an explicit rejection of conversion therapy doesn't – for these readers of the report – overcome the fact that the final report used the "E word" and recommends against prescribing puberty-delaying and gender-affirming medication. WhatamIdoing (talk) 17:56, 22 October 2026 (UTC)

Thanks very much for providing this context to the discussion.

In terms of the matter at hand, the issue seems to be that Simonm223 has unilaterally decided that the review is promoting conversion therapy. As I already noted, no WP:MEDRS source in this article seems to have come to this same conclusion, despite the copious inclusion of criticisms. In the eyes of Simonm223, this makes the review a WP:FRINGE document, which justifies calling it "heavily criticized" in the very first sentence, despite presenting no sources whatsoever which treat the criticism as an essential characteristic.

If I have summarized things correctly, this is a WP:NPOV violation, and a bad one. Astaire (talk) 21:53, 22 October 2026 (UTC)

you might call it smth that will be universally accepted to be false in the future, at the moment several govs and medical orgs in a major country accepted it, so calling it fringe is not legit ComfyLemur (talk) 16:46, 22 October 2026 (UTC)

We don't decide what's medical fringe based on what the UK government has to say. Simonm223 (talk) 16:59, 22 October 2026 (UTC)

no, I mean major UK and German medical orgs. That alone removes a "fringe" characteristic from a page supposed to reflect the diversity of views in major orgs ComfyLemur (talk) 18:34, 22 October 2026 (UTC)

https://www.bundesaerztekammer.de/fileadmin/user_upload/BAEK/Aerztetag/128.DAET/2024-05-10_Beschlussprotokoll_neu.pdf ComfyLemur (talk) 18:37, 22 October 2026 (UTC)

No German orgs came out in favor of the Cass Review, the AWMF led a review of the Cass Review involving every major German, Swiss, and Austrian org all of which found severely against the Cass Review's findings. If your position here is based on misinfo, that makes it a weaker position. Snokalok2 (talk) 18:37, 22 October 2026 (UTC)

I'm ready to admit I was wrong it good counter arguments are there, could you comment here pls? https://en.wikipedia.org/wiki/Talk:Cass_Review#c-ComfyLemur-20261022184100-Snokalok2-20261022183600 ComfyLemur (talk) 18:42, 22 October 2026 (UTC)

So I looked over the piece you linked, and perhaps this is just because ctrl+f is kinda terrible, but I couldn’t find any mention of the Cass Review. Certainly, it came out a month after the Cass Review, so one could imagine Cass having an effect, but it’s not mentioned anywhere so we can’t say that without running the risk of synth. Conversely, the AWMF piece linked here and in the article eviscerated it on grounds of methodology, conclusions, and straight up scientific competence.

https://register.awmf.org/assets/guidelines/028_D_G_f_Kinder-_und_Jugendpsychiatrie_und_-psychotherapie/028-014eng_S2k_Geschlechtsinkongruenz-Geschlechtsdysphorie-Kinder-Jugendliche_2025-06.pdf Snokalok2 (talk) 13:45, 23 October 2026 (UTC)

Apologies to @Tewdar, I clicked on this Loki edit nine days ago before the current intensity and assumed that was reflective of the statusquo, missing the great string of edits from before then. Snokalok2 (talk) 14:53, 25 October 2026 (UTC)

I don't get pings (just happen to be lurking right now), and no need to apologise :)  Tewdar  15:01, 25 October 2026 (UTC)

I'm going to second what Simon says, just because the UK - the country whose government wrote it - accepted it does not even come close to invalidating the rejection of every other country in the first world. Snokalok2 (talk) 17:57, 22 October 2026 (UTC)

Haven't we previously discussed the problems with sweeping statements like "every other country in the first world"? Russia is a first-world country. Where's your evidence that Russia has rejected it? WhatamIdoing (talk) 19:25, 22 October 2026 (UTC)

While I agree with your point regarding sweeping statement, Russia is not at all a first world country. The whole point of the term was to exclude Russia and other countries aligned with them. InfernoHues (talk) 19:35, 22 October 2026 (UTC)

@Simonm223 you have claimed Cass is fringe in various threads on this talk page here and here and now here too. As I have pointed out ( 1 and 2) you're opinion about whether Cass is FRINGE does nothing to help reach consensus or advance the conversation. It just derails the convo and raises the temperature. If your goal is to get consensus that Cass is fringe, make a new thread and post your sources. But what you are currently doing is disruptive and needs to stop. PositivelyUncertain (talk) 17:59, 22 October 2026 (UTC)

exactly ComfyLemur (talk) 18:04, 22 October 2026 (UTC)

sounds legit, it's well known because the main UK medical bodies accepted it. That gave the reason even to discuss it. Calling 2-3 western governments fringe is rather emotional ComfyLemur (talk) 16:44, 22 October 2026 (UTC)

governments are not medical experts Editing-dude144 (talk) 19:14, 22 October 2026 (UTC)

there's a problem: major UK medical orgs and major German medical orgs agree with Cass conclusions, while US and Canada ones oppose it. Its a classical clinical debate where both points are very far from fringe, ONLY if we postulate that western orgs are more important than the rest of the world. Its problematic. We might need to address orgs in China, Russia and India. ComfyLemur (talk) 18:32, 22 October 2026 (UTC)

That's actually flat out false, we have in article that the major German orgs under the AWMF all came out against the Cass Review. I think you should strike that Snokalok2 (talk) 18:36, 22 October 2026 (UTC)

thanks for the point. Do I interpret that correctly?

German Medical Assembly:

https://www.bundesaerztekammer.de/fileadmin/user_upload/BAEK/Aerztetag/128.DAET/2024-05-10_Beschlussprotokoll_neu.pdf

German Society for Psychiatry and Psychotherapy:

https://register.awmf.org/assets/guidelines/028-014l_S2k_Geschlechtsinkongruenz-Geschlechtsdysphorie-Kinder-Jugendliche_2025-06.pdf

they both state something along the cass lines, dont' they?

• Existing research does not justify a generally favorable benefit-risk assessment of puberty blockers in adolescents.
• More robust evidence is needed concerning long-term psychological outcomes.

Comprehensive psychiatric or psychotherapeutic assessments should be more strongly recommended.

• Participation in clinical studies and long-term observational research should be encouraged.

ComfyLemur (talk) 18:41, 22 October 2026 (UTC)

just in case, here is one quote:

für Jugendliche mit persistierender GI könne man noch keine generelle positive Nutzen-Risiko-Bewertung für eine hormonelle Pubertätsblockade aussprechen

(For adolescents with persistent gender incongruence, it is not yet possible to establish a generally positive benefit–risk assessment for hormonal puberty suppression.) ComfyLemur (talk) 18:46, 22 October 2026 (UTC)

The matter at hand here is wether or not they criticized the Cass review, which they did heavily. In part, they questioned it's credibility and evidence gathering methods. In other words, the authors of that paper thought the Cass Review was unreliable. Editing-dude144 (talk) 18:50, 22 October 2026 (UTC)

which paper? the one I provided? ComfyLemur (talk) 18:57, 22 October 2026 (UTC)

The AMWF article Editing-dude144 (talk) 19:04, 22 October 2026 (UTC)

yeah looks so, thanks. So they agreed on some points and rejected the other while criticizing many part of the review. ComfyLemur (talk) 19:24, 22 October 2026 (UTC)

so you're saying that, because it was criticized for more than one reason, we cant state that it was widely criticized in the lead?

I don't follke Editing-dude144 (talk) 19:36, 22 October 2026 (UTC)

no, I meant just what I've written, a mixed picture ComfyLemur (talk) 20:15, 22 October 2026 (UTC)

i don't think it is pushing a viewpoint to describe this review as controversial.

As stated multiple times in multiple threads, the vast majority of the responses in this article have criticized the reviews credibility and findings.As of now I see 12 medical expert organizations criticizing the review and ZERO supporting it.

If you think there are more medical orgs that accepted this review as a good exercise of science, by all means add them in.

But as of now the "widely criticized" word choice is firmly supported in the text of the article. Editing-dude144 (talk) 19:01, 22 October 2026 (UTC)

Yes, you made a good point, now the array of links demonstrates only that quite numerous med orgs agree with Cass conslusion but not the review itself, its a good task to look for explicit review feedbacks, yeah ComfyLemur (talk) 19:08, 22 October 2026 (UTC)

So maybe all those links belong more to the "Puberty blockers page" rather than to "Cass review" ComfyLemur (talk) 19:12, 22 October 2026 (UTC)

why? I'm not seeing your point. Editing-dude144 (talk) 19:13, 22 October 2026 (UTC)

quite a number of med orgs were shown to support key Cass conclusions, like poor understanding of the full picture and caution towards transition etc. What you proposed was that it doesnt tell anything about their critic of the review itself. But it shows their positions, so its important to move them to where they matter. thanks for your point ComfyLemur (talk) 19:18, 22 October 2026 (UTC)

That's not at all what I was saying. This discussion centers around the inclusion of the words "heavily criticized". The article shows enough proof for that statement to stand. It would be a wp:npov violation for it to not mention that controversial nature of the review. Editing-dude144 (talk) 19:23, 22 October 2026 (UTC)

yes, that sentence about belonging somewhere else was the development. A natural consequence, not your point ComfyLemur (talk) 19:26, 22 October 2026 (UTC)

so because it was criticized for multiple reasons we can't say it was "heavily criticized" in the lead? I don't follow Editing-dude144 (talk) 19:39, 22 October 2026 (UTC)

no, I just meant that now its natural to bring the posted links somewhere to the puberty blockers page. Its really a bit unexpected, but its what it is: orgs agree on many conclusions but criticize the review. The reason why people are interested in this review is they want to understand who approves the blockers and who doesnt, and what policies are correct, very very very roughly speaking. ComfyLemur (talk) 20:18, 22 October 2026 (UTC)

Astaire, you listed 3 sources all from British Media. I don't think that is very representative of the impact and globalized backlash that the Cass review incurred.

The statement is well sourced in the body of the article. I cant find a single expert medical organization supporting the usage of the Cass Review , yet I counted 12 that criticized it under "Global Medical Community Reaction" Editing-dude144 (talk) 19:20, 22 October 2026 (UTC)

We are talking about the lead sentence and DUE. And as it stands, the first paragraph begins with "heavily criticized" and ends with "widely criticized". The POV pushing is almost laughable. PositivelyUncertain (talk) 20:39, 22 October 2026 (UTC)

At this point we should probably move the article to Heavily Criticised Cass Review.  Tewdar  21:41, 22 October 2026 (UTC)

I mean, this book is even more controversial and widely criticised, right? But we don't say that five times in the lede and twice in the first paragraph...  Tewdar  21:53, 22 October 2026 (UTC)

if you can present a series of such articles to compare that alone would be enough to standardize this lede along with the whole lead section ComfyLemur (talk) 22:04, 22 October 2026 (UTC)

What's frustrating was the "widely criticized" sentence was just added last week. Despite my objections about repetition, lack of specificity, and weak sourcing, "heavily criticized" gets added yesterday and tag-teamed to be kept in. Neither are long standing unchallenged content and the lead is worse than it was a week ago. It shouldn't be this hard to get it removed and come up with compromise language. PositivelyUncertain (talk) 22:14, 22 October 2026 (UTC)

wheres the compromise? I haven't heard any suggestions from you on a compromise. Just stonewalling over removal of the terms Editing-dude144 (talk) 13:30, 23 October 2026 (UTC)

We don't make arguments based on whether things exist in other articles on wiki Editing-dude144 (talk) 13:29, 23 October 2026 (UTC)

Honestly, "we" should probably take a look at other articles to see how things are done elsewhere. Compared to Cass Review, and especially its lede, the Bell Curve article is an exemplar of encyclopaedic writing.  Tewdar  15:41, 24 October 2026 (UTC)

its not the wiki style, show any pages (except for pages on trans sceptic topics) that do that. Its not a comparison with another page, its comparison with the whole wiki, which style needs to be adhered

The current consensus in wiki pages is to festive criticism in the body, if criticism is central then in the lede, in exceptional cases word "controversial" is put in the second part of the 1st paragraph.

https://en.wikipedia.org/wiki/White_Fragility

https://en.wikipedia.org/wiki/Kinsey_Reports

https://en.wikipedia.org/wiki/How_to_Be_an_Antiracist

Including anything harsher than "controversial" to the 1st paragrah is exceptional. 1st sentence is tottaly a new developement in editorial wiki style. I think you might agree that substantial new developments in style belong to well meaning too but different platforms ~2026-56857-10 (talk) 00:04, 25 October 2026 (UTC)

Counterpoint, these are all sociological articles. For scientific and medically controversial pieces, we absolutely focus on criticism in the opening paragraph.

See:

https://en.wikipedia.org/wiki/Wakefield_MMR-autism_fraud

https://en.wikipedia.org/wiki/Phrenology

https://en.wikipedia.org/wiki/Rapid-onset_gender_dysphoria_controversy Snokalok2 (talk) 12:59, 25 October 2026 (UTC)

The first two examples are about a fraud and a pseudoscience, respectively, so it is reasonable to focus on that in those cases. The third example is similar in that it is about the controversy generated, rather than the hypothesis itself.  Tewdar  20:34, 25 October 2026 (UTC)

the third example is on a trans sceptic subject, the whole idea is the number of such articles substantially diverged from the wiki style. Of course I assume good faith so our mission is to show this divergence. As for now the divergence stands shown. ComfyLemur (talk) 22:56, 25 October 2026 (UTC)

so your argument is that those sources are *different* from the Cass Review? How so?

I believe that the Cass Review is pseudoscience as well. That's why so many scientists have criticized it on the basis of credibility, evidence gathering, and bias.

These happen to be the exact critiques of the Vaccine/Autism MMR study, which is more strongly worded than this one. They call the paper "fraudulent" throughout. Maybe we should do that here as well. Editing-dude144 (talk) 13:29, 26 October 2026 (UTC)

Why cass review is not a fraud at least in the way that article is?

- no retraction

- no shown conflict of interest

- no shown purposeful data manipulation

All mainstream criticism is focused on bad methodology.

The article in question has all 3 by consensus. ComfyLemur (talk) 17:20, 26 October 2026 (UTC)

Cass Review hasn't been retracted yet but the criticisms do often mention a conflict of interest ("politically motivated report") and data manipulation (picking and choosing studies to review, framing growth as exponential, etc) Editing-dude144 (talk) 20:02, 26 October 2026 (UTC)

Yeah, thats criticism that brings at nowhere near that example. Just as an illustration, not an analogy, wpath standards of care are very criticized as a whole and in parts both by affirmation approach proponents and critics. Along with conflict of interest and being issued by a side in a political debate. Yet we dont equate them with that fraudlent research. It was only an illustration.

Would you agree with that? ComfyLemur (talk) 20:23, 26 October 2026 (UTC)

I legitimately can't make out what you're trying to say. WPATH doesn't have a conflict of interest, they have a specialty. Editing-dude144 (talk) 21:23, 26 October 2026 (UTC)

do you want refs? Or we ll leave it as a common sense? ComfyLemur (talk) 22:05, 26 October 2026 (UTC)

ok, since that was a legitimate question, I spent some time and here is what really "heavily criticized" for conflict of interest is

in journals:

• SOC8 does not clearly describe how conflicts of interest were identified and addressed
• Of the authors of WPATH’s Standards of Care-8, 117 of 121 also participated in GAC programmes
• Editorial independence: 39% for SOC8
• Editorial independence: 15% for SOC7
• This sponsor trying to restrict our ability to publish

in major press:

• Research into trans medicine has been manipulated
• Biden Officials Pushed to Remove Age Limits for Trans Surgery
• Allegations that WPATH sought insurance coverage benefiting its members financially

in court reports and experts reviews:

• Financial Conflicts: Unsealed court documents ... revealed that many authors and executives involved in drafting WPATH’s Standards of Care Version 8 (SOC-8) had direct financial stakes in gender-affirming medical and surgical procedures.
• Intellectual and Professional Bias: Overwhelming majorities of SOC-8 and related guideline authors worked directly in gender dysphoria clinics or ran clinical programs promoting the gender-affirming model of care (117 of 121 participants in some analyses).
• Suppression of Evidence: Investigations by groups like The BMJ and agency reviews noted that WPATH suppressed or prevented the publication of independent systematic evidence reviews (such as those from Johns Hopkins University) when the findings did not support certain clinical or political goals. https://bmjgroup.com/the-bmj-investigates-dispute-over-us-groups-involvement-in-whos-trans-health-guideline/
• Political and Legal Influences: Internal communications exposed that guideline decisions—such as removing minimum age recommendations for cross-sex hormones and surgeries—were sometimes shaped by external political pressure, insurance reimbursement strategies, and legal considerations rather than pure clinical evidence.

ComfyLemur (talk) 01:09, 27 October 2026 (UTC)

Oh so you're trying to make an argument that WPATH is unreliable, and you post a list of lazily linked sources with zero quotes to support your argument.

your primary sources lack peer review and do not establish any sort of consensus. "Intellectual conflicts of interest and the ongoing controversy on guidelines regarding gender-affirming care" is just authored by one guy named Dr. Richard Santen.

Your secondary sources are literally all paywalled, and I'm not trying to pay money to fight an argument that you are too lazy to even make.

The court reports and "expert reviews" appear to be a) not Wikipedia:Reliable sources and b) op-eds

It feels like I'm arguing with a ai chatbot Editing-dude144 (talk) 04:27, 27 October 2026 (UTC)

> an argument that you are too lazy to even make.

please be WP:CIVIL ComfyLemur (talk) 17:07, 27 October 2026 (UTC)

no, I meant that it looked like a disagreement with a widely known statement: every org combining frontier research and treatment has inherent risk of conflict of interest. Not that it must have one, only the risk, so precautions are expected. Your statement looked like "WPATH cannot have conflict of interest by definition of what they are". That interpretation in my view lays very far from common consensus. And tt is explictly recognized by the World Medical Association, the American Medical Association, and the National Academies of Medicine. ComfyLemur (talk) 17:15, 27 October 2026 (UTC)

btw, I found some articles on some prominent researches that were criticized by many authors and major medicals orgs both for methodology and conflict of interest, yet the articles don't have with negative characteristic nor in the 1st sentence, nor in the 2st paragraph, nor in the lede, nor in the body at all. Are you interested in potential amending those articles? I could point to some ComfyLemur (talk) 17:55, 26 October 2026 (UTC)

wp:otherthingsexist Editing-dude144 (talk) 20:02, 26 October 2026 (UTC)

WP:OTHERSTUFFGENERAL ComfyLemur (talk) 20:13, 26 October 2026 (UTC)

also, it was an invitation, not a point. Would you like to join me in neutralizing them? ComfyLemur (talk) 20:15, 26 October 2026 (UTC)

It is not relevant whether you personally believe the Cass Review is "pseudoscience" or "fraudulent". To my knowledge, none of the WP:MEDRS sources in this article use those terms. Saying "maybe we should call the review fraudulent", purely because you believe it to be so, is clear WP:POVPUSHing. Astaire (talk) 16:05, 27 October 2026 (UTC)

thanks for disclosing some strong views on a controversial topic that we collectively neutralize ComfyLemur (talk) 17:08, 27 October 2026 (UTC)

The sourcing is not in question. The issue is whether "heavily criticized" is the very first thing that readers need to know about the subject of this article - even before they know what it is, who wrote it, or what it says.

We do not describe every movie which was a commercial flop as a "heavily criticized film" in the very first sentence. We start by mentioning the director, actors, and plot summary, and then move on to critical reception. I am very confident that the number of Wikipedia articles which call their subject a "heavily criticized X" in the very first sentence is close to zero.

Per MOS:LEAD and MOS:CONTROVERSIAL, we need a preponderance of sourcing in order to establish "heavy criticism" as an essential characteristic of the subject, worthy of mention in the first sentence. Can you find more than a couple reliable sources which immediately say things like "The Cass Review, a heavily criticized report ... blah blah blah" when introducing the subject? If you cannot, then it does not belong in the first sentence. Astaire (talk) 22:03, 22 October 2026 (UTC)

Yes, we actually have found multiple sources that say thar exact thing Editing-dude144 (talk) 13:28, 23 October 2026 (UTC)

And where are they? Please provide specific links. Astaire (talk) 14:05, 23 October 2026 (UTC)

1. "The “Keeping Children Safe in Education 2024” guidance uses the Cass Review as an evidentiary basis for this policy change, despite its poor and inconsistent use of evidence, pathologising approaches, and exclusion of service users and trans healthcare experts. "ILGA
2. "The methodology underpinning the Cass Review has been extensively criticized by medical experts and academics from a range of disciplines." Scientific American
3. "US experts have claimed that the controversial Cass Report has a “high risk of bias"" Pink News
4. "Worldwide, the Review has received criticism from expert professional organisations, the peer‐reviewed literature or its disregard of international expert consensus, methodological problems, and conceptual errors. UK trans community advocates have raised issues of justice and human rights." Moore et al

Editing-dude144 (talk) 19:08, 25 October 2026 (UTC)

Comment got cut off, but there are many more

5. "many countries have reacted critically regarding the Cass Review, disagreeing with its unfounded medical opinion to severely limit the use of puberty-blocking medication and hormone therapy for TGD young people. " "The Cass Review appears to be an outlier, ignoring more than three decades of clinical experience in this area as well as existing evidence showing the benefits of hormonal interventions on the mental health and quality of life of gender diverse young people" WPATH Editing-dude144 (talk) 19:11, 25 October 2026 (UTC)

1. N This is a WP:PRIMARY press release that itself criticizes the Cass Review; it is not a WP:SECONDARY overview of the review and the criticism. To justify putting "heavily criticized" in the first sentence, you need to bring forward secondary sources that mention the criticism as an essential defining characteristic of the review.
2. N This is a WP:OPINION article, and it does not discuss the criticism of the review until two paragraphs later. It first proceeds by introducing and defining the Cass Review and its conclusions: Led by retired pediatrician Hilary Cass, the review examined existing research on trans health care interventions for people under age 18, consulted with stakeholders and made recommendations for NHS England services. The final Cass Review report was released in April. It expresses concern about the number of young trans people presenting at doctors’ offices for treatment and argues there is “remarkably weak evidence” for the benefits of gender-affirming medical interventions...
3. = This is a secondary source which indeed calls the Cass Review "controversial" (not "heavily criticized") the first time it is mentioned. This is the only source here which comes close to what I asked for. However, Pink News has an obvious editorial bias and we would need much more than a single secondary source (i.e. different outlets, not just multiple Pink News articles) to consider "heavily criticized" WP:DUE for the first sentence.
4. N This is an opinion/commentary article. Like Scientific American, it does not frontload the mention of criticism; it discusses the criticism only after introducing the subject: The Independent review of gender identity services for children and young people, or Cass Review (the Review), was commissioned by England's National Health Service (NHS) following increased referrals to the NHS Gender Identity Development Service (GIDS), criticisms of GIDS, and the Bell v Tavistock case involving one young person who regretted gender‐affirming medical treatment (GAMT). The Review's April 2024 final report recommended that puberty suppression with gonadotrophin‐releasing hormone analogues (GnRHa) should only be available to transgender (trans) adolescents in a clinical trial, which has not commenced...
5. N Again, this is a primary source/press release which first introduces the subject and does not mention the criticism until later: The recently published Cass Review is the result of a four-year investigation initiated by the United Kingdom’s National Health Service England (NHSE) into the scientific basis of treating transgender youth and the experiences of those involved in transgender care in the UK. It contains 32 recommendations for a reorganization of transgender care for youth in England and Wales. The review took place after concerns arose around the increase in referrals, the evidence base for gender-affirming medical care, and the functioning of the NHS Tavistock Clinic’s Gender Identity Development Service (GIDS).... It is also not a WP:INDEPENDENT source, as the Cass Review criticized WPATH.

Astaire (talk) 15:58, 27 October 2026 (UTC)

So first off #4 (moore et al) Isn't an opinion, it's a meta review of existing studies and responses to the class review. As such, it is a secondary source according to wiki guidelines.

"To justify putting "heavily criticized" in the first sentence, you need to bring forward secondary sources that mention the criticism as an essential defining characteristic of the review."

No I do not, I need to illustrate that the case review was heavily criticized using a combination of secondary sources (which are essential) and primary sources to further illustrate the point. That addresses the reliable source complaint you raised.

Additionally, outside of the sourcing, there is also the fact that the body of the article sufficiently illustrates the subjects controversial nature. Again, 12/12 sources in the global medical reception category that were medical orgs criticized the review. Editing-dude144 (talk) 20:27, 27 October 2026 (UTC)

So first off #4 (moore et al) Isn't an opinion

• Yes, it is. It is categorized as a "perspective" by the journal . If you are not familiar with "perspective" articles, please read about them. Perspectives papers are especially about opinions, that are also positioned within a literature. Authors submit perspectives papers because their individual beliefs (and priorities) have been affected either by an epiphany (data-driven, or conceptual), or a gradual realization that a dominant scholarly narrative is no longer as sturdy. The author’s motivation is to alert others to this new intellectual position, seeking to convince scholars in the field that this new perspective is symptomatic of a zeitgeist (and not a highly idiosyncratic and personal voyage of discovery). (emphasis mine) You could have also figured this out by noticing how the article uses opinionated language like "remarkably", "surprising", and "gravely concerned".

it's a meta review of existing studies and responses to the class review

• No, it is not. Only a single paragraph discusses other responses in detail (the one beginning Worldwide, the Review has received criticism from expert professional organisations...). The rest of the article is the authors' own analysis of the review.

No I do not, I need to illustrate that the case review was heavily criticized using a combination of secondary sources (which are essential) and primary sources to further illustrate the point

• Yes, you do. I have already said this to you, and I will say it again: the sourcing is not in question. I have no doubt that you can assemble a number of individual primary sources that criticize the Cass Review. The issue is whether it is WP:DUE to insert the "heavily criticized" label in the article's first sentence. Please read WP:SYNTH: Do not synthesize meaning from multiple sources to state or imply a conclusion not explicitly stated by any of those sources. Finding various primary sources which are critical of the review, and then deciding by yourself that this justifies the "heavily criticized" label - without secondary sources to back you up - is synthesis/original research. Also see MOS:CONTROVERSIAL: Value-laden labels – such as calling an organization a cult, an individual a racist, sexist, terrorist, or freedom fighter, or a sexual practice a perversion – may express contentious opinion and are best avoided unless widely used by reliable sources to describe the subject.

there is also the fact that the body of the article sufficiently illustrates the subjects controversial nature

• This is a good reason to include mention of the criticism in the lead; it is not necessarily a good reason to insert "heavily criticized" in the very first sentence.

Astaire (talk) 21:53, 27 October 2026 (UTC)

First I'll address the peer reviewed study, Moore et al. You claim that Moore Et Al is a primary source because it's in the perspective section. But perspective doesn't necessarily imply "Op-ed" and it CERTAINLY does not imply that it's a primary source.

Moore et al. is, by definition, a secondary source. If you read the contents, you would see that it is an analysis of multiple sources and is heavily peer reviewed, has 16 authors who are experts in the field.

I don't want to go too deep into it, because I don't want to put words into your mouth. However, this surface-level source analysis you've done is not thorough and is based on the misconception that "Perspective"="Op-ed" and/or "primary source".

I will address the primary sources issue and others in separate responses to keep things neat. Editing-dude144 (talk) 16:22, 28 October 2026 (UTC)

next I want to address your strange interpretation of Wikipedia:DUE. You seem to believe we are pushing a minority view that the Cass Review was "widely criticized", however we have shown you verifiable and reliable sources that have directly stated that it's reception was controversial.

The qualifying factor isn't primary vs secondary source, it's WP:Reliable Sources vs unreliable sources.

Additionally we have demonstrated the breadth of criticism with simple arithmetic, pointing to the global medical community section where 11/11 countries in that section had medical experts that rejected the Cass Review as firm science. Arithmetic is not WP:SYNTH

What appears to ACTUALLY be happening here is Wikipedia:Civil POV pushing of the idea that there was NO or VERY LITTLE criticism of the class review, which is ridiculous given the above facts and quantity of criticism we detail in the body of the article.

I've also noticed a trend where you describe LGBTQ organizations as inherently biased because they are LGBTQ, which seems like a violation of Wikipedia:No queerphobia. Editing-dude144 (talk) 16:46, 28 October 2026 (UTC)

1. 5 WPATH:

You claim that WPATH is a primary source and discount it. However WPATH is an international organization of experts in transgender health. They are widely cited and release healthcare guidance thats cited by the World Health Organization, and providers across the globe.

As experts in the field, WPATH can be treated as WP:ReliableSource. WP:ReliableSource states that "the identity of the author may help determine reliability. The opinions of specialists and recognized experts are more likely to be reliable and to reflect a significant viewpoint."

Next you claim that WPATH is not independent because the Cass Review criticized them. However that also doesn't hold much weight. We wouldn't refuse to cite studies that demonstrated vaccines are safe in the Autism Vaccine MMR article, just because the study criticized existing research. WPATH are the recognized experts in the field, they specialize in transgender health. Hillary Cass is a retired pediatrician, not an expert in the field Editing-dude144 (talk) 16:32, 28 October 2026 (UTC)

A WPATH press release responding to the Cass Review - which heavily criticizes WPATH and lays blame at their feet - is not independent of the Cass Review. A better analogy would be the NYTs publishing an article about fraud committed Widgets Inc and then citing a Widgets Inc press release for facts about the NYTs article (We could cite the press release for an attributed response but not for facts) PositivelyUncertain (talk) 16:59, 28 October 2026 (UTC)

3 Pink news:

Can you explain "Pink News has an obvious editorial bias" to me? That seems like a violation of Wikipedia:No queerphobia which lists queerphobic arguments such as "[arguing] that LGBTQ editors have an inherent conflict of interest or are unable to write neutrally on LGBTQ-related topics because they are LGBTQ" Editing-dude144 (talk) 16:51, 28 October 2026 (UTC)

In all your responses, what you are missing is we are talking about the lead, not about the body. This means DUE is what we are considering and as Astaire has pointed out, sourcing does not show this information to be due.

As for Pink News, their use of "controversial" does not make the information DUE. Additionally, what authority/expertise allows Pink News to assess the international medical community response? None. It's a low quality source.

PS - pointing out Pink News bias is not queer phobic. Would you want us to cite Fox News for statements about the reports impact? Sources are biased and were allowed to consider that. PositivelyUncertain (talk) 17:15, 28 October 2026 (UTC)

Editwarring

All sides seem to be edit warring, and need to stop. We need to go back to WP:STATUSQUOANTEBELLUM which appears to have been without the wording around report being widely criticized by international medical community.

We need to think of perhaps workshopping an WP:RFC if there is need to continue this dispute. User:Bluethricecreamman (Talk·Contribs) 17:26, 28 October 2026 (UTC)

wasn't it just Editing-dude144 pushing unusual style and the rest was reverting his edits or partially reverting? also answering dozens of his questions.

pls correct me if I am wrong, just needed to mention it was not quite symmetric situation. The article had few edits and no talks at all until this October, when a single editor:

• created all the first 8 talk topics
• heavily edited the page for the whole October
• undid reverts of his edits
• survived temp ban on editing
• now goes on as before

that well might be a legal behavior at some aspects, but it takes its toll in terms of time of those who reverts those edits as unjustified ComfyLemur (talk) 17:46, 28 October 2026 (UTC)

your counting and facts are off. But I have no wish to engage in back and forth finger pointing Editing-dude144 (talk) 18:20, 28 October 2026 (UTC)

Okay, but as it stands I feel like there has been a deliberate effort via Wikipedia:Civil POV pushing to minimize the weight and widespread nature of the critical reactions to the Cass Review.

The article, especially the lede, is guilty of violating WP:UNDUE and seems to push the minority viewpoint that the Cass Review did NOT meet widespread criticism and that British acceptance of the review deserves more coverage in the lead than the widespread reaction via the medical community.

I think there is a false equivalency of support and critique, when the majority of experts in transgender health care and 12/12 of the medical organizations in the Global Medical Community reaction section criticized different aspects of the review. We should not elevate the acceptance of the Cass Review as a majority-held view point, or one with equal weight just because SOME UK organizations accepted it. Editing-dude144 (talk) 18:12, 28 October 2026 (UTC)

The Cass Review was not for the international community. The whole point of the review was to inform NHS youth GAC practices. It had no authority outside the UK and substantial authority within the UK. Of course British reception is due. What's also due for the lead is language describing criticism which is already included:

"Medical organisations outside the UK, international medical organisations, and other countries' clinical practice guidelines have criticised its methodology, findings, and recommendations."

This language is redundant to "The review was widely criticized by the international medical community." PositivelyUncertain (talk) 18:21, 28 October 2026 (UTC)

Ok, the next step is to try to build out options for folks to be polled on in a WP:RFC. What specific question do you want everyone to weigh in on from broader wikipedia community? What do you think are the broadly acceptable options for folks to vote on? User:Bluethricecreamman (Talk·Contribs) 18:21, 28 October 2026 (UTC)

hm, I'm going to think on this and get back to you. I want to make sure I present and word this in a fair and representative way Editing-dude144 (talk) 18:26, 28 October 2026 (UTC)

FYI - see conversation here where were discussing compromise language. PositivelyUncertain (talk) 18:46, 28 October 2026 (UTC)

Global medical reception, lets add Germany

Somehow Germany got missed, lets compile a list of medical orgs that generally criticized and rejected the review. The ones that generally agreed. And the ones that gave a mixed conclusion.

Lets start with a list of major medical orgs which provide some opinion authority.

As to me it would be:

• Bundesärztekammer (BÄK) / German Medical Association
• Deutscher Ärztetag / German Medical Assembly
• AWMF / Association of the Scientific Medical Societies in Germany
• Bundespsychotherapeutenkammer (BPtK) / Federal Chamber of Psychotherapists
• Kassenärztliche Bundesvereinigung (KBV) / National Association of Statutory Health Insurance Physicians
• Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde / German Society for Psychiatry and Psychotherapy, Psychosomatics and Neurology

but the list might be rather long since its Germany. ComfyLemur (talk) 18:56, 22 October 2026 (UTC)

I would ask politely for you to perhaps take another look at the section you’re discussing, as Germany is in the article and has been for quite a long time. Snokalok2 (talk) 13:46, 23 October 2026 (UTC)

ah, sure. Yesterday must have been overwhelmed by the discussion temperature lol ComfyLemur (talk) 22:20, 23 October 2026 (UTC)

@ComfyLemur Germany (plus Austria/Switzerland) currently has a small section in the article with only one response (from the AWMF). If you can find responses to the Cass Review from these other organizations, feel free to add them to the article. Astaire (talk) 16:01, 27 October 2026 (UTC)

Have any of these organizations commented on the topic? Katzrockso (talk) 00:23, 28 October 2026 (UTC)

AI-generated child

I'm looking back over the review, and there's an AI-generated picture of a very stereotypical non-binary child in it that I thought would make for a less dry article to include somewhere. What are the copyright laws on a screenshot from a public domain govt report of an AI-generated image? Snokalok2 (talk) 15:05, 25 October 2026 (UTC)

AIUI AI-generated images are not normally copyrightable in the US. I would suggest double-checking whether a UK report is actually in the public domain and not under Crown copyright. WhatamIdoing (talk) 17:56, 28 October 2026 (UTC)

"It has been widely criticized by the international medical community."

@Editing-dude144: you restored this disputed content with the edit summary added longstanding language back in that appears to have been removed accidentally .

• It is not "longstanding language"; it was added by you two weeks ago , and has been in dispute on this talk page ever since.
• It was not "removed accidentally"; I gave three good reasons for removing it in the edit summary, and there is no reason you would assume it was accidental.

Additionally, the sentence is a redundant, more vague version of this previous sentence in the lead: Medical organisations outside the UK, international medical organisations, and other countries' clinical practice guidelines have criticised its methodology, findings, and recommendations. It does not make the article better.

Please explain. Astaire (talk) 21:59, 27 October 2026 (UTC)

See: Talk:Cass Review#h-Criticism in lede-20261014162900 Editing-dude144 (talk) 13:16, 28 October 2026 (UTC)

That is not a response to my comment. Why did you claim that this sentence is "longstanding language" when you added it two weeks ago, and why did you suggest that it was "removed accidentally" when my edit summary was perfectly clear? Astaire (talk) 13:22, 28 October 2026 (UTC)

i self reverted my change. It got added back in via consensus by someone else. This a completely separate issue from the commit I initially self reverted.

You unilaterally reverted language that was added in via consensus and a relevant talk page. I restored the article to the current accepted state. Editing-dude144 (talk) 15:00, 28 October 2026 (UTC)

It did not get added back via consensus. As you can see throughout this talk page the language is contested. And stating it is longstanding in your summary is misleading. PositivelyUncertain (talk) 17:24, 28 October 2026 (UTC)

i self reverted my change. No, you did not. You added the sentence two weeks ago and never self-reverted. Someone else took it out , another person added it back , and it has been in and out of the article since then. Asserting that this is "longstanding language" when you added it two weeks ago is simply incorrect.

It is also highly debatable whether you actually had affirmative consensus to add it. Going by the activity on the article and talk pages, I would presume that PositivelyUncertain, Partofthemachine, ComfyLemur, WhatamIdoing, Maltazarian, Tewdar, Loytra, and myself all oppose including that sentence. (those editors: please correct me if I am mistaken.) There is significant debate about including it and you should not have restored it per WP:STATUSQUO. If you want to establish consensus, it would likely need to be via WP:RFC given the level of debate. Astaire (talk) 17:44, 28 October 2026 (UTC)

in your opinion, at which point this (quite) substantial stream of this activity crosses the line? Is this activity ok for wikipedia? I'm not that experienced in what constitutes a good faith editing ComfyLemur (talk) 17:59, 28 October 2026 (UTC)

Neutral; when I said redundancy is best avoided I took care to stress that I was not advocating for any particular action, as solutions not involving removing the sentence in question are possible too. Which option for structuring the lead is best depends on the core content policy (WP:NPOV) matters being discussed here, which I wont get involved in.

As for the non-content side of things, it is not long-standing content, so affirmative consensus to include would be required to reinstate it. If editors disagree whether such a consensus has been reached, WP:CR is available. –Maltazarian ^{ᚾparley$\lor$investigateᛅ} 18:46, 28 October 2026 (UTC)

I suggested that you accidentally reverted longstanding language because Wikipedia:Assume good faith Editing-dude144 (talk) 15:15, 28 October 2026 (UTC)

Again, it is not "longstanding language" when you added it two weeks ago. The logical implication of your statement is that if someone intentionally reverts you, they cannot be operating in good faith. Is that what you meant to imply? Astaire (talk) 17:46, 28 October 2026 (UTC)

I would support a sentence along the links of "The international medical community has also widely criticized parts of the review and its implementation." (We'd need a newer source for the last bit, but they certainly exist.) WhatamIdoing (talk) 17:54, 28 October 2026 (UTC)

While I don't disagree with that language, it doesn't address the repetition. This is currently the third paragraph of the lead:

Medical organisations outside the UK, international medical organisations, and other countries' clinical practice guidelines have criticised its methodology, findings, and recommendations.

PositivelyUncertain (talk) 18:09, 28 October 2026 (UTC)

Im thinking a good compromise could be:

Medical organisations outside the UK, international medical organisations, and other countries' clinical practice guidelines have widely criticised its methodology, findings, and recommendations.

If we can agree to add that in to the lead in the current place, and retain the above as its own paragraph, i'd be happy without adding in the disputed sentence. Editing-dude144 (talk) 18:33, 28 October 2026 (UTC)

I mean I'm not gonna flat out object to your suggestion but the wording is clunky. That said, I do appreciate you making this into its own paragraph and I have ideas about how we could add to that paragraph (as Ive said, the controversy is an important aspect of the review) but I'm flat out busy with work. Basically, my idea would be to add another sentence like "These organizations were especially critical of the finding that puberty blockers have a weak evidence base and its subsequent recommendations to discontinue prescribing puberty blockers to transgender youth." PositivelyUncertain (talk) 18:44, 28 October 2026 (UTC)

I think a brief detailing of the different critiques could work as long as we ensure it is concise and comprehensive of the major critiques of the review.

I don't want a run on paragraph that buries the critique POV in unnecessary detail for the lede. Mentioning the critiques of Cass' viewpoint on Puberty Blockers would be essential. Cass' ratings on the reliability of WPATH and other studies has received a ton of criticism as well.

I'm kind of swamped as well, but I would love to work together to form a good lead paragraph on the criticisms of Cass Editing-dude144 (talk) 19:32, 28 October 2026 (UTC)

This is a great idea! As I said I'm super busy with IRL deadlines and won't have time to dedicate until early next week. But don't let that hold you back from moving these discussions forward. I really appreciate your willingness to work on this paragraph:) PositivelyUncertain (talk) 21:23, 28 October 2026 (UTC)

I like this idea Snokalok2 (talk) 21:30, 28 October 2026 (UTC)

I think we should be as concrete as possible about the criticisms, and also that "widely" is weasel words so we should also be as concrete as possible about the identity of the critical parties. Loki (talk) 03:40, 29 October 2026 (UTC)

Wikipedia:WEASEL "The examples above are not automatically weasel words. They may legitimately be used in the lead section of an article or in a topic sentence of a paragraph when the article body or the rest of the paragraph can supply attribution" Editing-dude144 (talk) 13:32, 29 October 2026 (UTC)

Does body supply attribution for the word “widely”? User:Bluethricecreamman (Talk·Contribs) 15:07, 29 October 2026 (UTC)

did we agree here or not on whether its wiki style to put such characteristic in the lead even if it was established in the body AND its 2nd or 3rd most most important/known feature of the subject, not the 1st? ComfyLemur (talk) 16:26, 29 October 2026 (UTC)

The lead summarizes the body and, given that the criticism is a notable aspect of the review and the body, it deserves to be discussed in the lead. I also don't see any objections to its current placement (4th paragraph of the lead). We're just discussing how to expand the paragraph beyond one sentence. PositivelyUncertain (talk) 19:45, 29 October 2026 (UTC)

I'd say so, wide really couldn't be any wider than this Snokalok2 (talk) 18:40, 29 October 2026 (UTC)