The Cass Review reads like a soldier’s letter from the front — as if its author is trying to smuggle facts across enemy lines and through a censor. That this most eminent paediatrician, Dr Hilary Cass OBE, felt the need to open on the defensive by stating the report is “not about defining what it means to be trans, nor is it about undermining the validity of trans identities” makes it obvious that she knew she was painting a target on her back. For all her nonsensical equivocation about toxicity and extremes on all sides, Cass clearly understood that if the messenger was to be shot, it would be a trans activist holding the gun.

And Cass has every reason to be concerned. Her detractors are not confined to the activists who are even now planning a demonstration against the implementation of her recommendations — the entire NHS is in effect enemy territory.

Today there is a legion of activists within the NHS; some organise internally within workplaces, whereas others like GLADD are networked across the UK. 

GLADD describes itself as having “a national voice in LGBTQ+ health activism and education” and boasts of “working with leading figures such as the General Medical Council, British Medical Association, Royal Colleges and Parliament”. As a gender critical activist known simply as “Rebecca” has revealed in her blog, GLADD has gained signatures for its highly political “Charter on So-Called LGBTQ+ ‘Conversion Therapy’” from almost every medical school within the UK. Members of GLADD have taken an active role in lobbying for the use of puberty blockers. Duncan McGregor, co-chair of GLADD wrote behalf of the organisation in 2021 to protest a high court ruling which found patients under sixteen were unable to consent to puberty blockers.

Other activists have put themselves on the frontline. Earlier this month NHS clinician and trans activist Dr Ronx Ikharia was found to have led an intimidating protest which campaigned outside a conference where evidence-based approaches to treating gender dysphoria were discussed.

In the wake of the publication of the Cass Review, attention has focused on the horrifying truth that children have been given harmful drugs on the basis of a single, flawed study. But the report has also revealed how deeply entrenched trans ideology is within the NHS. When the University of York requested, on Cass’s behalf, data on the outcomes of 9,000 patients seen at gender clinics, all but one refused. Former health secretary Sajid Javid, who commissioned the report, reflected in the Times:

… parts of the NHS continue to block access and frustrate the express will of parliament. The common thread between all of these is an extreme gender ideology, which enables them to persist.

The report documents the reasons given by the clinics which refused to share their data. These include apparent fears from the clinics that the “study may not be fully independent” which included the claim that the study “may suffer from interference by NHS England, the Cass review team and government ministers” whose interests “do not align” with theirs and those of the patients.

The clinics are also said to have complained that the “unintended outcome of the study is likely to be a high-profile national report that will be misinterpreted, misrepresented or actively used to harm patients”.

This is unsurprising. A quick glance at how these organisations describe themselves makes it clear they are staffed by activists with links to radical transgender organisations.

The Nottingham Centre for Transgender Health Network, where staff initially refused to share data with Cass, introduces Medical Doctor and Transgender Health Specialist Jon Arcelus (pronouns: he/him/his) with the dubious honour that he co-chaired of the Standards of Care version 8 (SOC-8) developed by the World Professional Association for Transgender Health (WPATH). These are the guidelines which included “eunuch” as a gender identity that even children may have. Arcelus’ biography on the site continues:

He works closely with trans organisations, including Mermaids, Gender Intelligence and Translearning partnership. He is also an Associate Editor of the International Journal of Transgender Health.

Similarly, the Indigo Centre, an adult gender service for Greater Manchester, is run in partnership with the LGBT Foundation and describes itself as staffed by a “team of trans, non-binary and LGBQ practitioners and allies”. This is in effect, the gift of taxpayer money to trans activists within the NHS who in turn, create more trans activists.

Thankfully, in the wake of the report the adult clinics have now backed down and agreed to comply, after health secretary Victoria Atkins ordered them to end a “culture of secrecy and ideology”. But the reluctance of those within the adult clinics ought not to be surprising given the years that agenda driven individuals and interest groups have been allowed to act with impunity, under the borrowed standard of earlier campaigns against homophobia.

The Cass Review has already made huge changes. But to truly stop the ideologues we must now look outside of the treatment of children to the culture within the NHS. The recommendations for training and a more holistic approach to children’s confusion over gender will mean nothing if the zealots are allowed to stay in post. Faced with accepting the horror of what they have done, activists will hunker down and continue fighting sanity. We must make them realise that they are in the unfortunate position of the Japanese soldiers who refused to surrender even when the war was lost.