Conference motion submitted to Liberal Democrat Federal Conference Committee for Autumn Conference 2022 (rejected):
Looking Ahead to Cass
Conference notes that:
A. Transgender medicine has changed substantially since the Liberal Democrats passed its “health charter” motion in 2015 [1], with increasing numbers of people undergoing gender reassignment.
B. The cohort of people undergoing gender reassignment has changed substantially, from predominantly middle-aged men in 2010 to predominantly teenage girls in 2022. Considering children only: in 2018-19 1740 females were referred to Gender Identity Development Service (GIDS) in England compared with 624 males. In 2009-10 these figures were 32 females and 40 males. [2]
C. In a wish to alleviate gender distress in adolescents, clinicians have been recommending medical interventions without high-quality research into the long-term health outcomes, including those relating to cognitive and bone health. [3] There is evidence that puberty blockers followed by cross-sex hormones can result in irreversible harm including irreversible infertility. [4]
D. Children who receive affirmation therapy are more likely to go on to receive puberty blockers, and 98% of those given puberty blockers then progress to cross-sex hormones (GIDS study). [3]
E. Finland and Sweden have now banned the use of puberty blockers in children identifying as transgender. [5]
F. Dr Hilary Cass, a renowned paediatrician, is producing a review of GIDS for NHS England. The interim report was released in March [3]; its interim findings identify major concerns with GIDS, including the lack of adequate research into long-term outcomes from medical interventions offered by GIDS. The full report is due out this year.
G. In the meanwhile, the interim findings bring into serious doubt the party’s 2015 policy calling for ‘transgender and gender-variant children to receive puberty-blocking medications until they are eligible for hormone replacement therapy.’ Also in question is part of motion F4 Autumn 2022 which states “Practices which seek to affirm or support an LGBT+ orientation or identity are not conversion therapy.” [6] The Cass interim report states that affirmation is ‘not a neutral act.’
Conference believes that:
1. Children expressing gender-related distress should be treated holistically, without ‘diagnostic overshadowing’ where other issues are overlooked once gender-related distress is expressed [7]
2. “Affirmation therapy”, which promotes social transitioning by encouraging children to change their names and pronouns, is not a “neutral act”
3. Medical practitioners should seek to “First Do No Harm”, in accordance with the Hippocratic Oath;
4. The Liberal Democrats should base policy on evidence and should review existing policy when evidence arises that brings that policy into question.
Conference calls for:
a. The policy group to put in place a panel with external expert clinicians, including experts from the Cass Review, to review and update Liberal Democrat policy in this area.
b. The revised policy should be brought to Conference at the earliest opportunity once the finalised Cass review has been published and scrutinised.
c. Until this policy review is concluded, Liberal Democrat policy that pertains to transgender medicine should be withdrawn and marked ‘pending review’ so the Liberal Democrats are not proposing outdated and potentially harmful medical care.
Notes for Federal Conference Committee
[1] = Lib Dem Transgender and Intersex health charter https://lgbt.libdems.org.uk/en/page/transgender-and-intersex-health-charter
[2] = Statistics from GIDS https://tavistockandportman.nhs.uk/about-us/news/stories/referrals-gender-identity-development-service-gids-level-2018-19/
[3] = Link to the interim Cass review https://cass.independent-review.uk/publications/interim-report/
[4] = “In both transmen and transwomen loss of reproductive capability will accompany the use of cross-sex hormones which, although usually reversible if the person elects to stop taking the hormones, may be irreversible.” https://journals.sagepub.com/doi/pdf/10.1177/0004563215587763
[5] = Decision by Sweden to ban puberty blockers https://segm.org/segm-summary-sweden-prioritizes-therapy-curbs-hormones-for-gender-dysphoric-youth
[6] = Motion F4 Autumn Conference 2021 https://www.libdems.org.uk/f4-ban-conversion-therapy
[7] = Children who express gender distress often experience ‘diagnostic overshadowing; namely “many of the children and young people presenting have complex needs, but once they are identified as having gender-related distress, other important healthcare issues that would normally be managed by local services can sometimes be overlooked…” (Cass Interim Report 1.16)