Talk:Cass Review

	This Gender related article has been awarded BRONZE status for quality. It's getting there, but could be better with improvement. See RationalWiki:Article rating for more information.

Remove from draft?

I think this article is ready for mainspace. I'd like to expand the section on unsupported claims, but it seems like a comprehensive overview as-is. Burnt Toast (talk) 05:59, 9 August 2024 (UTC)

There are inaccuracies. For instance she didn't remove all non double-blind RCT papers from consideration; from what I understand it was even more botched than that as they had no consistent standard. From what I remember they did select a couple studies as "high quality", including bizarrely enough at least one that supported transition as having positive outcome on gender-dysphoric people. Also considered were medium quality studies if I recall correctly. Basically it's worse than you think, they seem to have arbitrarily included or excluded studies then misrepresented the studies they included. Chillpilled (talk) 12:26, 9 August 2024 (UTC)

Took in a lot of info in a short time. Might've digested some stuff incorrectly. Feel free to correct any errors. "Cass discounted studies that weren't double-blind RCTs" is the understanding put forward by the Los Angeles Blade and Them articles. I do feel it's important to try to break down exactly what Cass did to shape its outcome for a lay audience. Without a reasonable degree of scientific literacy, the fuckery of the first paragraph isn't obvious. If there's competing understandings of the fuckery – non-double-blind, non-RCTs were thrown out vs. a totally arbitrary "standard" was applied – I guess this article could present both. Burnt Toast (talk) 13:52, 9 August 2024 (UTC)

I would need to collect citations/page numbers and such to correct it with which could take a lot of time, but I can drop some other points about the review elsewhere. What I said is my understanding. I think the Yale report actually covers it. There is actually a ton of additional problems with the review other than just what has even been reported or published on. It was bizarre to look at the section on twin studies and see Milton Diamond's paper was nowhere to be found. The review cites a speculative commentary about whether gender dysphoria could be caused by pornography on page 110. At multiple points it will cite a paper and just misrepresent it or omit inconvenient findings from it. It's all over the place. Chillpilled (talk) 14:19, 9 August 2024 (UTC)

Yeah, there's so much blatant nonsense in the Cass Review, it's hard to know where to start in debunking it. One approach might be to have the sub-sections under "Methodological flaws" focus on systemic issues with the Review (e.g. the dodgy measure of study quality it uses) and have a bullet-point list for isolated examples of false claims etc. Burnt Toast (talk) 15:18, 9 August 2024 (UTC)

Just to correct myself on something relatively minor, I think I linked the wrong paper by Diamond, meaning to link this one. Chillpilled (talk) 18:37, 10 August 2024 (UTC)

Would someone be interested in expanding the section on the Cass Review's numerous methodological issues and unsupported claims? My next focus will likely be expanding coverage on the political fallout surrounding Cass, particularly the alleged suicide coverup scandal and the so-called Appleby review. Burnt Toast (talk) 22:12, 10 August 2024 (UTC)

After my edits I think the page is more accurate. I just wonder if the lead section could be written better since it doesn't summarize the rest of the article too well. Also, I wonder if we should mention some of the erroneous statements by Cass post-publication, like (not direct quotes): "treat trans teens with SSRIs instead", "use employment as a measure of objective mental health" (which, given that HR Magazine citation I used in this article, is a problem), proposing a pornography link, comparing critics to anti-vaxers, etc. Chillpilled (talk) 17:02, 12 August 2024 (UTC)

The new intro to the "methodological flaws" section provides a very good overview. But I do wonder if it's a little on the dense side. Will it help less-scientifically-literate readers approaching this article? I.e. people who don't have a basic grasp of evidentiary standards and study methodology? I think a list highlighting some of the more spurious claims (e.g. the claim of a causal relationship between gender dysphoria and porn) could strike a balance. Maybe the spurious claims Cass has personally made in interviews could be included in that section?

I also don't think mention of the "Cass threw out everything but double-blind RCTs" theory should be tucked away in a footnote. This is a really common understanding of Cass's main flaw among laypeople. It's made it into articles about the Cass Review. It should probably be covered head-on even if it's just to be debunked or recontextualised. It might even serve as a springboard for a more explicit explanation of what the Cass Review did wrong. I know that's made clear in the concluding quotation: "driven by unexplained protocol deviations, ambiguous eligibility criteria, inadequate study identification, and the failure to integrate consideration of these limitations into the conclusions derived from the evidence syntheses." But someone with a less firm grasp of science might not be able to translate that into "The Cass Review seemingly applied completely arbitrary standards, picking-and-choosing what studies to include and exclude." I think the article should state this in plain language to make it clear that the Cass Review is actually worse than popular understanding believes it to be. Burnt Toast (talk) 18:19, 12 August 2024 (UTC)

Would it be worth including coverage of the secrecy over the Cass Review's advisory board? I believe that Finnish doctor Riittakerttu Kaltiala is the only member who's been publicly identified. She facilitated the meeting between Hilary Cass and Patrick Hunter. The reported practices of the youth gender clinic she oversees in Finland are pathologising and downright alarming. Burnt Toast (talk) 22:23, 13 August 2024 (UTC)

┌────────────────────────────────────────────────────────────────────────────────────────────────────┘I think so. It's highly unusual for a published review in the fields of medicine or science to have anonymous contributors. It calls into question whether they have something to hide: were the reviewers political appointees with an agenda, were they qualified to do a review? For example, simply being a practicing medical doctor is not really sufficient: doing a thorough review of medical papers is not a skill set that all medical doctors have. Bongolian (talk) 03:25, 14 August 2024 (UTC)

I'm not sure it's that unusual especially seen through the lens of it being a government-commissioned report. But for this review in particular I think they would ideally let people know by now, because there was involvement from people affiliated to groups like Genspect or SEGM that are now recognized as hate groups by SPLC. So people may like to know how involved those networks were with narrative-building, or structuring of the review.

On another note I edited the thing about toy preferences in the article. I think it's actually possible toy preferences could be influenced by prenatal hormones but I wouldn't take a strong stance about it. What's bizarre about the Cass report making this claim is, it does in the same sentence it denies prenatal hormone influences on gender/sex identity. This is a rather strange thing to claim to my eye, because if something so subsidiary as gender expression were influenced by prenatal hormones I should think they would also influence something so base as your instinctive/reflexive understanding of your own sex (J. Serano: "my brain expects my body to be female"). This article notes one of Cass's citations did past research into toy preferences in non-human primates; that was contradicted by some later research (lower sample, different species). But leading primatologist Frans de Waal says non-human primates have a gender identity from birth, also noting non-conforming cases. I'm also baffled why Cass would bring this stuff up while elsewhere citing Ken Zucker, who seems to have been directing parents to pressure gender non-conforming children out of playing with the "wrong" toys. Chillpilled (talk) 20:27, 18 August 2024 (UTC)

"Girls like dolls because biology" is bio-essentialist nonsense on its face. Correlation is not causation. The science supports gender identity being "hard-wired" in some manner. But gender expression seems more likely to be a product of culture and socialisation. Studies that set out to prove neurological sex differences often seem to fall into the priming trap. I.e. women tend to perform more poorly on math tests when primed with statements like "men do better than women on this test." This is touched upon in Cordelia Fine's Delusions of Gender. (Full disclosure: it's been a decade since I read it.) Basically, kids will seek to express, understand, and solidify their emerging sense of self through whatever tools they're given. That's why all these brain sex studies have had to run with the ever-shifting landscape of toys. Tonka trunks didn't exist a 100 years ago to prove boys have a biological affinity for them. Back then, researchers would've had to "prove" the same claim with toy soldiers, guns, etc. If we told kids "cubes are for girls, spheres are for boys," the studies would say girls have a biological preference for Platonic solids. My thinking is that kids will generally prefer whatever toys and forms of play they're conditioned to associate with the gender of their neurotype. As for primate studies it's a huge leap from their findings to the conclusion that human toy preferences may be biologically-based. It's doubtful non-human primates understand the utilitarian function of cooking pots and trucks. It's even more doubtful they understand human gender roles and the overarching social context in which these toys exist. We should be careful not to map human psychology and sociology onto non-human animals. Burnt Toast (talk) 01:24, 19 August 2024 (UTC)

To circle back, should we mention in the article that Cass cites Zucker's research, as an example of the preference shown toward trans-hostile experts? Burnt Toast (talk) 01:41, 19 August 2024 (UTC)

Maybe. My point is that these claims the report is making on this subject and adjacent ones appear to contradict each other... and that the contours in which these pieces contradict each other highly suggest the review's framers were working backwards from their conclusions (policy-based evidence making). This would seem to be the case whether or not we accept prenatal hormonal influence on toy preferences (by the way if this were true, note it would also mean girls who don't prefer stereotypically feminine toys also dis-prefer those for biological reasons). The report also may misrepresent why Zucker's papers were criticized; they say it's because his patients weren't diagnosed under an ICD/DSM standard or something. I don't think that's necessarily even the case, I had been under the impression that at least some of them were diagnosed, but that the diagnosis was strangely loose as a vestige of a time when children were pathologized for gender non-conforming behavior thanks to a range of clinicians who capitulated way too much to conversion-therapy oriented parents and religious leaders, as some kind of appeasement (at bare minimum, assuming they didn't agree with those people in the first place). Chillpilled (talk) 02:07, 19 August 2024 (UTC)

Found another advisory board member: Emma Cave, a professor of healthcare law. Seems to specialise in medical ethics. Can't find anything connecting her to the anti-trans movement. Worth mentioning in the article? Burnt Toast (talk) 10:23, 29 August 2024 (UTC)

More reporting from Zinnia Jones confirming the Cass Review was stacked with SEGM members. Burnt Toast (talk) 00:08, 3 October 2024 (UTC)

Noone et al. in the Lancet?

I was keeping an eye on when that preprint will enter publication. Google Scholar tells me it's been published in "The Lancet Regional Health Europe". But the links it provides are now dead for some reason. It seems to be going off of this. Chillpilled (talk) 01:20, 9 September 2024 (UTC)

Perhaps it's between preprint and publication? Still accessible here for now. Burnt Toast (talk) 01:38, 9 September 2024 (UTC)

According to the authors last month it will in fact be published somewhere. I don't know if that means it'll be The Lancet Regional Health at the end of the day but it looks like that's where they expected it to be published, as of June. Chillpilled (talk) 02:09, 9 September 2024 (UTC)

My guess is that there's still behind-the-scenes work going on in preparation for publication (really hope LRHE hasn't gotten cold feet) but someone accidentally spilled the beans by prematurely naming the journal in their CV. Burnt Toast (talk) 02:44, 9 September 2024 (UTC)

Levy Review

The NHS has predictably announced that it's launching a "review" of adult gender services. To be headed by David Levy, who was also chosen from a shortlist of one. Burnt Toast (talk) 00:06, 3 October 2024 (UTC)