Hilary Cass

Hilary Dawn Cass OBE is a British physician and a consultant in paediatric disability at St Thomas' Hospital, London. She was the President of the Royal College of Paediatrics and Child Health (RCPCH) from 2012 to 2015. Commissioned in 2020, the Independent Review of Gender Identity Services for Children and Young People (known as the Cass Review) was published in April 2024.

Quotes

2012–2015

• If a family can walk out of the hospital having lost their child and say that they couldn't have been better supported, then I can go home and feel OK.
  • "'We're doing medicine in a really inefficient way,' says RCPCH leader", The Guardian (4 September 2012)

• It is really difficult to spot a sick child.
• Children are well one minute and very sick the next. So you have much less time than you have with adults.
  • From an interview with Yvonne Roberts, as cited in "'It's time to say: we're not getting it right on children's health' – paediatricians' leader", The Observer (13 July 2013)

• Half the kids in A&E outpatients need not be in hospital and, if you come to hospital, you are more likely to be admitted.
  • From an interview with Karen Attwood, as cited in "Dr Hilary Cass: Britain doesn't need to have the worst child mortality rate in western Europe", The Independent on Sunday (8 March 2015)
  • "A&E" is Accident and Emergency/Casualty in British usage, or a hospital's emergency room/department in US terminology.

• Someone will bring in a baby because the baby has green poo, but grandma could have been able to say 'that's normal'.
  • As cited by Kat Lay in "Advice from granny could save children a trip to A&E", The Times (28 April 2015)

2024–present

• I have been disappointed by the lack of evidence on the long-term impact of taking hormones from an early age; research has let us all down, most importantly you.
  The reality is we have no good evidence on the long-term outcomes of interventions to manage gender-related distress.
  • From the Foreword of the Cass Review, as cited in "Hilary Cass: Weak evidence letting down children over gender care", BBC News (10 April 2024)

• We've got it locked into this focus on medical interventions. And certainly some of the young adults said to us, they wish they'd known when they were younger, that there were more ways of being trans than just a binary medical transition.
  • From an interview with Amelia Gentleman, as cited in "'Children are being used as a football': Hilary Cass on her review of gender identity services", The Guardian (10 April 2024)
  • On the findings of the review.

• Because of the toxicity of the debate, [children have] often been bypassed by local services who've been really nervous about seeing them. So rather than doing the things that they would do for other young people with depression or anxiety, or perhaps undiagnosed autistic spectrum disorder, they’ve tended to pass them straight on to the Gids service.
  • From an interview on the Today programme (BBC Radio 4, 10 April 2024), as cited in "GPs 'scared off' treating children over gender identity, says Dr Hilary Cass", The Times (10 April 2024)
  • Gids = Gender Identity Development Service at the Tavistock Centre (which closed following the recommendations of the Cass Review's interim report); GP = General practitioner, known as a family doctor or primary care physician in the United States. The term Asperger syndrome was formerly used to describe ASD.