New UK Government Review: “For most young people, a medical pathway will not be the best way to manage their gender-related distress.”
—Key finding of the Cass Review, a comprehensive, independent, and international review of the current effectiveness of so-called gender medicine, funded by the UK government, released 4/10/24.
“Today's not a triumph, it's the laying bare of a tragedy.”
—JK Rowling, in response to the release of the Cass Review.
A person can go through her entire life never offending anyone, carefully guarding her reputation as a likable and wonderful human, never stepping on anyone’s toes. Being socially acceptable to all. She never wants anyone to be mad at her, and because that is her North Star, she may well succeed. She gets invited to parties. Everyone loves her, everyone thinks she is great.
You know that person. Maybe it’s you. Maybe it’s one of you who used to be in my life and who will never even read this post because you have ghosted, blocked or unfriended me. Without any angry words or willingness to engage with me, of course, because that might be unpleasant.
To me, that way of being seems false and shallow, even as it makes life easier in some ways. That way is not the way of JK Rowling, who is my greatest hero alive today.
Why don’t more people stand up for what is right?
I was raised to believe it is morally important to stand up for what is right and face the consequences. My heroes as a child (with a child’s limited knowledge of history) were people like Jesus, Martin Luther King Jr., Abraham Lincoln, and the white-clad suffragettes who fought to bring the vote to women. Their bravery to do what was right—despite severe consequences—inspired me and made me want to be brave too. I often wondered, “Would I have been that brave?” Each of them worked to change what was wrong in their cultures for future generations. And each of them paid prices, often their lives.
“When you stand up in the light, you cast a shadow,” as my friend Jordan Hughes says. When you stand up for what you believe, especially if' it’s unpopular, many people won’t like it. You are vulnerable to attack from those most invested in the status quo. You certainly give up being universally liked. Even if you have a message as beautiful as “love one another,” like Jesus did, the message may be a threat to the power structure and make you a target. If you are really “standing up” and calling out institutional rot in the culture, some people will hate you, attack you and vilify you, because you are threatening existing structures and institutions in society. You may even be threatening their livelihood, if they are working for government agencies, churches, schools, non-profits, entertainment companies, media companies, and other corporations which profit or in some way benefit from the harm and suffering you are trying to point out.
They cannot have that. They cannot bear to look at the truth themselves. Their entire world could implode. They will say that you are the bad one, that you are hateful, bigoted, and evil. They will try to tar and feather you with their words, delegitimize and stigmatize you. They will try to destroy your employment opportunities, hurt your family. They will reject you if you stand up for a truth out of step with the dominant ideals, laws, and customs of their cultures.
They might call you a heretic or a witch. They might call you a TERF.
Social exile is the one of the worst punishments a person can face. In ancient times it was worse than a death sentence. The fear of it keeps people in their place.
The economic and social costs are very real, so most people do not stand up to point out what is wrong or corrupt in any society. Most people are not Martin Luther King Jr., or even close. They don’t want to think about it and do nothing to change it. Even in whispered tones, it may not be safe. Most people do not speak up to anyone, even when they know or suspect there is something very wrong happening.
The Cass Review reveals the truth.
As the Cass Review revealed, many “experts” know we should not be experimenting with irreversible and drastic physical procedures on children. These procedures are not “settled science,” no matter how much propaganda The Trevor Project or GLAAD spin out in coercive lies. The truth is finally out.
The Cass Review, an authoritative and independent source, finally makes this clear: the effects of puberty blockers and cross-sex hormones in children are not reversible as claimed by trans rights advocates. There is no evidence that these disfiguring surgeries and other harmful procedures improve the lives of children who are distressed about their bodies. The Cass Review discourages “social transition” for young children. Research in this entire area of “gender medicine” has been of very poor quality.
Reporting about the Cass Review from the Boston Globe 4/15/2024:
The National Health Service had already recently declared that puberty blockers would no longer be used for young people with gender dysphoria, “because there is not enough evidence of safety and clinical effectiveness.” The Cass Review confirms this, noting that “bone density is compromised during puberty suppression” and that doctors don’t know enough about the effects on “psychological or psychosocial wellbeing, cognitive development, cardio-metabolic risk, or fertility.” No evidence proved that blockers provided “time to think,” as many proponents of affirmation claim, but there is “concern that they may change the trajectory of psychosexual and gender identity development.”
The primary justification for “gender affirming care,” is the threat that kids will kill themselves if they don’t get “treatment.”
So many parents have been warned by doctors and gender clinicians, “Would you rather have a dead daughter or a live son?” But the Cass Review clearly shows that this emotional blackmail presents a false dichotomy:
“It has been suggested that hormone treatment reduces the elevated risk of death by suicide in this population, but the evidence found did not support this conclusion.” (from the Cass Review)
The Cass Review concludes that the justification for these social and medical interventions are “built on shaky foundations.” As a result of these findings (some of which were released in a preliminary report), puberty blockers for children have been almost entirely eliminated in the UK, except in experimental trials. Norway, Sweden, Finland, and Denmark have also pulled back significantly from this approach to helping children who are confused or upset about their sexed bodies, though none have banned the practice entirely.
The Cass Review notes that many children who are distressed about their sex also have mental health comorbidities such as autism, neurodiversity or developmental disabilities. In the UK and Europe, compassionate and holistic counseling is now recommended as the first course of action, instead of these extreme medical and social interventions. This is great news for UK and European families.
The American Medical Association, the American Pediatric Association, the Endocrine Society, the Mayo Clinic, and other US institutions have embraced unproven opinions which the Cass Review has revealed are based in shoddy science. As the Cass Review documents and as Chrstina Buttons describes so well, these organizations have betrayed the public trust and the most vulnerable by being caught in circular referencing loops, with weak or non-existing evidence for their recommendations.
JK Rowling stood up in the light.
But long before the Cass Review was released, JK Rowling took a stand and stated simple truths that most people agree with. Such as:
We should not be conducting these world-wide experiments on children with no solid evidence base. Driven by activism rather than by science, children are being harmed.
The fundamentals of basic biology have not changed. Just like all other mammals, there are two sexes in humans.
Men cannot become women just because they declare they are women.
Men competing in women’s sports is obviously unfair to women.
Putting male rapists and male sex offenders who say they are women in women’s prisons and shelters is heinous.
Free speech on this topic has been shut down and must be defended.
Science matters.
Rowling stood up in the light because nobody else with power and influence was doing it. She looked long and carefully at the evidence before speaking out. She stood up in the light because she is a deeply moral person, which is obvious if you have read her books. Although some of her many fans expressed feeling hurt and betrayed by her, she did not choose to speak up to “cause division,” as one person claimed to me. Why in the world would she risk tarnishing her massively beloved reputation, if she did not believe it was important to use her platform to protect children and women’s rights? The author whose books are so beloved that their sales have only been exceeded by the Bible? Because of the Voldemort-black, transphobic heart who created Harry Potter? It’s completely absurd.
Shielded by wealth, fame and artistic brilliance, JK Rowling was not destroyed by years of vilification. But the attacks and many death threats did send a chilling message to all of us who know she is right. Dare to speak up with reasonable concerns, and we will come after you. Pretend that all this is “social justice,” and you will be rewarded.
We all are part of the tide turning.
The entire world is waking up to the harms resulting from institutionalized gender ideology. There is a long way to go, but with the release of the Cass Review, those of us who have listened to the heart-wrenching stories of parents and the horror stories of detransitioners finally see a light at the end of a long and dark tunnel. We can envision a time when the biggest medical scandal in history, this atrocity perpetuated on children and young adults, may eventually come to an end.
I am not as brave as some people are, and I also did not begin to see the harm until 2020. This was literally decades after some feminists (from the left, the political pole that birthed feminism) had been pointing out the dangers to society of abandoning the defense of sex in favor of gender identity. (Note: I did not say “the danger of trans people.” It is gender ideology that is toxic and blinding. To understand this concept, read Helen Joyce’s book Trans or watch Andrew Doyle speak about this and other revelations of the Cass Review.) These early warnings did not reach my ears, or the ears of many people. But once I recognized the truth, I added my voice to theirs, in private and in public.
I don’t want to be killed or punished for my views either! But I will never regret standing up for free speech, for the rights of women, and for the protection of children. I will never be ashamed of standing up in the light against such brutal harm, even with the costs. It has been painful, but the costs to me have been relatively minor compared to what many others have experienced.
I am glad to have supported the parents of children ensnared in this cultural moment by writing the song Icy Storm for them. I hope this song can continue to bring comfort and hope.
I am glad to have joined with radical feminists working hard for women’s rights and incarcerated women by writing Tomiekia’s Song.
I am glad I worked as a volunteer editor of GC News for a year to try to spread news on this topic, from both left-leaning and right-leaning publications. This should never have been a partisan issue. It’s kids who are paying the price from the contentiousness. We felt we had to stop GC News once the American press on the right had so thoroughly dominated the coverage. The extreme political polarization and tribalism in the US has made exposing the truth particularly difficult. One of our primary goals was always to pressure the left-leaning press (who we at GC News used to trust) to cover this topic honestly and with journalistic integrity. This has finally begun to happen.
I’m glad I testified with other feminists before a Washington State Legislative committee (facing Senators I used to know on a first-name basis—it was hard) expressing my concerns about men being housed in the women’s prison in our state. We were unsuccessful in stopping a bad bill, but I am proud to be on the record standing up for vulnerable incarcerated women who could not stand up for themselves.
I’m glad I went to a peaceful “Let Women Speak” rally in Tacoma, WA, even as our constitutional right to free speech was not protected, even as some of us were injured by trans activists and all of us experienced fear and hatred spewed against us.
I am a drop in an ocean of changes and have played a very small part, but I am glad to have taken a stand with so many other courageous and intelligent humans around the world. I continue to do what I can.
Part of an artist’s job is telling the truth. I would not have taken a stand if it had not become clear that left-leaning people like me needed to be honest with their communities about the real harms. I can look myself in the mirror, and that is important to me. I know that I am motivated by caring and wanting to make a positive difference. I have expanded my intellect, made some wonderful new friends and deepened some close family relationships along the way. Those gifts are priceless.
I also continually question myself, and am committed to saying, “I was wrong about this” if the facts as I understand them convince me. I disagree with people I very much respect on many things in this fraught area (and other fraught areas). Life is pretty fraught right now for all of us. I constantly wrestle with trying to understand life better. I try to see past my own confirmation bias. I am sure I am not entirely successful in that (nobody is!), but I try.
Gay Pride
I am still an outsider, still an artist. I continue to write songs and stories all the time. You should see my hair these days, shaggy silvery curls (rather Einstein-ish). I am still committed to celebrating and supporting gender non-conforming people and gay and lesbian and bisexual people, as I have always been. Gay and lesbian people make the world better and richer. I know that people cannot change sex, but I also support the human rights (already established in US law) of people who are trans identified. I do not support public policy or law which tramples on women’s safety and dignity or pushes children and young adults to make irreversible medical decisions, causing life-long harm that too many will regret.
Gender ideology does not actually support any of these “LGBTQ+etc” groups. Each of those letters belongs to a different group of people, and sometimes their needs and desires conflict. The mashing together has not been helpful, especially for lesbians whose spaces have been erased and who should not be pressured and gaslit to date humans who have penises, aka men. Sex matters in law and life.
Denying the reality of our sexed bodies and deifying “gender” (a very fuzzy and ambiguous concept) has made our society more sexist, more homophobic, more dysfunctional, more confused, and more intolerant. Nobody can be born in the wrong body—each of us just has the body we have. Most of us don’t like aspects of our bodies, but accepting reality is a baseline for finding true happiness in life. Our bodies mean we are alive, part of the earth, part of nature. Our bodies are a precious gift. No magic pill can eliminate suffering, which happens through and in our bodies, even when psychological. I want a culture which supports people to accept and nourish our imperfect, hurting, aging, yet always beautiful bodies. Yes, medicalization can reduce our suffering, but it will rarely if ever help ease existential pain, as is promised by “gender affirming care.” We cannot become more “authentic” by denying the reality of our biological selves.
Some of you have been on my mailing list for decades. I performed at what was then called Gay Pride festival in 1993 or 94 in Balboa Park in San Diego. Most of my other singer-songwriter friends did not perform there. It was not cool then. It did not feel entirely “safe” way back in the early days of big celebrities and local stars starting to come out as gay, but I wanted to support that festival. I still want a world where creative human expression is celebrated, regardless of what sex you are or how you express your colorful personality.
Transness in our culture
I admit that I often wish “all things trans” would go away because normalizing and even glorifying trans identities (as seen on TV, social media and increasingly in schools) has the effect of more troubled kids thinking there is something wrong with their bodies and demanding these procedures they think will make them happy. Children don’t “know who they are” as trans rights advocates claim: they absorb from adults and other kids who they think they should be. That is how all primate youngsters learn. More unnecessary psychological and physical damage is being done, every day. Leave the kids alone. Let them have their issues, let them be. Don’t teach pseudoscientific genderqueer ideology in public schools—teach science, art, math and literature.
I believe the many studies which conclude that most kids outgrow their discomfort with their sex, many turning out to be gay or bisexual. Noting these robust studies, the Cass Review is an especially authoritative source indicating that we are harming these gender non-conforming children.
In effect, we are sterilizing gay kids.
Opinion article about the Cass Review from the Washington Post, 4/18/24
I know all too well how the absence of good-faith, healthy debate on this subject can affect clinicians and patients. When I was 15, a therapist affirmed my conviction that I was born in the wrong body. After more than a decade of hormonal and surgical interventions, I detransitioned at age 30. I had come to realize that my transition was motivated by my difficulty reconciling with being gay. Today, I am a licensed clinical social worker and board president of Therapy First, formerly the Gender Exploratory Therapy Association, a nonprofit organization that advocates psychotherapy as a first-line treatment for youth gender dysphoria.
But as Corinna Cohn and Nina Paley, co-hosts of the excellent podcast Heterodorx, declare: “Sex is real. People are weird.”
Which I can relate to, being a weirdo myself. Whether anyone likes it or not, there will continue to be people who modify their bodies in all kinds of ways—because people want to do that. People are weird. I don’t particularly approve of getting a facelift or a nose job, but people get them, and some of those people are my friends.
I do realize the comparison isn’t perfectly analogous—but I wouldn’t want to live in a society that polices the choices adults might make to have cosmetic surgery. Although I have heard the stories of so many detransitioners who feel damaged and hurt, I also know that some who have opted to medicalize in these ways report being very happy with how the procedures have affected their lives, even decades after. Some of them are people I care for. I want them to be happy and I want them to be safe.
Besides these freedom of choice issues, there is also a billion-dollar industry pushing sex-modification (see the important work of Jennifer Bilek) and the damaging effects of ubiquitous and increasingly violent and degrading pornography, some of which has apparently led to some males to demand to be seen as women. Where there are huge sums of money to be made, change is slower and harder to come by and impossible to reverse. We can only move forward.
So no, given all these factors, I do not see people who identify as trans or the normalization of these procedures for adults going away anytime soon. There must be dialogue and compromises made, or we all will lose. At least “no debate” is finally over.
And distressed as I am about the harms of gender ideology, I reject being fueled by hatred towards any group. No group is a monolith! And I am just not smart enough to know how the world should spin. I must accept contradictions and my lack of knowledge. I must stay curious, humble and keep learning. To live within the values I hold, I try to cultivate tolerance and curiosity—even when I am upset and angry about changes that I see as harmful, even as I find there is no tribe I really belong to anymore. I am committed to moving from a place of love, as well as common sense, reason and safeguarding for those who are vulnerable. I do my best.
I have my battle lines. First and foremost, I want this madness to stop with children and young adults. I also want women’s spaces to be safe and free of men when women need or want them to be. But people are people. Our sex is only one aspect of who we are, just as being human or being a mammal or being a pale or brown-skinned person is only one aspect of who we are. Some trans-identified and transsexual people are sane and interesting and wonderful, in my estimation. I want to be at peace and be allies with those who do not deny reality. I respect and admire some of these folks, especially when they work their asses off to stop the worst of the madness harming women and kids.
Friendships and fallout
I mourn the friends I used to have. I still remember what I love about them. I cannot see them as enemies, but they are no longer my friends. I must let them go. I do not need to reconcile with those who have rejected me. Like me, it’s themselves they must face in the mirror each morning. I am grateful to have kept some friends who have not agreed with me, who have argued with me in a civil way, but have kept the bond alive, however tenuously. I hope they will continue to investigate the implications of this medical scandal for themselves, but that is up to them. Or this posting may result in us moving farther apart, which I also accept.
Reporting from the Atlantic about the Cass Review, April 12, 2024:
If you still think that concerns about child medical transition are nothing more than a moral panic, then I have a question: What evidence would change your mind?
I hope, now that it’s a bit safer, that some of you who do share my concerns will stand up to change our culture (especially those of you on “the left”) in whatever ways you can, privately or publicly. Do this the sake of your own families, your own children and grandchildren. There are now plenty of reliable sources to learn from besides me.
Continuing in the light
Like JK Rowling, I do not see the revelations of the Cass Review as a vindication or something to celebrate. It has been devastating to watch this tragedy unfold and feel helpless to stop it, helpless to know how to wake people up. I have friends whose lives have been demolished because of gender ideology. Parents whose schools lied to them about their child adopting a trans identity, helping to secretly solidify it and exacerbate other mental health issues. There is damage that can never be undone, hearts that will never mend. And I know others who realize they were lied to when told they could “change sexes,” and now have missing body parts and sexual functions, suffering serious long-term complications from surgeries. Oceans of nearly unbearable pain and regret, so much to mourn. All of it was fueled by greed and hubris, none of it was necessary. My heart hurts daily for the people I know and also for those I don’t know but whose stories I witness, such as the parents at PITT.
It’s not fun to be the one saying, “This is not right!” or being told “shut up, bitch.”
But I am reconciled with the shadow I have cast, the judgements others have made of me and will continue to make of me, even as there has been a toll on my physical and mental health. “When you stand in the light, you cast a shadow.” Playing it safe has its costs too—you don’t make a difference, and you have to live with your own cowardice and lack of honesty.
I will continue to follow my heart in doing what seems right to me in the time I have left in life. And I’ll continue to make music for humans of any sex or identity or hair color as long as I can, most of it having nothing to do with this gender stuff. That’s the main thing I’m here for.
This was an update I felt had to be made in case anyone on my list needed this information. If you are new to my Substack and subscribed because of a recommendation from my friends at PITT, you should know that the content here is mainly my music and videos, very little of which has anything to do with gender politics. I also have another Substack called Some Glad Morning with essays and songs connected to my work with music and elders.
Here are a few articles about the Cass Review from the past week:
The Cass Review prompts rethinking gender transition treatment for the young (Washington Post)
Youth Gender Medications Limited in England, Part of Big Shift in Europe (New York Times)
Britain is Leaving the US Gender Debate Behind (The Atlantic)
Thanks to Cass, evidence not ideology will be used to guide children seeking gender advice (The Guardian)
We need a youth gender medicine panel like the Cass Review (The Boston Globe)
Next time, back to our regularly scheduled programming: Truth in Music.
History shows us that it's a tiny minority of people who have the courage to follow the truth, whatever the consequences -- and even fewer take a clear, public stand when they know their view runs counter to popular opinion or the doctrines that happen to be intellectually fashionable within their cultural circles. Thank you for being one of those exceedingly rare people who care deeply about what feels most true, even when so many voices around them declare the righteousness of the prevailing creeds based on edict alone, rather than by evidence, reason, and compassion.
Thank you for standing up publicly in such a powerful way, using your music and writing talent to speak out against a medical travesty. The shadow you cast gives courage to others, including me, to stand up as well. ❤️