Thanks to Cass, evidence not ideology will be used to guide children seeking gender advice | Sonia Sodha

Significant numbers of gender-questioning children – it’s impossible to know exactly how many because the clinic did not keep records, itself a scandal – were put on an unevidenced medical pathway of puberty-blocking drugs and/or cross-sex hormones, despite risks of harm in relation to brain development, fertility, bone density, mental health and adult sexual functioning.

Puberty blockers will only be prescribed as part of an NHS research trial and she recommends “extreme caution” in relation to cross-sex hormones for 16- to 18-year-olds; one might expect this to be contingent on it being possible to develop diagnostic criteria for gender dysphoria that will last into adulthood.

Cass’s vision is what gender-questioning children deserve: to be treated with the same level of care as everyone else, not as little projects for activists seeking validation for their own adult identities and belief systems.

There will be resistance among captured clinicians wedded to quasi-religious beliefs; it is astounding that six out of seven adult clinics refused to cooperate with the review on a study to shed more light on those the NHS treated as children.

On single-sex spaces and sports, it wrongly advises that a child’s chosen gender identity should override their sex, which is likely to lead to unlawful discrimination against other pupils, particularly girls.

The Cass review is an immense achievement; it has stripped the heat out of one of the most contested areas of modern medicine and restored the role of evidence back to its rightful place.