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The Guardian - UK
The Guardian - UK
Politics
Denis Campbell, Health Policy Editor

BMA stance on Cass review of transgender care ‘has damaged its reputation’

Dr Hilary Cass, a retired consultant paediatrician, seated in an office, gesturing as she speaks
Dr Hilary Cass, a retired consultant paediatrician, recommended sweeping changes in the way the NHS treats under-18s who are unsure about their gender identity or are experiencing gender dysphoria. Photograph: Yui Mok/PA

The British Medical Association has threatened the reputation of all UK doctors by rejecting the findings of the landmark Cass review of transgender healthcare, a leading member of the BMA has told the Observer.

Dr Jacky Davis claims that the doctors’ union’s stance on the Cass review is “irrational”, has created a “fracture” between its leadership and the grassroots doctors it represents and left the medical profession “in an uproar”.

The BMA refused to endorse the findings of Dr Hilary Cass, whose review was published in April and was widely welcomed. It claimed the review contained “unsubstantiated recommendations” and its council called on members to “publicly critique” it. Last month, the BMA also called for the ban on prescribing puberty blockers for under-18s to be lifted.

The BMA is the only medical organisation in Britain to not accept and to find fault with Cass’s findings, which were accepted by the last government and its Labour successor. It has said that it wants to carry out its own evaluation.

Doctors on the BMA’s ruling council who have dared to challenge its criticism of the Cass review have been subject to “abuse” and its decision-making body is now shrouded in “a climate of fear and intimidation”, Davis claims.

Writing in the Observer, Davis, who has been a member of the association’s council for 18 years, says: “The BMA now finds itself isolated in its opposition to Cass, and with its reputation and integrity damaged.”

Other council members, talking on condition of anonymity, have shared similar concerns about the organisation’s standing, and the potential harm it could suffer over its internal strife on trans issues.

The “toxic atmosphere” around BMA council debates has left some of its 69 members fearful of speaking up to share their views on the issue, Davis says. Its refusal to endorse Cass’s findings means the reputation of the entire medical profession is now “threatened”, she adds.

The BMA’s position, decided at a council meeting on 17 July, has led to around 1,500 doctors, including former heads of medical royal colleges, signing a letter of protest and some longstanding members resigning.

The union has adopted its position on Cass because a campaign group called DoctorsVote, which has led the junior doctors’ pay strikes, has used political “entryism” to gain a significant influence over the BMA and dictate its policy, Davis alleges.

Davis, an NHS consultant radio­logist, challenges the union’s leadership to “embrace democracy” and put its stance to a consultation of its estimated 185,000 members. “If it fails to do this, one would be forced to conclude that it is afraid of the views of its wider membership,” she writes.

She also claims in her piece that those driving the union’s “anti-Cass” policy “are sincere in their beliefs [but] have no hard evidence for their opposition”, and that the union is in danger of undergoing what one critic describes as “descent into madness”.

Responding to Davis, the BMA said it respected differences in opinion during its internal debates, which were “fair and open”. It denied that DoctorsVote was behind the controversial motion.

A spokesperson said: “We do not accept any form of bullying, or inappropriate behaviours, and where these are brought to our attention due process is followed if further investigation is needed.

“We are not aware of any bullying complaints from Dr Davis or supporters of her position through BMA channels or processes.

“This is in contrast to the frankly abhorrent transphobic and homophobic abuse directed at BMA members and staff on social media in response to our work on the Cass review.”

The union, which has spoken for the medical profession since 1832, did not respond to Davis’s claim that it has harmed its reputation as a result of its stance on Cass.

DoctorsVote did not reply to a request for comment.

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