BMA reverses opposition to Cass review on NHS youth gender services

The British Medical Association (BMA) has reversed its stance on the Cass review, a major assessment of NHS gender identity services for young people. Previously, the organisation had rejected the findings and refused to back its recommendations. Now, after a fresh internal review, it has dropped its opposition. The Cass review, led by Dr Hilary Cass, examined care for children and adolescents within NHS gender services. Its final report warned that routine medical interventions—such as sex hormones for under-18s—lacked strong evidence. It also found that patients had been poorly served by weak research and that services were 'built on shaky foundations'.

The BMA initially opposed the review’s 32 recommendations, calling them 'unsubstantiated'. Its council had voted against implementing them. But a new assessment by 12 union members has now led to a change in position.

Professor David Strain, chair of the BMA’s board of science, described the review process as constructive. He noted that clinicians with differing views had engaged respectfully throughout. He also emphasised that the evidence had been carefully examined, with proper regard for data and ethical concerns. The BMA’s shift means it no longer opposes the Cass review’s recommendations. The decision follows a detailed re-evaluation of the findings and the process behind them. The review’s conclusions about evidence gaps and service weaknesses now face less institutional resistance.