The British Medical Association's (BMA) recent announcement to lobby against implementing recommendations from the Cass review on NHS child gender services has ignited a firestorm of controversy within the UK medical community. The decision, made on July 31, 2024, has drawn sharp criticism from prominent doctors and sparked a significant backlash among BMA members.
Dame Professor Clare Gerada, former president of the Royal College of General Practitioners, expressed her dismay at the BMA's stance:
"What right has the BMA to second-guess the Cass review, the Academy of Medical Royal Colleges – which represent our professional values – and the three major royal colleges covering psychiatry, paediatrics and GPs?"
The Cass review, published in April 2024 by leading paediatrician Dr Hilary Cass, found "remarkably weak evidence" about the long-term impact of puberty-suppressing hormones on children. This landmark report, which took four years to complete, involved thousands of interviews and eight independent systematic reviews.
In response to the BMA's decision, over 1,400 doctors have signed an open letter expressing their "dismay" at the union's position. Among the signatories are 70 professors and 23 former or current presidents of medical royal colleges and clinical leaders.
Dr Az Hakeem, a consultant psychiatrist specializing in gender dysphoria, criticized the BMA's approach:
"The BMA has been taken over by a brigade of people wearing red braces and putting pronouns in their bios who have turned their back on evidence-based medicine in favour of a cult of ideology."
The controversy has exposed deep divisions within the BMA, with many members questioning the union's decision-making process and its representation of their views. Dr Stella Kingett, who heads a group on women and mental health at the Royal College of Psychiatrists, expressed disappointment in the lack of open debate on the issue.
Dr Camilla Kingdon, former president of the Royal College of Paediatrics and Child Health, warned that the BMA's stance could delay improvements in care for the over 5,700 children currently on waiting lists for gender services.
The BMA's decision has prompted some long-standing members to consider leaving the union. Dame Professor Clare Gerada, a member since age 18, stated she would "seriously consider" resigning after Christmas.
This controversy has encouraged more doctors to speak out on issues of child gender treatments, breaking what some describe as a previous "bubble" of fear around challenging gender-affirming care for children.
As the BMA faces internal turmoil, questions remain about the long-term impact on the union and whether the deep fractures within its membership can be healed. The medical community awaits the BMA's planned evaluation of the Cass review, due by Christmas 2024, with both anticipation and skepticism.