This letter was sent out on May 9, 2024 to Amy Goodman and Democracy NOW, written by a FIST committee, and approved by FIST’s membership.

Feminists in Struggle (FIST)
Attn: Democracy Now!
RE: Coverage of the Cass Review

May 9, 2024

Dear Amy Goodman and team at Democracy Now!

We are Feminists in Struggle, a national female-only, radical feminist network fighting for women’s liberation from sex-based oppression. Many of our members have been long-time listeners and supporters of Democracy Now! We appreciate your contributions to U.S. journalism over the past several decades – and for the information you continue to disseminate every week.

That said, we are curious about the conspicuous lack of coverage into The Cass Review, an Independent review of gender identity services for children and young people, conducted by British Pediatrician Dr. Hilary Cass, and released on April 9, 2024 to major headlines around the world. The Cass Review constitutes the largest and most comprehensive examination of the evidence base to date for pediatric gender medicine, including 237 papers from 18 countries and 113,269 children and adolescents.

Dr. Hilary Cass was commissioned by the UK’s National Health Service (NHS) to lead this exhaustive, systematic review due to her decades of renowned work as a British pediatrician with research interests including autistic spectrum conditions, cognitive impairments, and the care of children with multiple disabilities. Conducted over a four year period, the Cass Review contains nearly 400 pages and 32 recommendations — with a rather damning commentary about the “lack of an effective evidentiary base” supporting youth gender medicine practices. This includes the effectiveness and safety of prescribing puberty blockers, and emphasizes the importance of using “extreme  caution” when prescribing hormone or other medical interventions for minors due to the risks for causing permanent infertility, chronic medical conditions, and impairment of the permanent infertility, chronic medical conditions, and impairment of the ability to experience sexuality outweighing the possible benefits.

The UK formally closed its pediatric Gender Identity Services (GIDS) on March 24, 2024 and other nations (including Finland, Norway, and Sweden) have also been rolling back their services for youth and favoring a much more conservative approach to treatment
and clinical care with this vulnerable population. The Cass Review specifically highlights the necessity of using comprehensive, “holistic” clinical screenings and assessments in treating minors, as childhood and adolescence are unique developmental stages distinct from adulthood, and require non-medicalized approaches to care.

Additionally, the Cass Review underlines the fact that there is often an extremely high rate of co-occurring mental health conditions in minors seeking gender identity services (including complex post-traumatic stress, major depression, eating disorders, and neurodevelopmental conditions such as autism) that must be considered, addressed, and treated using a bio-psycho-social model, rather than an affirm-and-medicalize approach. Evidence also demonstrates that a significant number of gender confused youth will eventually  “grow out” of their distress – as many are simply gender nonconforming, neurodifferent, and/or bisexual, lesbian, or gay. To medically transition an autistic, gay, lesbian, or bisexual child on the basis of “gender identity” alone constitutes reparative therapy and eugenics as well as what has been long delegitimized and rejected as “conversion therapy.”

The Cass report also raised alarms about the striking, historically unprecedented increase in the number of adolescent girls referred to the UK’s Gender Identity Services (rising from 15 to 1,071) over the seven year period from 2009 – 2016. What, exactly, is driving this entirely new cohort to seek services from gender medicine clinics? Reem Alsalem, the UN Special Rapporteur on Violence Against Women and Girls, recently expressed her concern about the “devastating consequences on the human rights of children and girls” being caused by the blind adherence to gender identity ideology over sound, long-established clinical practice.

It is beyond time to bring all of the evidence to light in the discussion of gender identity ideology and to return to the use of unbiased journalistic principles —we’d like to see your fair and unbiased coverage of the Cass Review.

In solidarity with other radical feminists:

● We request a published explanation as to why the Cass Report, taken very seriously in Europe, and covered by all major European media outlets, has not been mentioned at all on Democracy Now!

● We request that Democracy Now! repair this serious omission immediately.

● We request that Democracy Now! differentiate between sex and gender in reporting.

● We request that Democracy Now! cover gender identity issues going forward in compliance with basic rules of journalism — balanced, presenting multiple opinions from multiple sources.

Again, we thank you for the valuable work you do and look forward to your future reporting on the important findings of the Cass Review.



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