Proof the Cass Review deliberately excluded trans people from the Assurance Group.
You may remember back at the start of the Cass Review there was a bit of a furore because the review website had wording that appeared to show it was deliberately excluding trans voices from the governance process? - if not, we covered this in Part 1 of our ongoing blog following the Cass Review's activities on 19th April 2021.
The Cass Review denied this at the time, but then surreptitiously changed the website to remove the offending sections without telling anyone.
I went digging via the Freedom of Information Act to see if this was true. I actually wanted to get a copy of the original Terms of Reference as defined by NHS England, as well as any comms relating to it. Should be pretty easy right? Well, it should be, if you’re not hiding anything.
In my previous exchanges with the Review, they categorically stated that the terms of the review had been set by NHS England - who are also funding this so-called ‘independent review.
However , NHS England claim they have absolutely no documentation in relation to setting these terms of reference. For a review that they commissioned. This means that either NHS England or The Cass Review are being somewhat untruthful, or NHS England is so monumentally inept in commissioning things that they shouldn't be allowed to operate. More likely, both.
In an interesting twist, apparently, there was only one item of communications in relation to this between the Review and NHS England - an email between Dr Hilary Cass and John Stewart of NHS Commissioning on 6/10/20. The same John Stewart who stated that all GICs accept self referrals at the Women & Equalities Committee GRA Enquiry - a statement that is not accurate itself.
What that email reveals is the following:
As the following extract from the email shows.
Members will be appointed to the Advisory Group by The Chair.
The Advisory Group will not contain subject matter experts, as its role is focused on the governance of the review process. Members will have proven expertise relating to the proper conduct of high-profile public reviews and investigations.
Members of The Advisory Group will be independent of NHS England, and of providers of gender dysphoria services, and of any organisation or association that could reasonably be regarded as having a significant interest in the outcome of the process of review.‘
As you can see, this presents two major and significant hurdles for trans people that amount to deliberate exclusion from the governance of the review - which in itself may be a breach of EA2010 as it looks like both direct and indirect discrimination, and is neither proportionate nor a legitimate means of an appropriate aim.
Let’s take them in turn.
‘Members will be appointed to the Advisory Group by The Chair.‘
This means only Dr Cass has had any input whatsoever into Assurance Group appointments, and it assumes Dr Cass is coming from a position of neutrality - which is already strongly in doubt. No cisgender person is neutral when it comes to transgender lives, and assuming that they are is deeply flawed.
There is also the issue where it is known Dr Cass followed a number of high profile trans hostile people and groups prior to being appointed, and no trans positive people or groups - so we have someone with apparent trans hostile bias populating the Assurance Group.
‘The Advisory Group will not contain subject matter experts, as its role is focused on the governance of the review process. Members will have proven expertise relating to the proper conduct of high-profile public reviews and investigations.’
Right off the bat we have a reinforcement of the assumption cisgender people are unbiased, and subject matter experts - i.e. trans people & allies, are not - a deeply transphobic starting point, and a clear determination of exclusion.
The second point in this paragraph drives that home. There are few, if any trans people in the UK who fulfill the criteria of ‘proven expertise relating to the proper conduct of high-profile public reviews and investigations’ due to major issues with transphobia in every sphere of public life - from the medical professions to public bodies. This is well known, and amounts to systemic discrimination.
Let’s look at the last paragraph.
‘Members of The Advisory Group will be independent of NHS England, and of providers of gender dysphoria services, and of any organisation or association that could reasonably be regarded as having a significant interest in the outcome of the process of review.‘
While this appears to be balanced when taken on its own - it is anything but when coupled with the previous two paragraphs. It appears to provide some scope to allow for a trans individual, rather than an organisation to be on the Assurance Group - but to do that they would have to satisfy the criteria indicated in paragraph 2 - an impossible feat due to the systemic transphobia trans people face.
This de-facto removes any trans positive involvement from the review in entirety, and when taken together the whole composition of the Assurance Board appears to be a carefully worded exercise in deliberate exclusion - and one based entirely on the fatally flawed and faulty assumption that cisgender people are unbiased.
Which as any trans person will tell you, is not the case. What the Cass Review have done is deploy a version of Trans Catch 22 to ensure trans people have no voice in the running of the Review.
What’s more galling is that it was entirely preventable. They could have, for example, convened an additional panel composed solely of trans individuals to provide assurance to the community that this was above board. They chose to exclude instead.
Authored by Claire, co-editor
Addition from Steph, 10/10/2021:
The Steph's Place website was launched in the early summer of 2020 with the aim to offset the bias of the British press and increase trans visibility online. With the influence of others within our community, our role has changed to some degree to make Steph's Place a magazine but with a role to play in investigative journalism.
Our investigative team is not the same as my co-editors who joined me in the early summer of 2021, though Claire, Nicola and myself are active in the team. We are always looking for others to join us to do research by Freedom of Information Requests and general "digging". We have backup via numerous trans solicitors and lawyers.
We do offer online training and guidance and if you feel you can do this please message us via the contact page. There was a time professional journalists would do this work, but sadly their editors will often not publish their stories. We will, and also encourage those working in organisations where transphobia exists to contact us. In short, whistleblowers are welcome!
More revelations are coming soon. Some via us, one via an established journalist who has some freedom to publish. In regards to trans health, it is pretty clear from the Helen Webberley case that established NHS healthcare for trans people is not fit for purpose and this website revealed some months back that NHS England has never recorded how many trans patients were waiting for care. How can you plan for care if you do not know the demand?
Thank you for your support.