Holistic care, the therapeutic misconception and the puberty blocker trial: response to Giordano

Simona Giordano1 raises objections to Recommendations 1, 2, 6 and 7 of the Cass review. While I do not have space to cover all of them, I will discuss some of Giordano’s major concerns, which I argue are unfounded or misguided.

Cass recommendations 1 and 2

Giordano objects to recommendation 1 of the Cass review, which recommends that gender services maintain the same standards as any other service supporting patients with ‘complex presentations and/or additional risk factors.’2 Giordano claims this recommendation ‘seems to suggest that gender dysphoria in young people is inherently a complex situation and that all transgender and gender-diverse young people (TGDY) have complex presentations and/or additional risk factors.’ ‘Some might,’ Giordano writes, ‘and some might not’ (p1). But recommendation 1 was not made merely on the assumption that some patients might have complex presentations or additional risk factors. Rather, it responds to the uncontested…

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