Sonia Sodha in the Observer - The BMA’s stance on puberty blockers defies the key principle of medicine: first, do no harm:
There’s no two ways about it: the Cass review pulled back the curtain on how gender-questioning children have been starkly failed by the medical profession. You might think that would prompt reflection. Not at the BMA: it has just announced that its governing council of 69 medics has passed a motion accusing the Cass review of making “unsubstantiated recommendations”, calling for the BMA to “publicly critique” the review and to “lobby… to oppose the implementation of its recommendations”, including halting the use of unevidenced drugs on children outside a trial. The BMA has also, ludicrously, called on the government not to implement the Cass review while it undertakes its own review. It would be one thing if the BMA had a serious critique of the review. It does not. When I asked, it could not tell me which of the Cass recommendations the council believed to be unsubstantiated, saying it would not prejudge its own review. Its press release points to two papers that are not peer reviewed or published in a reputable scientific journal – thus obliged to declare conflicts of interest – as evidence of sufficient concern about the review’s methodology to justify pausing its implementation....
How on earth did the BMA get itself into a position where its doctors are calling for the NHS to reinstate the prescription of unevidenced medicines to children, prompting the Academy of Royal Medical Colleges and the Association of Clinical Psychologists to put out statements in support of the review? I’ve spoken to several of its members who are absolutely furious at the lack of consultation beyond the council, elected on a turnout of just 7% of the BMA’s 160,000-strong membership, and the way this seems to have been stitched up behind closed doors, despite the consultants’ committee last year passing a motion calling on the BMA to facilitate discussion of the Cass review. One council member has gone on the record to say that she believes the BMA’s position to be out of step with its membership.
It’s not the first time that the BMA has embarrassed itself by making interventions in critical health policy issues that it doesn’t properly understand; it did the same over Covid vaccines in 2021.
It seems that the BMA leadership has been sucked into a polarised debate, characterised by a misinformation campaign by activists and academics who don’t like what the Cass review found. That campaign has included an unsuccessful judicial review of the government’s decision to ban the private prescription of puberty blockers for gender dysphoria (the high court last week ruled that the Cass review amounted to “powerful scientific evidence in support of restrictions on the supply of puberty blockers”), and false claims made about young people and suicide that the government’s adviser on suicide prevention described last month as “distressing and dangerous”.
Yes, the BMA is run by doctors. But it was clinicians who were behind this scandal in the first place. The BMA’s intervention serves as a reminder of how easily some doctors can become blinded by misinformation to the reason, rationality and evidence that are critical to the best interests of patients.
It shows that the publication of the Cass review isn’t enough. The many doctors who stand by “first, do no harm” must ensure that their colleagues return to the evidence in relation to this group of vulnerable children who deserve so much better from the medical profession.
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