The Responsibility of Journal Publishers: Addressing the Flaws of the Cass Review
I’ve quickly come to realise that impartiality in journalism isn’t just about reporting both sides—it’s about standing up for what’s right while staying true to the facts. That’s why it’s frustrating to see some of the biggest names in medical publishing failing to take a stand when it really matters. Scientific integrity isn’t just an abstract principle; it has real-world consequences, shaping policies and, ultimately, people’s lives.
The fight over gender identity and healthcare isn’t just an academic debate—it’s a battle over the rights and dignity of real people. We saw how dangerously science can be twisted when the Trump administration is pursuing their version of “Paragraph 175”, in an attempt to erase gender as a recognised category and our eradication. Under orders from their oligarch and his privileged lackeys, the CDC has started the erasure of the existence of transgender individuals, which is just simply the Nazi Party book burning 2.0, which resulted in the destruction of The Institute for Sexual Research, the world’s first trans clinic. Thankfully, some are standing up against it, including the BMJ (oh the hypocrisy is strong here). This moment proves that journal publishers can—and should—push back against political interference when it distorts scientific truth. But if that’s the standard the BMJ wants to be seen to uphold, then why are they still standing by the deeply flawed Cass Review?
The Cass Review: A Report That’s Causing Real Harm
On paper, the Cass Review was meant to be a fair and rigorous evaluation of gender-affirming healthcare for young people. But in reality? It’s been torn apart by experts for its biases, methodological flaws, and the harmful ways it’s being used. Leading medical bodies worldwide—including the World Professional Association for Transgender Health (WPATH) and the Endocrine Society—have made it clear that gender-affirming care saves lives. Yet, the Cass Review has been weaponised by Wes Streeting to justify rolling back access to vital services for transgender youth, regardless of the pile of evidence stacked up against it.
Let’s talk about credibility—or in this case, the total lack of it. The Cass Review wasn’t even peer-reviewed. That’s right, a report being used to justify restricting healthcare for trans youth didn’t go through the basic process of expert scrutiny that ensures scientific standards are actually met. Without that independent review, its conclusions are just opinions wrapped in authority, not solid, evidence-based findings. But that hasn’t stopped politicians and anti-trans activists from treating it like gospel, wielding it as if it’s some bulletproof takedown of gender-affirming care. Spoiler: it isn’t.
When a report like this gets the stamp of approval from a ‘respected’ medical journal, it isn’t just an academic endorsement—it’s a green light for policies that make life harder for trans individuals. It allows politicians and activists with an anti-trans agenda to claim they have ‘science’ on their side, even when that science is riddled with flaws and controversy. And let’s be honest: when a piece of research is being used almost exclusively by those who want to strip away our rights, that should be a red flag.
How Misinformation Gets a Free Pass
The worst part? We’ve seen this playbook before. Throughout history, flawed research has been used to justify some of the worst policies—whether it was used to prop up conversion therapy, racial segregation in medicine, or discrimination against people with HIV. Now, it’s happening again, and transphobic activists are using the Cass Review as their new weapon of choice.
BMJ is a ‘trusted’ name in medical publishing, which makes their inaction all the more dangerous. When they continue to lend credibility to outdated, biased research, they aren’t just failing in their duty to report responsibly—they’re actively enabling harm. And it’s not just about publishing a flawed review—BMJ’s own Editor-in-Chief, Kamran Abbasi, has written in support of the Cass Review, and going so far as to give his own article ‘Editor’s Choice’ status. When a journal’s leadership openly promotes and legitimises such a controversial report, it sends a clear message: this isn’t just about reporting research—it’s about reinforcing a narrative, regardless of the harm it causes.
Unsurprisingly, this has been scooped up by the ‘TERF’ cult over at Mumsnet, and their other echo chambers, who have latched onto it as further ‘evidence’ to legitimise their anti-trans crusade. A site notorious for platforming gender-critical rhetoric, Mumsnet has become a breeding ground for misinformation, with users eagerly citing the Cass Review, and the disgraceful endorsement by the BMJ, as a tool to push their harmful agenda. When bad-faith actors seize upon flawed science to push their narrative, it should be a wake-up call—not an endorsement.
BMJ Needs to Do Better
BMJ has an opportunity here to correct course. A refusal to acknowledge the mounting criticisms of the Cass Review is, at best, irresponsible and, at worst, complicit in legitimising discrimination. And let’s not forget, by allowing papers that are not peer-reviewed to be published in their journal, they further diminish the integrity of the scientific process. Journals like BMJ aren’t just passive observers of scientific debate—they play a crucial role in shaping which research gets taken seriously and which ideas gain traction in public discourse. That responsibility should mean something. It’s time for them to act with the accountability we expect from such a powerful institution.
The Right Side of History
BMJ, it’s time to take a stand. Are you going to keep backing a review that has been torn apart by experts and misused by bad-faith actors? Or will you choose the side of rigorous, ethical science and update your position? This isn’t just about an academic report—it’s about the lives of transgender people who are being failed by institutions that should be protecting them.
There is one thing I’ve learned already, it’s that silence in the face of injustice is just another form of complicity. BMJ, history is watching. The question is: where will you stand?