British Trade Unions Oppose the Cass Report. Here’s Why That Matters.

By Matilda Fitzmaurice

On the last Thursday and Friday in June, the TUC LGBT+ conference took place at the magnificent Congress House in London. This 2-day event, which brings together LGBTQIA+ members from the unions affiliated to the TUC, was attended by a large UCU delegation. Many important motions were debated and passed, including on HIV discrimination in the workplace, international solidarity and anti-LGBT+ bias and AI. UCU brought an emergency motion condemning the Cass report and committing to organise against it and trans-hostile approaches to trans healthcare more generally. A version of this motion had already been carried at UCU NEC on Friday 21st June, and it was also carried overwhelmingly at the TUC LGBT+ conference, with lots of fantastic speeches in the debate including from health and fellow education unions. There were no speeches against the motion from any of the delegations.

Since the conference, however, and Labour’s triumph in the general election, the outlook for trans rights under a new government has only deteriorated. The Labour manifesto, while promising to “remove indignities for trans people who deserve recognition and acceptance”, also contained a promise to implement all of the Cass Report’s “expert” recommendations. Meanwhile, the new Secretary of State for Health and Social Care Wes Streeting had enthusiastically endorsed the Cass Report when it was published. Commentators have compared Streeting’s recent statements on trans rights to those he has made previously, which makes us question whether his sole motivation is political expediency and the furthering of his own career. Now a powerful member of the government, not only did Streeting endorse the Conservative government’s emergency legislation to ban private prescription of puberty blockers to trans children (while defending their continued prescription to cis children). Even worse, he has promised to make it permanent, despite opposition from many fellow MPs, including some in his own party. While the Cass Report does not in fact recommend a complete ban on puberty blockers, both Streeting and Victoria Atkins (the former Health Secretary) cited the Cass Report as ‘evidence’ for a ban. It was always clear that the Cass Report would be used for political purposes even beyond the remit of its recommendations, which are themselves dangerous. Indeed, NHS England has already announced its decision to bring forward a review of adult gender-affirming care services.

This article doesn’t reprise the arguments about how the Cass Report is unethical and unsound from evidential and methodological perspectives, as this has already been documented. Rather, it suggests that trade unions’ rejection of what has been framed by the media and political establishment as a ‘moderate’ and ‘reasonable’ line on trans rights should be seen as a cause for hope. Britain’s trade unions are steadfast backers of trans rights, and this really matters. First, the Labour Party, which is now the governing party and enjoys a huge parliamentary majority, receives substantial funding from its affiliated unions, which as a result enjoy significant influence within the party. Especially important here is UNISON. Now the UK’s biggest trade union with over 1.3 million members, of which a huge majority are women working in lower-paid public sector roles, UNISON is a vocal supporter of trans rights, showing that claims that support for trans rights are somehow ‘bad for women’ are false. This matters not only for the protection of individual trans people’s rights in the workplace, as vital as this is. Trade unions are a key societal and political constituency, which can use their established relationships, organising capacity, and members’ lived experience to help beat back this politically motivated, establishment assault on the dignity, autonomy and lives of trans people.

More broadly, the leadership shown by British trade unions in this area, from the TUC’s support for a demedicalised model of gender recognition to the founding of the Trade Unions For Trans Rights network in 2023, also forms vital resistance to the British establishment’s anti-trans onslaught. Trade unions have been crucial allies in the past, as we know from the National Union of Mineworkers’ pivotal role in pushing the Labour Party towards commitment to LGBT rights in 1985. But not only this: LGBT+ solidarity is the future of trade unionism. If younger generations of workers can see that trade unions have their backs, and care about the issues they care about, including LGBTQIA+ rights, racial justice, Palestinian solidarity and the proud championing of gender diversity, this is significant for the future membership and leadership of trade unions in the UK, especially since the current iteration of the Labour Party shows little to no interest in these and seems to treat younger people with indifference. This is a moment for intergenerational education, in which older or less well-informed members can listen to and learn from younger members and those with lived experience. Trade unions are also embedded in broader international networks, which are a critical site of learning, support and solidarity. The anti-LGBT agenda is deeply networked within the international far-right, and we must draw on our international connections if we are to confront it.

Other social and political movements further underline why the Cass Report must be fiercely resisted, and trade unions must continue to listen to and learn from them. Trans people were deliberately excluded from the Review’s governing board, which as generations of disability activists have insisted, is itself anathema from a justice perspective. The report lends credence to the myth  of ‘contagion’, in which peer pressure and social media are framed as causes of increasing youth identification with trans identities, and this can be seen in the demonisation and disenfranchisement of other marginalised groups. As Aubrey Gordon of the Maintenance Phase podcast pointed out, the Cass Report’s warnings about “exponentially” increasing numbers of trans young people (2024: 72) mirrors anti-fat discourse, as well as fatphobic panic about rising ‘obesity’ as an impending threat to the future. We see similar fear-mongering around the rise in diagnoses of autism and ADHD. According to reporting by the Trans Safety Network, the Royal College of Psychiatry suppressed criticism of the Cass Report raised by delegates on ethical and methodological grounds to the RCPsych’s 2024 International Congress. Furthermore, anti-trans voices feign concern for the welfare of autistic and neurodivergent people, infantilising them as gullible and suggestible when it comes to gender-affirming care and gender transition. Transphobic legislators in US states including Georgia and Arkansas have used the ‘protection’ of autistic and neurodivergent people, as well as people with mental illnesses such as depression, to defend anti-trans laws. The Cass Report lends legitimacy to this view by recommending - without justification - that all children presenting with what it calls “gender incongruence” be screened for autism (2024: 29). Moreover, as histories of HIV activism also tell us, nothing good - whether that’s investment in HIV research, or involvement in the planning and conduct of research - is offered to affected communities unless they repeatedly demand it, and in a parallel with gender-affirming care for trans children, the absence of treatment is not a ‘neutral’ or ‘no risk’ option.

This was and still is a fast-moving situation. Since the TUC LGBT+ Conference, it has been revealed that Hilary Cass (who has no experience in gender care) was selected from a shortlist of one for her role on the Cass Review. She was subsequently awarded a peerage by the outgoing government, providing yet more evidence for the theory that the Cass Review was politically motivated. This week’s King’s Speech promised a trans-inclusive ban on conversion therapy, but this sits sharply at odds with a (perhaps permanent) ban on prescription of puberty blockers to trans children. It seems likely that the inconsistencies in Labour’s cowardly position on trans rights will come under more scrutiny as the election dust settles and their plans for government solidify. This may be an opportunity for trans-led organisations and their allies to intervene. Meanwhile, the British Medical Association (BMA) were this week set to vote on a motion calling for the public disavowal of the Cass Report, much to the dismay of ‘gender-critical’ journalists and commentators. This would surely be a huge blow to the Report’s credibility, as suggested by the fact that ‘gender-critical’ social media users, as they did with UCU, have already begun casting doubt on the professional credentials of the BMA member who moved the motion. Regardless of what comes next, though, we must be guided in everything we do by what trans communities and trans-led organisations are asking for. As members of organisations founded on worker self-representation, “nothing about us, without us” must be at the front of our minds and hearts.