Chief Executive Officer
13 April 2023
Dear Jackie Tiotto,
We are writing to again raise serious concerns about CAFCASS advice to your staff on the issue of children and their “gender identity”.
In February 2022 we made a formal complaint to you that “…CAFCASS has adopted, and is promoting, unevidenced beliefs about gender identity, sexual orientation and sexuality which compromise its independent role in representing children and advising the Family Courts about what is safe for children and in their best interests.” This complaint centred on practice advice that CAFCASS was promoting to staff, including a “Knowledge Bite” and “Ten Top Tips”. This material advised staff that they should encourage children to discuss their gender identity, and should wear rainbow lanyards and have other similar motifs in their office in order to encourage this. Staff were also advised that parents who objected to this exploration could be told they might be referred to the family court for an order to enforce conversations about gender identity and sexuality regardless of their wishes. The advice also informed staff that sexual orientation in children should be defined by their gender identity and not their sex, and that therefore e.g. a boy could be lesbian and a girl might be gay. Overall the advice supported unquestioning affirmative approaches and social transitioning to be in children’s best interests.
You rejected our complaint on 14 March 2022 but were not able to provide the evidence base that we had asked for. In our response we drew your attention to the interim report of the Cass Review of NHS gender identity services for children which had then been published. This Review had found no evidence of the benefit of affirmative approaches, including social transitioning.
In your final response, on 11 May 2022, you wrote that “I believe our letter of the 14 March 2022 set out very clearly that we do not adopt a particular theoretical position, particularly in areas such as gender identity where there are both conflicting and changing views.”
We drew our concerns to the attention of Professor Eileen Munro, vice Chair of CAFCASS and an acknowledged expert in the field of child protection. Professor Munro reported to us in August 2022 that our comments had helped inform a new toolkit for work in this area which was being tested and that new practice guidance would be produced in consequence.
We have now had sight of the new guidance and are dismayed that it continues to assert an unevidenced belief in “gender identity” in children. The guidance includes a claim that “Transgender/gender-expansive people (as well as LGB people) have existed since time immemorial. Therefore, any perception that being transgender/ gender expansive is a social construct or a new phenomenon is factually incorrect. Gender expansive children have existed in all times and all cultures of which records remain." No references are provided for this or any other belief promoted in the guidance. We are also shocked that, instead of referencing the Cass Review for its comprehensive approach to the evidence, the guidance recommends a TED Talk by a Professor Spack of Boston Children’s Hospital in the USA. Professor Spack’s TED Talk is several years old and is uninformed by outcomes of what was then and is now highly controversial advocacy for puberty blockers (drugs which have not been approved for use in children) and of mastectomies and other surgeries for children. As the Cass Review found, these practices are not supported by any evidence of benefit to the children treated in this way. Systematic longitudinal review revealed long term harmful impacts and no benefits of puberty blockers and have led several countries to immediately cease their use in cases of gender dysphoria.
We understand that the guidance was deliberately launched on the 31 March to celebrate an “International Day of Trans Visibility”. This “Trans Day of Visibility” was called by and for those adults who are legally competent to make life-changing decisions and to take responsibility for these decisions. It is therefore surprising that CAFCASS chose such a day to launch guidance on work with children who are not legally able or equipped to make adult choices regarding changing their sex.
It should be a matter of concern to CAFCASS and to all child welfare and protection agencies that children should not be encouraged to believe that they can change their sex and that this possibility is not presented to them as their right, achievable through declaration and then by medication and surgery. As the Cass report found, there is no evidence to support affirmative approaches, including social transitioning which is in itself a major intervention in a child’s normal development. There is no commissioned provision in England that has been proven to safely manage gender dysphoric children or those children who have been subjected to online or other grooming on the existence of a gender identity separate to their sexed bodies. Until such time as there is confidence in the treatment of seriously dysphoric children and a greater understanding of the social impact of teaching children about gender identity, it is surely incumbent on CAFCASS and other agencies to take an extremely cautious approach and desist from encouraging staff to adopt unevidenced beliefs and practices.
A growing number of social workers, including employees of CAFCASS, have made contact with EBSWA in confidence, concerning what has become for many an oppressive organisational culture within social work, which demands acceptance of gender identity and of affirmative approaches. This is preventing them from confidently and independently acting to use their professional knowledge and skills to assess and safeguard children, fearing reprisals in the form of bullying by management and staff, disciplinary action, and even of being driven out of employment.
Accountability and transparency are key principles of good governance. We therefore ask that CAFCASS either publishes this controversial guidance along with the evidence which you relied on in developing it, or that you withdraw it and develop guidance based on evidence, in consultation with your staff and with wider child welfare and health interests.
In the meantime, we are drawing this correspondence and our concerns to the attention of government, and are asking them to intervene to require you to produce any and all evidence which you have relied on,
Maggie Mellon (Chair)
on behalf of EBSWA