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This week Dr Hilary Cass published her report on the review of gender identity services for children and young people. The report is on a divisive topic, and though I have my opinion, in this question I am not here for arguments on the basic issue, I would merely like to know what medical researchers think about the methodology of the report.

This is a meta review, it seeks to aggregate information from a lot of former studies. Not all studies are the same quality, and a lot of studies were dismissed by the review as being too low quality. (For an introduction to this idea, see this unrelated medical paper's section on inclusion criteria. )
There is a claim going around that most of these dismissed studies have shown a positive effect of some gender identity services, while the studies accepted by the report have mostly shown a negative or close to neutral effect of the same services, raising concerns about biased dismissal.

There is some disagreement about whether it was fair to require 'double-blindness' from the interventions in these studies, and whether it was actually a requirement, or whether they used the more complex Newcastle-Ottawa Scale.

So basically I would like to know if medical researchers think that the Cass review had methodological problems in these or other areas.

Again, I have my own opinion on the basic issue, but here I would insist that the researchers you cite in your answer are not Dr. X from the Clearly-Involved-In-This Foundation or Senior Expert Y from the We-Get-A-Lot-Of-Money Think Tank. I am not saying advocacy is necessarily wrong, but methodological problems are value neutral and can be pointed out in such a way. Please feel free to post your own question where you are also seeking answers from more involved parties, but don't post those answers/comments here.


I got the request to reference a notable claim to be skeptical about:
The implicit notable claim is that the Cass review is scientific without methodological problems. Some have cast doubt on this. Is there reason to be skeptical about the Cass review or can we accept its findings?

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  • According to the FAQ, Skeptics.SE is for researching the evidence behind the claims you hear or read. This question doesn't appear to have any doubtful claims to investigate. Please edit it to reference a notable claim and flag for moderator attention to re-open (or get 5 re-open votes).
    – Oddthinking
    Apr 12 at 9:31
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    "The methodology" as a whole isn't a claim. Is there a particular statement that you doubt? The idea that poor-quality research might reach different conclusions to high-quality research isn't a red flag; it occurs in homeopathy, acupuncture and a number of other areas of pseudoscience.
    – Oddthinking
    Apr 12 at 9:34
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    At present this is very broad and lacking an explicit claim for us to test. To perform an analysis of the whole paper with its many points is way too broad for what we do here. Apr 12 at 9:38
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    Meanwhile, this is a 388 page document that has just been released. If you want proper post-publication review of it, you will need to wait.
    – Oddthinking
    Apr 12 at 14:41
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    @Oddthinking I will have another look at it, I honestly thought it reviewed and aggregated papers per subject. I understand and agree that more time will be necessary for a proper review, though there was a midterm report 2 years ago, so the methodology on what studies to include could have already been peer reviewed. I still don't understand your point on how dismissing studies which lean in one direction would not be a concern. I do not claim it is proof of bias, just something to be examined. Anyway, I will not contest the closure of the question, thank you for your time.
    – Giskard
    Apr 12 at 14:49

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