Dr Hilary Cass: How world-renowned paediatrician behind damning review of NHS gender care for children is no stranger to ‘toxic’ debates (and loves a Snickers!)

She’s undeniably one of the most influential paediatricians of her generation and, perhaps most importantly, is no stranger to raising the alarm about patient safety concerns.

So it’s no wonder that Dr Hilary Cass was tasked with overhauling care for gender-questioning children in the UK. 

Appointed by NHS bosses in the wake of the Tavistock scandal, Dr Cass has sorted fact from fiction in a debate which has become exceptionally toxic.

Her damning review of gender identity services for young people spans nearly 400 pages and has been close to four years in the making. 

It says children have been let down by a lack of research and evidence on medical interventions, specifically puberty blockers and hormone drugs. 

Guidelines themselves aren’t evidence-based, she ruled.

As Dr Cass herself bluntly puts it, the entirety of gender medicine is ‘built on shaky foundations’. 

Dr Cass, in her 60s, is no stranger in raising concerns to those in power.

In 2013 it was revealed she left Great Ormond Street Hospital after raising concerns about patient safety.

She warned bosses that inadequate staffing, poor morale and a lack of co-operation between departments was putting patients at risk. 

After emailing managers an account of her concerns, GOSH used a confidentiality agreement to settle a long-running dispute with her which saw her demoted and led to her departure.

It sparked a national conversation about the use of so-called ‘gagging clauses’ in the NHS. 

Dr Cass, who went to a prestigious London private school for girls before studying medicine at the University of London, herself is a recognised leader in the field of medical care for children, having served as president of the Royal College of Paediatrics and Child Health from 2012-2015.

On top of that, she was chair of the British Academy of Childhood Disability between 2017 and 2020.

While no longer working clinically, she remains an honorary consultant paediatrician at Evelina London Children’s Hospital — part of Guy’s & St Thomas’s NHS Foundation Trust.

While at Evelina she worked on the development of paediatric palliative care services for extremely ill children and their families.

Dr Cass, who has previously described her ideal guilty pleasure as eating a Snickers while watching an episode of The Thick Of It, has also published multiple articles of the care of children with neurodisability.

Previous work of hers involves children with autism, cognitive and visual impairment as well as those with multiple disabilities. 

The care of children is clearly a subject close Dr Cass’s heart, as even after stopping clinical practice she has worked with charities dedicated to helping youngsters with complex medical conditions.

These include being an ex-chair of the children’s palliative care charity Together for Short Lives and a trustee for the Noah’s Ark Children’s Hospice.

Dr Cass, an avid fan of the theatre, has been recognised multiple times for her work, including receiving an OBE for her services to child health in 2015.

She has also been granted honorary fellowships by the Royal College of Nursing and Royal College of General Practitioners

Dr Cass has form for wading into controversial medical topics, previously speaking in 2013 on her support for doctor assisted suicide, otherwise known as medical euthanasia. 

When she retires, she plans a ‘gap year for grown ups’, according to an interview she did with the British Medical Journal in 2013. 

In that same piece, she spoke of her love of ‘crispy duck from the local Chinese takeaway’.

Her parents ‘always thought that I was argumentative and perverse enough to be a lawyer’, Dr Cass also said.