Recently I wrote about Dr. Hillary Cass, author of the Cass Review of the treatment of pediatric trans patients in the UK. Dr. Cass's report essentially makes the case that gender-affirming care is doing harm to children and that the use of puberty blockers and hormones should be suspended until there is more solid evidence on their effects. Trans activists were not pleased about this and she was recently warned not to use public transportation for her own safety. 

Dr. Cass said she was less bothered by the threats she has received than by the misinformation she has seen spread about her report. She specifically cited some claims being made by a Member of Parliament from the Labour Party named Dawn Butler.

In the days after the Cass review was published, activists claimed on social media that only two out of 100 studies were included in the report.

Butler told the House of Commons: “There are around 100 studies that have not been included in this Cass report and we need to know why.”

Cass explained that researchers had appraised every single paper, but pulled the results from the ones that were high quality and medium quality, which was 60 out of 103.

Of Butler, she added: “You don’t get up in parliament with an intent to spread misinformation … [but] what I was dismayed about, was the understanding she got [from the report].”

To her credit, MP Butler spoke to Dr. Cass and has since apologized for misleading parliament about the report. She blamed the false information she repeated on an LGBT charity called Stonewall.

Acknowledging she had relied on the LGBT charity for her information, Ms Butler said: “I was quoting Stonewall’s briefing and there was some fallout from this.

“I spent the week in conversation with Stonewall and Dr Cass. By quoting this briefing, it seems as though I may have inadvertently misled the House.”

She added: “Having spent the weekend speaking to Dr Cass, for which I’m very grateful for her time, she’s made it very clear not just to me but through a number of clarifications … that all reports were included, but both high and moderate quality reports were considered as part of the evidence review.”

It's good news that the public record has been corrected but this obviously doesn't look very good for Stonewall who seemed to be trying to pass the buck to other analysts who misled them about how the Cass Review evaluated studies.

It has not been a good week for Stonewall. First, the charity was blamed in the Commons by MP Dawn Butler for leading her astray about the methodology of the Cass Review. As she apologised for having “inadvertently misled” the House about the number and quality of studies surveyed in Cass’s final report, she explained she had been “quoting Stonewall’s briefing”. 

Meanwhile, web administrators were making changes to the organisation’s own published response: parts that had originally cast doubt on Cass’s survey vanished. And just as Butler blamed Stonewall, a briefing of theirs now appeared to blame others, describing “early analyses of the Cass Review” as having made it “unclear how and why research had been graded”. 

All of this raises an obvious question: Where did the false claims repeated by Stonewall and subsequently by MP Dawn Butler originate? A reporter named Benjamin Ryan has done a very thorough job of looking into those false claims on his Substack site. After showing in detail how the Cass Review incorporated information from two separate literature reviews, he points out some of the news outlets that ran with the false claim about the report only using two out of 100 studies.

The Canadian Broadcasting Corporation published an article quoting, and failing to challenge, doctors repeating the false claim that the Cass Review disregarded any studies about pediatric gender-transition treatment that were not randomized controlled trials.

Numerous accounts on X (formerly Twitter) broadcast the false claim that the Cass Review and two of the systematic literature reviews on which it was based simply discarded 101 of 103 studies on pediatric gender-transition treatment. This includes the British singer Billy Bragg, Dr. David Gorski (who also falsely claimed that Cass referred to so-called rapid-onset gender dysphoria in her report) and activist Substacker Erin Reed,

Where is this all coming from? Can you guess?

From what I can estimate, the first person to have pushed the false claim that Cass simply disregarded the vast majority of the available studies about pediatric gender-transition treatment was trans activist and attorney Alejandra Caraballo.

The key problem is that Caraballo cited the wrong systematic literature reviews in her viral tweet about the Cass Review.

Ryan went into detail in an X thread.

5 hours before the Cass Review was published on April 9, Caraballo tweeted a screenshot of what appeared to be the new systematic lit reviews that would published alongside Cass. But these screenshots were *actually* from the NICE reviews from 2020. https://t.co/0W9Xd0X35X

— Benjamin Ryan (@benryanwriter) April 15, 2024

Essentially, it all boils down to confusion by a trans activists who hadn't even seen the report she was dismissing.

Caraballo did not yet have a copy of the final Cass Review report when she tweeted on April 9 the false claim that it rejected all but randomized controlled trials about gender-transition treatment for minors.

— Benjamin Ryan (@benryanwriter) April 15, 2024

Caraballo did not yet have a copy of the final Cass Review report when she tweeted on April 9 the false claim that it rejected all but randomized controlled trials about gender-transition treatment for minors.

— Benjamin Ryan (@benryanwriter) April 15, 2024

A lot of people mistakenly believed Alejandra Caraballo had some advance knowledge of the report but it wasn't true.

Caraballo’s April 9 tweet set the tone for discussion about the Cass Review on Twitter. Posted 5 hours before Cass went live, it gave the illusion that she had seen the still-embargoed report; but she had not. So her false assessment was first out of the gate. It got 750K views.

— Benjamin Ryan (@benryanwriter) April 15, 2024

Was this intentional? Maybe.

Did Alejandra Caraballo knowingly tweet what she knew were details from the *wrong* systematic lit reviews about the Cass Review? What I do know is that she at least had access to the *correct* lit reviews when she tweeted that, because 64 minutes prior, she leaked those papers:… pic.twitter.com/aV1fkrG4Tb

— Benjamin Ryan (@benryanwriter) April 15, 2024

So there you have it. From one confused or intentionally misleading (take your pick) activist to the House of Commons. This is how leftist nonsense gets spread.