Calls to end 'fear culture' in gender research

Cass review found medical professionals scared to discuss views amid risk of reputational damage and online abuse

- Hannah Devlin, Ian Sample

Critical thinking and open debate are pillars of scientific and medical research. Yet experienced professionals are increasingly scared to openly discuss their views on the treatment of children questioning their gender identity.

This was the conclusion drawn by Hilary Cass last week in her landmark review of the services provided by the NHS in this field, which said a toxic debate had resulted in a culture of fear. Her conclusion was echoed by doctors, academic researchers and scientists, who told the Guardian this has had a chilling effect on research in an area in desperate need of better evidence.

Some said they had been deterred from pursuing what they believed to be crucial studies, saying merely entering the arena would put their reputation at risk. Others spoke of abuse on social media, academic conferences being shut down, biases in publishing and the personal cost of speaking out.

"In most areas of health, medical researchers have freedom to answer questions to problems without fear of judgment," said Dr Channa Jayasena, a consultant in reproductive endocrinology at Imperial College London.

"I've never quite known a field where the risks are also in how you're seen and your beliefs. You have to be careful about what you say, both in and out of the workplace." Sallie Baxendale, a professor of clinical neuropsychology at UCL's Institute of Neurology, received abuse after publishing a systematic review of studies that investigated the impact of puberty blockers on brain development. Her review found that "critical questions" remained around the nature, extent and permanence of any arrested development of cognitive function linked to the treatment.

The paper, which merely summarised the state of relevant research, provoked anger. "I've been accused of being an anti-trans activist, and that now comes up on Google and is never going to go away," Baxendale said.