This book is a detailed dissection of the Cass Review, an independent review commissioned in 2020 by NHS England and NHS Improvement and led by Hilary Cass. The author argues the review is anti-transgender pseudoscience designed and intended to end gender affirming pediatric care in the UK. The book provides a detailed account and analysis of the sequence of hostile interventions that have undermined the access to gender-affirming care that trans children elsewhere in the world have access to. It provides a detailed examination of the politics and history of organized transphobia in the UK and the devastating consequences for trans youth, and examines the huge amount of clinical and peer-reviewed support for gender-affirming care for trans youth.

In a climate dominated by voices hostile to the existence and empowerment of trans people, this book provides an informed and compelling counter-argument based on recognizing the dignity, autonomy, and needs of trans youth. In so doing, the book is an urgent call to action, in particular regarding the need for gender-affirming healthcare for trans youth, with services that recognize their needs as opposed to the demands and actions of those ideologically hostile to the existence and rights of transgender people. Through its numerous references to the growing data that affirms the benefits of gender-affirming care, the book convincingly argues the case for a patient-led approach to gender-affirming care and for the removal of the recent, seemingly politically-motivated obstacles created by politicians and ideologically hostile voices.