In a major challenge to the secrecy surrounding the UK’s Cass Review, a coalition of transparency campaigners has filed a lawsuit against Dr. Hilary Cass, NHS England, and the UK Information Commissioner’s Office. The legal action, officially filed on June 4, 2025, demands disclosure of internal documents used to create the controversial 2024 Cass Review.
The story was first reported in detail by Not Ashley on Medium in the post “Hilary Cass Hit with Lawsuit for Concealing Review Papers,” and their work has been critical in bringing this to light.
Background on the Cass Review
Dr. Cass, a former president of the Royal College of Paediatrics & Child Health, led the review of NHS gender-affirming care for youth in England. Released in 2024, the final report has shaped a new wave of policy and clinical guidelines, but concerns have lingered over the reliability and transparency of the evidence it used.
Families, transgender individuals, and medical experts have criticized the Cass Review’s recommendations for potentially restricting access to puberty blockers, hormones, and supportive care, despite strong international medical consensus on the benefits of gender-affirming treatments. Critics also note that the review leans on questionable claims about brain development and gender identity while ignoring lived experience and the global body of evidence supporting trans care.
The Lawsuit’s Core Argument
The lawsuit centers on alleged failures to comply with the Freedom of Information Act 2000 and the Public Records Act 1958. Multiple FoI requests had been made over the past year, seeking drafts, notes, correspondence, and raw data behind the Cass Review’s conclusions. NHS England initially claimed it held no such records—despite the final report referencing them.
A subsequent investigation by the Information Commissioner found that NHS England’s blanket refusal was unlawful, but still, no records were released. Instead, NHS England doubled down on denying the existence of any responsive documents, actions that advocates argue undermine public accountability.
What’s at Stake for Trans People
For transgender youth and their families, the Cass Review has real consequences. If care is delayed or restricted based on flawed or incomplete evidence, it can have devastating impacts on mental health, well-being, and overall safety. The lawsuit demands clarity—ensuring that decisions shaping trans healthcare are based on solid, transparent evidence.
Trans advocates argue that the secrecy surrounding the Cass Review further erodes trust in a system already perceived as hostile or dismissive to trans lives. “We suspect public records were illegally destroyed,” writes Not Ashley, whose reporting has been pivotal in shedding light on these concerns. She is a former lawyer that specializes in intellectual property, international trade, and public law.
The Bottom Line
The plaintiffs have given NHS England and Dr. Cass seven days to produce the requested documents or to explain their whereabouts. If the records have been lost or destroyed, it could signal a major breach of public record law, raising alarms for anyone concerned about transparent healthcare governance.
A tribunal judge is expected to rule in the coming weeks on whether these documents must be released. The outcome will be closely watched by trans people, families, and medical professionals worldwide, as it could set a precedent for how health authorities handle sensitive and potentially life-saving care for transgender youth.
