A landmark report published April 10 in the United Kingdom said children had been "let down" by a lack of research on the use of puberty blockers.

The so-called Cass Report -- named for the pediatrician who compiled it, Dr. Hilary Cass, said clinicians were deeply affected by the "toxicity" of public debate around transgender identities.

"There are few other areas of healthcare where professionals are so afraid to openly discuss their views, where people are vilified on social media, and where name-calling echoes the worst bullying behavior. This must stop," Cass wrote.

Addressing children and young people in her foreword, Cass stated: "I have been disappointed by the lack of evidence on the long-term impact of taking hormones from an early age; research has let us all down, most importantly you."

Britain's health secretary has criticized what she described as a "culture of secrecy and ideology" around health care for children experiencing gender identity confusion.

In March, the National Health Service in Britain announced that children experiencing issues with their gender identity will no longer routinely be prescribed puberty blockers, saying there is "not enough evidence" the drugs are safe or effective.

Puberty blockers pause the physical changes of puberty as children grow, such as the development of breasts in girls and facial hair in boys.

Health Secretary Victoria Atkins welcomed the pause and said an urgent update on the practice of hormone prescription must now follow. She also praised clinicians who spoke out about their concerns.

"I commend those brave voices who spoke up to raise the alarm about how treatment was diverging so far from guidance -- a culture of secrecy and ideology over evidence and safety. Today I'm saying 'enough,'" she wrote in an opinion article in the London-based Daily Telegraph newspaper.

The publication of Cass's report revealed that six of seven adult clinics had refused to take part in the study -- meaning that the outcomes for approximately 9,000 people who were moved from child services into adult care were not included in the report.

Cass described this as "hugely disappointing" as these people's experiences would be valuable in studying the long-term impacts of hormone treatments.

The reasons adult clinics gave for not taking part included ethical considerations and concerns about funder motivation and political interference.

Many children were treated at the Tavistock clinic, which was NHS England's only specialist gender clinic for children and young people. It closed in the first weeks of April, four years after it was rated as "inadequate" by inspectors.

Prime Minister Rishi Sunak also has responded to the review, saying the findings "shine a spotlight" on the need to "exercise extreme caution" when it comes to gender care for children.

In the newly released declaration, the Vatican said that -- among other things -- being a Christian means defending human dignity and opposing gender transition.

"We cannot separate faith from the defense of human dignity, evangelization from the promotion of a dignified life and spirituality from a commitment to the dignity of every human being," Cardinal Víctor Manuel Fernández, prefect of the Dicastery for the Doctrine of the Faith, wrote in the opening section of the declaration "Dignitas Infinita" ("Infinite Dignity"), released at the Vatican April 8.

It also condemned gender theory as "extremely dangerous since it cancels differences in its claim to make everyone equal."

Gender theory, the document said, tries "to deny the greatest possible difference that exists between living beings: sexual difference."

The Catholic Church teaches that "human life in all its dimensions, both physical and spiritual, is a gift from God,” it said. “This gift is to be accepted with gratitude and placed at the service of the good."

Quoting Pope Francis' exhortation “Amoris Laetitia,” the declaration said gender ideology "envisages a society without sexual differences, thereby eliminating the anthropological basis of the family."

Dicastery members said it is true that there is a difference between biological sex and the roles and behaviors that a given society or culture assigns to a male or female, but the fact that some of those notions of what it means to be a woman, or a man are culturally influenced, does not mean there are no differences between biological males and biological females.

"Therefore," they said, "all attempts to obscure reference to the ineliminable sexual difference between man and woman are to be rejected."

The advocacy group Christian Concern welcomed the Cass Report, saying it "makes clear that vulnerable children have been failed by clinicians who have followed an affirmative approach to treating children with gender dysphoria and prescribed powerful drugs which lack evidence to support their use in such ways."

While the report does not recommend an outright ban on social transition or on puberty-blockers or cross-sex hormones, it does advise "extreme caution" on these treatments.

The review notes, "Whilst some young people may feel an urgency to transition, young adults looking back at their younger selves would often advise slowing down."

Andrea Williams, CEO of Christian Concern, said, “The Cass Review makes clear that children have not been told the truth by clinicians and other adults."

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Michael Kelly