Document resource
In response to the Cass Review, Giordano offers a vital critique of how clinical trials have been framed as a precondition for access to puberty blockers for trans youth in England.1 Giordano challenges the ethical coherence of this demand, noting how scientific uncertainty is being used to delay or deny care, rather than improve it. This commentary extends that critique by locating the Cass framework within a broader history of biopolitical regulation of sex development, particularly through parallels with the medical treatment of intersex children. I argue that both the Cass Review and related US policy developments (eg, the 2025 Health and Human Services (HHS) Gender Dysphoria Report)2 reflect longstanding evidentiary double standards that govern whose bodies warrant urgent intervention and whose must wait for perfect evidence.[i]