Gender Identity Research & Education Society

GIRES is a UK wide organisation whose purpose is to improve the lives of trans and gender diverse people of all ages, including those who are non-binary and non-gender.

GIRES is a professionally managed membership charity supported by volunteers that, in collaboration with other groups in its field, hears, helps, empowers and gives a voice to trans and gender diverse individuals, including those who are non-binary and non-gender, as well as their families.

We use evidence from individuals’ lived experiences, combined with scientific research into gender identity development, to educate all those who are able to improve trans and gender diverse individuals’ wellbeing. We contribute to policy development regarding equality and human rights for individuals, especially in healthcare.

We also deliver training, e-learning and information to public and private sector organisations, including supporting trans and gender diverse employees or students.

Information GIRES Services Information and GIRES Support Information.


10th April 2024

The Cass Review: Final Report

CASS Report Cover

GIRES Statement following the publication of the CASS Report

Based on the peer-reviewed evidence published in reputable academic articles and the guidance published by the Endocrine Society and World Professional Society for Transgender Health the Gender Identity Research and Education Society (GIRES)  has consistently endorsed a cautious affirmative approach to caring for people of all ages who experience atypical gender identity development. The Cass Review and NHS England have chosen to ignore most of that evidence and guidance.

Affirmative approaches, in the last few years, have been conflated with the medicalisation of young people. This is however a misrepresentation: affirmative approaches refer to being supportive of a child’s needs and expressions – some children might not ever need medical treatment, and yet will need to be approached in a non-judgmental way. Even the provision of puberty blockers is not affirmative in the new meaning that the word has taken: blockers in fact do not cause any permanent alteration of the body and are used in the treatment of precocious puberty.

The Cass Review and NHS England have decided to ignore the above guidance as well as significant important peer-reviewed literature, either because it did not satisfy the GRADE method of appraisal (which is unsuitable in areas of care that concern quality of life and health measures to be assessed in the long term) or because they only accepted studies that looked into puberty blockers and gender-affirming hormones separately, when instead disentangling the effects of the two forms of treatment is often not scientifically possible.

Of note, many other pediatric medications that are routinely used in pediatric care, do not and cannot have the level of evidence that Cass and NHS England demand. Anti-psychotic medications and many others have comparable if not lower levels of evidence.

In this area of care, as in any other area of care, treatment is to be provided if and when the risks of not offering treatment are worse than the risks of offering it. Doctors have a duty to consider not only the side effects and the benefits of interventions but also, obviously, the risks of leaving patients without treatment. On occasions, it is best not to treat, because the side effects of treatment would outweigh the benefit. But nobody would deny that clinicians have a duty to offer medical and surgical treatment, which might be risky and cause harm and suffering if leaving patients without those treatments were to cause patients greater risks of harm and suffering. The decision to treat, and the decision not to treat, are seldom, if ever, neutral. These decisions need to rest both on existing evidence, but also on consideration of the circumstances of the patients, of available alternatives, and likely or predictable outcomes in the short and long term of both options (treating and not treating).


Professor Simona Giordano’s book provides very full lists of relevant scientific references:Children and Gender Ethical issues in the clinical management of transgender and gender diverse youth, from early years to late adolescence: Oxford University Press 2023

Dr Ruth Pearce, Lecturer in Community Development at the University of Glasgow, and a researcher on trans healthcare,  has written an article titled: What’s Wrong with The Cass Review, a round up of commentary and evidence:




April 2024

HM Governments Further Education Residential Accommodation: National Minimum Standards Consultation 2024

This consultation aims to align the Standards with the position on residential accommodation being consulted upon in the draft ‘Gender Questioning Children: non-statutory guidance for schools and colleges in England’, which was published for consultation on 19 December 2023.

GIRES Submission: Further Education – accommodation for gender questioning children 202404

PDF (113KB)

March 2024

GIRES Submission in Response to HM Governments Guidance for Schools and Colleges: Gender Questioning Children Consultation 2024

Consultation document: Guidance_for_schools_and_colleges_gender_questioning_children_consultation_document

GIRES Submission: Response to HM Governments Schools Guidance

PDF (211KB)

Celebrating Infinitely Diverse Gender Expressions

A few of GIRES’ friends colleagues and supporters.

Together Logo


Galop logo

The National LGB&T Partnership

TGEU logo

LGBT Foundation Logo