British Medical Association and transgender people

by Andrea James Reviewed October 30, 2026 15 min read

The British Medical Association is the main trade union and professional association for doctors in the United Kingdom. It sets policy and publishes positions on medical, ethical, and public health questions.

In 2024, The BMA was subjected to a sustained campaign of attacks after criticizing the Cass Review and subsequent UK policies and laws based on it.

The BMA’s official peer-reviewed journal is The BMJ, which has editorial independence from the BMA. Since 2022, The BMJ under editor Kamran Abbasi has made a number of controversial editorial decisions around coverage of trans healthcare, written primarily by anti-trans activists Jennifer Block and Jane Feinmann.

Background

On July 19, 1832, the group was founded by Charles Hastings as the Provincial Medical and Surgical Association. Its first aim was to share scientific and medical knowledge among doctors outside London. In 1840 it launched the Provincial Medical and Surgical Journal. In 1856 it renamed itself the British Medical Association, and in 1857 its journal became the British Medical Journal (The BMJ).

The BMA was registered as a company in 1874. In the 1920s it moved to its present London headquarters on Tavistock Square. Under the Trade Union and Labour Relations Act 1974 it was listed as a trade union. BMA-wide policy is set at the Annual Representative Meeting (ARM). Conferences for particular branches of practice pass their own motions, but these become association-wide policy only if the ARM adopts them.

Transgender healthcare

Since the mid-2010s, the BMA has issued a number of guidances and policy statements regarding transgender healthcare.

In 2016, the General Medical Council (GMC), the UK’s independent regulator, published a guidance that stated, “Some trans people – after many years of suppression, and facing continued deterioration in their mental health while waiting for a specialist appointment – become desperate for medical intervention and may turn to self-medication.” It said providers “may prescribe ‘bridging’ endocrine treatments as part of a holding and harm reduction strategy while the patient awaits specialised endocrinology or other gender identity treatment.” In its guidance [original] responding to the GMC’s 2016 advice, the BMA’s GP Committee told general practitioners (GPs) they were not obliged to start “bridging” hormone prescriptions. The BMA argued this advice didn’t address the significant medico-legal risks for GPs.

At the 2020 ARM, BMA representatives passed a motion [original] affirming the right of trans and non-binary people to access healthcare and to have their identities respected. The motion called on the government to allow legal gender recognition through a witnessed, sworn statement rather than a medical diagnosis of gender dysphoria. It also called for under-18s to be able to access gender-related healthcare under existing UK case law on consent, and for trans patients and staff to use facilities and services matching their gender identity. The meeting’s chair called the tension in the debate “palpable.” At least one member argued that medical interventions for gender diverse youth were not evidence-based.

Cass Review

From 2024 on, the Cass Review dominated the BMA’s work on trans healthcare. The BMA’s position shifted several times and was contested by some within the membership.

In July 2024, the BMA’s UK Council passed a motion to “publicly critique” the Cass Review and to lobby against implementing it. On July 31, the BMA announced [original] its own evaluation. In a separate piece, UK Council Chair Phil Banfield stated that NHS England’s restrictions and the government’s emergency ban on puberty blockers “goes further than any recommendation in the Cass Review.”

The BMA’s July 31 announcement [original] included the text of the motion:

‘This meeting recognises that the provision of gender identity services in the United Kingdom is inadequate, and that transgender people should be treated with compassion and respect for their bodily autonomy. Following the publication of the Cass Review on Gender Identity Services for children and young people, this meeting is concerned about its impact on transgender healthcare provision because of its unsubstantiated recommendations driven by unexplained study protocol deviations, ambiguous eligibility criteria, and exclusion of trans-affirming evidence. Therefore, this meeting calls on the BMA to:

i. Publicly critique the Cass Review;

ii. Lobby and work with other relevant organisations and stakeholders to oppose the implementation of the recommendations made by the Cass Review;

iii. Lobby the Government and NHS in all four nations to ensure continuity in provision of transgender healthcare for patients younger than 18 years old;

iv. Lobby the Government and NHS in all four nations to ensure continuity in provision of transgender healthcare for patients aged 18 or older;

v. Publicly state support for transgender people, particularly transgender youth, and provision of prompt access to gender identity services and treatment at all ages;

vi. Condemn the increasing political transphobia which is ostracising transgender people and discriminating against them by blocking their access to healthcare’.

The backlash BMA faced from anti-trans activists was immediate and intense. BMA’s critics created the website Not in Our Name BMA and collected about 1,500 signatories for an open letter objecting to the motion. That letter’s primary signer was Louise Irvine of Genspect and Clinical Advisory Network on Sex and Gender. Some BMA members resigned. Of anti-trans activists in the media, Hannah Barnes in particular was deeply involved in criticizing the BMA in several articles for several outlets. Pieces attacking the BMA appeared in Christian Institute, GB News, New Statesman, The Telegraph, The Times, The Guardian, UnHerd, BMJ, and the Free Speech Union. In September 2024 the BMA announced [original] that the Council voted to take a neutral position while a Task and Finish Group carried out the evaluation.

The BMA’s evaluation of the Cass Review was published in May 2026. It accepted that the Cass Review had handled the evidence soundly and that the evidence on puberty blockers and hormones is limited and uncertain. It argued, however, that later NHS and government restrictions went further than the Review itself, and the group stayed divided on whether restricting puberty blockers is proportionate.

Sex segregation laws

After the Supreme Court’s April 2025 For Women Scotland ruling that “sex” in the Equality Act means biological sex, the BMA expanded its focus on adult trans healthcare and access to services. Its Resident Doctors Conference voted on Emergency Motion 4 condemning the ruling and calling it “scientifically illiterate,” though that motion was not association-wide policy:

This meeting condemns the Supreme Court ruling defining the term ‘woman’ with respect to the Equality Act as being based on ‘biological sex’, which they refer to as a person who ‘was at birth of the female sex’, as reductive, trans and intersex-exclusionary and biologically nonsensical. We recognize as doctors that sex and gender are complex and multifaceted aspects of the human condition and attempting to impose a rigid binary has no basis in science or medicine while being actively harmful to transgender and gender diverse people. As such this meeting:

i. Reiterates the BMA’s position on affirming the rights of transgender and non-binary individuals to live their lives with dignity, having their identity respected.

ii. Reminds the Supreme Court of the existence of intersex people and reaffirms their right to exist in the gender identity that matches their sense of self, regardless of whether this matches any identity assigned to them at birth.

iii. Condemns scientifically illiterate rulings from the Supreme Court, made without consulting relevant experts and stakeholders, that will cause real-world harm to the trans, non-binary and intersex communities in this country.

iv. Commits to strive for better access to necessary health services for trans, non-binary and gender-diverse people.

In June, the BMA’s UK Council passed a motion in response to the Resident Doctors Conference motion that stated BMA members should criticize other bodies professionally and with appropriate language.

In May, the BMA issued a statement of support for trans and gender diverse members and patients which argued that access to care shouldn’t depend on a “hierarchy of rights.” It also called for more NHS resources to protect every patient’s privacy and dignity and asked that changes to NHS and EHRC guidance include the views of trans staff and patients.

Also in June, the BMA sent a letter to the EHRC and a letter to the NHS, noting that discrimination and harassment against trans, non-binary, and gender non-conforming people had risen since the ruling. They asked the EHRC to consult widely and complete an equality impact assessment before finalizing its Code of Practice and avoid issuing public guidance before the consultation was over. The BMA called requiring people to disclose their sex at birth or show birth certificates intrusive and potentially harmful. They asked NHS to tell trusts not to bring in hasty policies before the EHRC’s final code was published, to make sure all staff can use facilities with dignity, and to confirm that there is generally no right to know someone’s sex at birth, except for individual safety. It argued that any monitoring of sex at birth should stay confidential and be used only in specific safety cases. It said separating trans patients in communal accommodation wasn’t practical given NHS bed shortages.

and warned the EHRC and NHS England about harm to trans people’s access to care.

References

Parsons, Ludovic (July 18, 2026). Reporting about British Medical Association critique of Cass Review was ‘factually wrong.’ QueerAF https://www.wearequeeraf.com/exclusive-reporting-about-british-medical-association-critique-of-cass-review-was-factually-wrong/

St. Palmer, Poppy-Jay (May 7, 2026). British Medical Association no longer opposes Cass Review – apart from puberty blockers ban. PinkNews https://www.thepinknews.com/2026/05/07/british-medical-association-bma-cass-review-2026/

Billson, Chantelle (April 28, 2025). BMA resident doctors condemn Supreme Court’s ‘scientifically illiterate’ trans ruling. PinkNews https://www.thepinknews.com/2025/04/28/british-medical-association-condemns-supreme-courts-scientifically-illiterate-trans-ruling/

Perry, Sophie (October 10, 2024). Hilary Cass calls BMA doctors who criticised review of trans youth care a ‘small minority.’ PinkNews https://www.thepinknews.com/2024/10/10/hilary-cass-bma-criticism-cass-review-trans/

Parr, Eliza (October 2, 2024). BMA will approach Cass review ‘neutrally’ after vote overturns critical stance. Pulse https://www.pulsetoday.co.uk/news/clinical-areas/mental-health-pain-and-addiction/bma-will-approach-cass-review-neutrally-after-vote-overturns-critical-stance

Lowden, Sarah (September 30, 2024). BMA takes neutral position on Cass review recommendations. Doctors.net.uk https://www.doctors.net.uk/news/bma-takes-neutral-position-on-cass-review-recommendations

Kheraj, Alim (September 27, 2024). The BMA votes to take a ‘neutral position’ in its evaluation of the Cass Review. Attitude https://www.attitude.co.uk/news/bma-neutral-position-evaluation-cass-review-473647/

Paterson, Kirsteen (September 17, 2024). Trans healthcare experts reject call to suspend Cass Review implementation. Holyrood https://holyrood.com/news/view,trans-healthcare-experts-reject-call-to-suspend-cass-review-implementation

Lowden, Sarah (August 5, 2024). BMA calls for ‘pause’ to implementation of Cass Review recommendations. Doctors.net.uk https://www.doctors.net.uk/news/bma-calls-for-pause-to-implementation-of-cass-review-recommendations

Edensor, Mila (August 3, 2024). Cass Review Under Fire From The British Medical Association: Will the government listen to the experts? The Cambridge Student https://www.thecambridgestudent.co.uk/opinion/cass-review-under-fire-from-the-british-medical-association-will-the-government-listen-to-the-experts

Gaubert, Pierre (August 2, 2024). The British Medical Association calls for ban on puberty blockers to be lifted. myGwork https://mygwork.com/news/the-british-medical-association-calls-for-ban-on-puberty-blockers-to-be-lifted

Carson-Holt, Elsie (August 2, 2024). UK’s largest doctors’ union condemns Cass Review’s attacks on gender-affirming care. LGBTQ Nation https://www.lgbtqnation.com/2024/08/uks-largest-doctors-union-condemns-cass-reviews-attacks-on-gender-affirming-care/

Hansford, Amelia (August 1, 2024). British Medical Association calls for puberty blocker ban to be lifted. PinkNews https://www.thepinknews.com/2024/08/01/bma-cass-report-implementation-review/

Reed, Erin (July 31, 2024). British Medical Association Calls Cass Review “Unsubstantiated,” Passes Resolution Against Implementation. Erin in the Morning https://www.erininthemorning.com/p/british-medical-association-calls

Mann, Nick (July 31, 2024). BMA urges pause on implementation of Cass transgender child treatment advice. Pulse https://www.pulsetoday.co.uk/news/clinical-areas/paediatrics/bma-urges-pause-on-implementation-of-cass-transgender-child-treatment-advice/

Paterson, Kirsteen (July 31, 2024). British Medical Association calls for pause on implementation of Cass Review. Holyrood https://holyrood.com/news/view,british-medical-association-calls-for-pause-on-implementation-of-cass-review

Staff report (July 31, 2024). Doctors’ union will ‘critique’ Cass Review after criticising puberty blocker ban. Express & Star https://www.expressandstar.com/news/uk-news/2024/07/31/doctors-union-will-critique-cass-review-after-criticising-puberty-blocker-ban/

Staff report (September 30, 2016). GPC guidance tells GPs to ignore GMC advice on prescribing for gender dysphoria. Pulse https://www.pulsetoday.co.uk/news/regulation/gpc-guidance-tells-gps-to-ignore-gmc-advice-on-prescribing-for-gender-dysphoria/

Anti-trans coverage

Clinical Advisory Network on Sex and Gender (June 14, 2026). BMA’s Critique of Cass Review: Cass vindicated, but BMA still getting it wrong. https://can-sg.org/2026/06/14/bmas-critique-of-cass-review-cass-vindicated-but-bma-still-getting-it-wrong/

Coombes, Rebecca (May 6, 2026). Puberty blockers: BMA critique vindicates Cass review but questions government “overreach.” BMJ, 393, s876. https://doi.org/10.1136/bmj.s876

Cheung, C. Ronny; Abbruzzese, Evgenia; Lockhart, Elaine; Maconochie, Ian K.; Kingdon, Camilla C. (2025). Gender medicine and the Cass Review: why medicine and the law make poor bedfellows. Archives of Disease in Childhood 110(4): 251. https://doi.org/10.1136/archdischild-2024-327994

Staff report (October 1, 2024). BMA adopts interim ‘neutral position’ on Cass Review. The Christian Institute https://www.christian.org.uk/news/bma-adopts-interim-neutral-position-on-cass-review/

Staff report (September 27, 2024). BMA takes ‘neutral position’ on gender review BBC https://www.bbc.com/news/articles/c20pn0164ypo

Barnes, Hannah (September 27, 2024). The BMA turns away from rejecting the Cass Report. New Statesman https://www.newstatesman.com/thestaggers/2024/09/the-bma-turns-away-from-rejecting-the-cass-report

Staff report (September 5, 2024). Ex-BMA chair blasts council for opposing Cass Review The Christian Institute https://www.christian.org.uk/news/ex-bma-chair-blasts-council-for-opposing-cass-review/

Manning, Sanchez (September 2, 2024). The trans row ripping apart Britain’s doctors’ union The Telegraph https://www.telegraph.co.uk/news/2024/09/02/trans-row-bma-british-medical-association/

Cowper, Andy (September 1, 2024). Cowper’s Cut 338: September Gurls Health Policy Insight https://www.healthpolicyinsight.com/cowpers-cut-338-september-gurls/

Barnes, Hannah (September 1, 2024). Politics, power and puberty blockers: the trans row dividing the BMA The Times https://www.thetimes.com/uk/healthcare/article/politics-power-and-puberty-blockers-the-trans-row-dividing-the-bma-xl52dgdmb

Staff report (September 27, 2024). BMA takes ‘neutral position’ on gender review. BBC News https://www.bbc.com/news/articles/c20pn0164ypo

Staff report (August 30, 2024). Doctors resigning over BMA’s ‘outrageous’ opposition to Cass Review The Christian Institute https://www.christian.org.uk/news/doctors-resigning-over-bmas-outrageous-opposition-to-cass-review/

Campbell, Denis (August 29, 2024). ‘Witch-hunt’: BMA tries to identify who leaked planned opposition to Cass review. The Guardian https://www.theguardian.com/society/article/2024/aug/29/witch-hunt-bma-tries-to-identify-who-leaked-planned-opposition-to-cass-review

Smith, Victoria (August 29, 2024). BMA civil war over Cass Review deepens UnHerd https://unherd.com/newsroom/bma-civil-war-over-cass-review-deepens/

Staff report (August 27, 2024). Doctors union sees membership PLUNGE as hundreds quit in fury at ‘bonkers’ trans stance GB News https://www.gbnews.com/news/doctors-quit-british-medical-association-bma-trans-stance-cass-review

Hayward, Eleanor (August 26, 2024). BMA members resign in revolt over transgender children stance. The Times https://www.thetimes.com/uk/healthcare/article/bma-members-resign-in-revolt-over-transgender-children-stance-nvqd0vgv5

Staff report (August 26, 2024). Doctors resign from BMA over union’s opposition to Cass review. The Telegraph https://www.telegraph.co.uk/news/2024/08/26/doctors-resign-bma-opposition-cass-review-puberty-blockers/

Bartosch, Josephine (August 9, 2024). BMA chiefs face revolt over rejection of Cass Review UnHerd https://unherd.com/newsroom/bma-chiefs-face-revolt-over-rejection-of-cass-review/

Barnes, Hannah (August 8, 2024). Hundreds of doctors are challenging the BMA’s stance on puberty blockers. New Statesman https://www.newstatesman.com/politics/health/2024/08/hundreds-of-doctors-are-challenging-the-bmas-stance-on-puberty-blockers

Huls, Jennifer (August 8, 2024). BMA under fire for promoting trans ideology at children’s expense. The Christian Institute https://www.christian.org.uk/news/bma-under-fire-for-promoting-trans-ideology-at-childrens-expense/

Feinmann, Jane (August 8, 2024). Nearly 900 doctors sign letter urging BMA to abandon inquiry into Cass review. BMJ https://doi.org/10.1136/bmj.q1772

Hayward, Eleanor (August 7, 2024). Doctors criticise BMA for resisting ban on puberty blockers. The Times https://www.thetimes.com/uk/healthcare/article/doctors-criticise-bma-for-resisting-ban-on-puberty-blockers-c6p85kbfl

Sapper, Paul (August 6, 2024). The BMA’s shameful support for puberty blockers. Spiked https://www.spiked-online.com/2024/08/06/the-bmas-shameful-support-for-puberty-blockers

Attenborough, Frederick (August 4, 2024). BMA calls for trans teenagers to be prescribed puberty blockers. Free Speech Union https://freespeechunion.org/archive/bma-calls-for-trans-teenagers-to-be-prescribed-puberty-blockers

Sodha, Sonia (August 4, 2024). Opinion: BMA stance on puberty blockers defies first principle of medicine: first do no harm. The Observer https://www.theguardian.com/commentisfree/article/2024/aug/04/bma-stance-on-puberty-blockers-defies-first-principle-of-medicine-first-do-no-harm-cass-review

Pym, Hugh (August 1, 2024). BMA calls for ban on puberty blockers to be lifted. BBC https://www.bbc.co.uk/news/articles/c3vxlnkv3x0o

Saunders, James (August 1, 2024). Doctors’ union opposes Cass review and calls for puberty blocker ban to be lifted. GB News https://www.gbnews.com/news/doctors-union-cass-review-puberty-blocker-ban-trans

Whelan, Ella (August 1, 2024). The militant BMA has thrown children under the bus. The Telegraph https://www.telegraph.co.uk/news/2024/08/01/the-militant-bma-is-becoming-an-enemy-of-the-people/

Donnelly, Laura; Martin, Daniel (July 31, 2024). BMA calls for trans teens to be prescribed puberty blockers The Telegraph https://www.telegraph.co.uk/news/2024/07/31/bma-calls-trans-teens-prescribed-puberty-blockers/

Duggan, Laurel (July 31, 2024). British Medical Association takes aim at Cass Review UnHerd https://unherd.com/newsroom/british-medical-association-takes-aim-at-cass-review/

Barnes, Hannah (July 26, 2024). Why are BMA Council’s confidential discussions on the Cass Review a matter of public interest? New Statesman https://www.newstatesman.com/comment/2024/07/why-are-bma-councils-confidential-discussions-on-the-cass-review-a-matter-of-public-interest

Barnes, Hannah (July 16, 2024). Why are British doctors considering rejecting the Cass report? New Statesman https://www.newstatesman.com/politics/health/2024/07/why-are-british-doctors-voting-to-reject-the-cass-report

Selected publications by BMA

Recent guidance and policies

British Medical Association (May 7, 2026). LGBTQ+ equality in medicine. https://www.bma.org.uk/advice-and-support/equality-and-diversity-guidance/lgbtplus-equality-in-medicine/lgbtqplus-equality-in-medicine

British Medical Association (2022; updated April 20, 2026). Guidance: Inclusive care of trans and non-binary patients. https://www.bma.org.uk/advice-and-support/equality-and-diversity-guidance/lgbtplus-equality-in-medicine/inclusive-care-of-trans-and-non-binary-patients

British Medical Association (February 12, 2026). Policy position on the rights of transgender and non-binary people in healthcare settings. https://www.bma.org.uk/advice-and-support/equality-and-diversity-guidance/lgbtplus-equality-in-medicine/policy-position-on-the-rights-of-transgender-and-non-binary-people-in-healthcare-settings

British Medical Association (January 17, 2020; updated June 28, 2024, June 28, 2025). Guidance: Managing patients with gender dysphoria. https://www.bma.org.uk/advice-and-support/gp-practices/gp-service-provision/managing-patients-with-gender-dysphoria

For Women Scotland Supreme Court ruling on sex segregation

British Medical Association (October 21, 2026). STATEMENT: NHS guidance on the provision of single-sex services and facilities. https://www.bma.org.uk/news-and-opinion/statement-nhs-guidance-on-the-provision-of-single-sex-services-and-facilities

British Medical Association (June 19, 2025). Letter to NHS England. https://www.bma.org.uk/media/tpvdy0dg/bma-letter-to-nhse-re-supreme-court-biological-sex-ruling-190625.pdf

British Medical Association (June 19, 2025). Letter to the EHRC. https://www.bma.org.uk/media/byfcnq0o/bma-letter-to-ehrc-re-supreme-court-ruling-190625.pdf

British Medical Association (June 2, 2026). STATEMENT: EHRC code of practice for services, public functions and associations. https://www.bma.org.uk/news-and-opinion/statement-ehrc-code-of-practice-for-services-public-functions-and-associations

British Medical Association (May 29, 2025). Statement of support for doctors affected by the Supreme Court ruling. https://www.bma.org.uk/news-and-opinion/statement-of-support-for-doctors-affected-by-the-supreme-court-ruling

Cass Review controversy

British Medical Association (2026). Cass Review: Evidence, Interpretation, and Implementation. Paper C93 2025-26 https://cdn.intelligencebank.com/eu/share/qMbw14/VEeb4/XeJDR/original/20260347+Cass+Review+update+document

British Medical Association (September 26, 2024). BMA confirms support for undertaking its evaluation of the Cass Review from a position of neutrality. https://www.bma.org.uk/bma-media-centre/bma-confirms-support-to-undertake-its-evaluation-of-the-cass-review-from-a-position-of-neutrality [archive]

Banfield, Phil (August 8, 2024). BMA to undertake evidence-led evaluation of the Cass Review. https://www.bma.org.uk/news-and-opinion/bma-to-undertake-evidence-led-evaluation-of-the-cass-review

British Medical Association (July 31, 2024). BMA to undertake an evaluation of the Cass Review on gender identity services for children and young people. https://www.bma.org.uk/bma-media-centre/bma-to-undertake-an-evaluation-of-the-cass-review-on-gender-identity-services-for-children-and-young-people [archive]

Earlier guidance and statements

British Medical Association (November 2, 2022). Sexual orientation and gender identity in the medical profession. https://cdn.intelligencebank.com/eu/share/qMbw14/VEeb4/oYbrn/original/bma-sogi-report-2-nov-2022

British Medical Association (March 2022). Role of GPs in managing adult patients with gender incongruence (BMA reference 20220091).https://www.bma.org.uk/media/5481/bma-role-of-gps-in-managing-adult-patients-with-gender-dysphoria-mar2022.pdf

British Medical Association (November 2020). Written evidence submitted by the British Medical Association (GRA1504), Women and Equalities Committee inquiry into reform of the Gender Recognition Act (2004) https://committees.parliament.uk/writtenevidence/17655/html/

British Medical Association (~2018). BMA submission: Women and Equalities Committee inquiry on Reform of the Gender Recognition Act. https://www.bma.org.uk/media/3584/bma-submission-reform-of-the-gender-recognition-act.pdf [archive]

British Medical Association (September 15, 2020). ARM 2020 Motion 4: Healthcare and rights of transgender and nonbinary individuals. https://www.bma.org.uk/media/3264/motion-4-healthcare-and-rights-of-transgender-and-nonbinary-individuals-briefing-arm-2020.pdf [archive]

British Medical Association (September 15, 2020). Leading doctors affirm trans and non-binary rights in healthcare. https://www.bma.org.uk/bma-media-centre/leading-doctors-affirm-trans-and-non-binary-rights-in-healthcare [archive]

British Medical Association (September 2016). Focus on gender incongruence in primary care. https://blmc.co.uk/docs/Focus-on-gender-incongruence-in-primary-care.pdf [archive]

response to General Medical Council (March 15, 2016). Advice for doctors treating transgender patients. http://www.gmc-uk.org/guidance/28851.asp [archive] later replaced by Trans healthcare https://www.gmc-uk.org/professional-standards/ethical-hub/trans-healthcare