He's not using evidence to inform his position. He's decided what his position is and he's pantomiming evidence to support it. It's almost as if we've stumbled into The Sorcerer's Apprentice. Little Mickey puts on the hat and declares "I know how this works! You stand up all big and tall and say 'I have a study that says you have to do what I tell you'. That's how you always play it. Well, this time I've got a study, so you have to do as I say!"
This is
literally what Ollie does. Except he often doesn't even bother pantomiming evidence in his arguments, so he uses "I/we want".
Trans people don't
want to go to "segregated" clinics to see a specialist, so you should make GPs prescribe trans healthcare!
Trans people don't
want to have diagnostic assessments, so you have to just give them the medications no questions asked!
Trans people don't
want evidence based medicine, so you have to fund any and all plastic surgery they request!
I have a voice, so you have to do as I say!
"Oh, look at you, moving the goalposts. Look at you, gatekeeping. Deciding which studies count and which ones don't. Well, I believe this one's every bit as good as yours. And I believe it proves me right."
This is also
literally what Ollie does. Ollie is in no more of a position to judge what studies are good or bad because he doesn't have so much as an undergraduate degree in biology, biomedical science or pre-med. Given the choice between the President of the Royal College of Paediatrics and Child Health or a guy who did an undergrad in Philosophy and makes youtube videos with a dress on, I think I know who's more likely to have clinical insight.
Ollie would of course point to groups like WPATH or some trans people working in the medical field as disagreeing with Cass... but that's obviously based in picking people who agree with him, which Ollie is classifying as "doublewrong". And ultimately the decisions made in the Tavistock to disregard the Dutch protocol and just hand out puberty blockers to children with comorbidities, sudden onset claims of gender dysphoria with no prior history and indeed who were already midway through puberty were not rooted in clinical evidence...
which is why the NHS is soon launching a clinical trial and a wider joint programme of research. Ollie has already decided that if this doesn't agree with him, it will be proof that the clinical study is ideologically poisoned and so doesn't count.
If there was a drug with a 1% chance of healing your terminal cancer and a 99% chance of dangerous side effects, I'd support your right to take it if you wanted
I would too. But I don't support taxpayer funding for that, sorry, because we have a finite pot and need to focus that money on treatments that demonstrably have a better impact based on cost. This is why the National Institute for Health and Care Excellence rejects multiple drugs, including - in the last year -
Olaparib (but only in the treatment of prostate cancer, it can be used for breast cancer) and
Enhertu. In both of these cases the treatment was too expensive for the potential benefit to the patient.
I also think doctors play a diagnostic role. In this case it's not even "the drug has a 1% chance of healing my terminal cancer", but "I think I have terminal cancer, and therefore I demand this drug". Maybe you don't have cancer and the doctor needs to assess you? This is why breast augmentations outside of reconstructive surgery post mastectomy, or finasteride for male pattern baldness (but the same medication is given for other conditions) are not provided on the NHS because in both of those cases you can learn to live with your flaws and just giving you cosmetic treatments doesn't help you. In that regard the "government" (NHS clinicians) "own your body and force you to do things you don't want" (decline treatment because you don't actually need it).
Anyway, always fun to get a peak behind the curtain with Ollie. If his new tactic is to literally argue "gender criticals are writing their own studies, they're gaming the process of peer review and are lying all the time, so research is a ritual and you need to just do what I say" then that's going to get precisely zero traction in the NHS.
Even if we're generous and agree Olly's vending machine idea is correct about healthcare, like Ollie was told there is only 8 clinics that can provide what Olly wants. A quick guess based off a 2021 census means there is about 1 clinic for every 14,250 people likely to seek out those services in the UK. Any reasonable person would understandably conclude waiting in line for a vending machine with over thousands of people ahead of you is going to be a massive wait and that is not including the clinic staff needing time to rest and resupply, and additional resource scarcity due to treatments for the non-trans citizens like hair treatment for balding men.
This is actually a key tenet of his argument. "The waiting lists are too long to go to special clinics and get a diagnosis, so scrap the special clinics and scrap the diagnosis".
At the end of 2023 there were 31,000 transgender patients on a waiting list for an initial assessment at a Gender Identity Clinic. In part this is due to the massive jump in referrals; in 2012 there were under 250 referrals of under 18s to gender identity clinics while in 2022 there were more than 5000 (which itself was more than twice the number in 2021). I don't see figures for year on year totals of all adult patients, but there's various figures getting thrown around; 18% year-on-year increase in Oxfordshire over a 6-year period (2011–2016), 49% increase in referrals in Nottinghamshire 2018-2024, 94% increase nationally 2016-2020, 500% increase in transgender identification 2000-2018. And from what I've been able to work out, there's not been a point where the discharge rate has exceeded the referral rate, so the number of people in treatment is continually growing.
For comparison a 13% increase in referrals to paediatric emergency mental healthcare in the last year
has basically caused collapse of the paediatric emergency healthcare system (no, this increase is not from all the trans kids on waiting lists, Ollie). No secondary care service would be able to handle that massive jump in that time frame and - very obviously - this also triggers massive alarm bells that this specific form of treatment is seeing continual surges in demand. Which Ollie would probably frame as just being the result of increased acceptance and compare it to
handedness... he would of course be avoiding "research as a ritual" when asserting that and going off vibes. Thus part of why he argues the only way to cope with this surge in demand is to just get GPs to issue prescriptions for anything anyone wants.