Charities should follow Cass Review recommendations – The Charity Commission

The Charity Commission has published guidance on wider issues in connection with its report into Mermaids, a UK charity with the object of supporting transgender young people. Significantly, the Charity Commission advises that charity trustees operating in this area need to ensure that they have due regard to the findings, conclusions and recommendations of the Cass Review.

The Cass Review is an independent review of gender identity services for children and young people in England, commissioned by the NHS. Although not legally binding in its conclusions, the Cass Review has significantly influenced the approach towards youth gender identity services in England, which has included the NHS planning for the closure of the Tavistock clinic; the only NHS clinic in England providing specialised gender identity services for young people.

The Charity Commission's inquiry into Mermaids revealed lapses in governance, but no evidence of misconduct relating to safeguarding, issuing medical advice or medical referrals.  The Commission found that while the charity faced internal management issues, conducted insufficient due diligence when appointing trustees and failed to adhere to its own internal HR policies, there was no evidence that it had provided medical advice or made medical referrals for young people without the approval of their parents or carers.  Further, the Charity Commission found no ties between Mermaids and the Tavistock and Portman NHS Foundation trust.

The findings conclude a near two-year investigation launched after concerns emerged around the support services provided by Mermaids.  Mermaids voluntarily ceased providing chest-binders to transgendered young people following growing criticism in October 2022, and has been at the centre of increased scrutiny following the release of the Cass Review.

The Charity Commission provided guidance requiring Mermaids to align its policies on medical topics, such as puberty blockers, with recommendations from the Cass Review.  

Kathryn Downs, the chair of Mermaids, acknowledged these governance concerns, confirming that Mermaids has since strengthened its internal policies and due diligence procedures, addressing these issues independently before the inquiry's publication.  Downs highlighted the lengthy duration of the inquiry as a setback to the charity's fundraising efforts and ability to fulfil its mission of supporting transgender youth. 

As well as the Commission's endorsement of the Cass Review there is a general lesson for charities here that grow swiftly in scale and prominence.  Such charities must ensure that their governance, culture and processes adapt to match the increased demands and public expectations placed upon them.