The publication of Hilary Cass's final report on healthcare for gender-questioning children laid bare the devastating scale of NHS failures of a vulnerable group of children and young people, buoyed by adult activists bullying anyone who dared question a treatment model so clearly based on ideology rather than evidence. Cass is a renowned paediatrician and her painstakingly thorough review was four years in the making. She sets out how the now-closed NHS specialist gender clinic for children abandoned evidence-based medicine. Significant numbers of gender-questioning children ... were put on an unevidenced medical pathway of puberty-blocking drugs and/or cross-sex hormones, despite risks of harm in relation to brain development, fertility, bone density, mental health and adult sexual functioning. Cass finds a childhood diagnosis of gender dysphoria is not predictive of a lasting trans identity and clinicians told the review they are unable to determine in which children gender dysphoria will last into adulthood. If this is indeed impossible, is it ever ethical to put a young person on a life-altering medical pathway? If there are no objective diagnostic criteria, on what basis would a clinician be taking this decision other than a professional hunch? Cass's vision is what gender-questioning children deserve: to be treated with the same level of care as everyone else, not as little projects for activists seeking validation for their own adult identities and belief systems.