Experienced professionals are increasingly scared to openly discuss their views on the treatment of children questioning their gender identity. This was the conclusion drawn by Hilary Cass in her review of gender identity services for children this week, which warned that a toxic debate had resulted in a culture of fear. Her conclusion was echoed by doctors, academic researchers and scientists. Some said they had been deterred from pursuing what they believed to be crucial studies, saying that merely entering the arena would put their reputation at risk. Others spoke of abuse on social media, academic conferences being shut down, biases in publishing and the personal cost of speaking out. Sallie Baxendale, a professor of clinical neuropsychology ... received abuse after publishing a systematic review of studies that investigated the impact of puberty blockers on brain development. Her review found that "critical questions" remained around the nature, extent and permanence of any arrested development of cognitive function linked to the treatment. The paper, which summarised the state of relevant research, was met with an immediate backlash. "I've been accused of being an anti-trans activist, and that now comes up on Google and is never going to go away," Baxendale said. "Imagine what it's like if that is the first thing that comes up when people Google you? Anyone who publishes in this field has got to be prepared for that."