Wes Streeting has said he wants the Cass review to be a watershed moment in the provision of health services for young people questioning their gender identity but understands why some trans people may feel “frightened”. The shadow health secretary said children and young people, but trans people more generally, had been “utterly failed” by the state of healthcare available, adding: “We’ve got to get this right” for them. Streeting said the Cass review, which recommended sweeping changes in the way the NHS treats under-18s who are unsure about their gender identity or are experiencing gender dysphoria, created an opportunity to move beyond “some of the toxicity” around the issue to a “more thoughtful, careful and considered” approach. “I’ve gone out of my way, particularly in the wake of the Cass review, not to throw rocks at Tory party and to see if we can try to build a more positive consensus,” he said. “But that will rely on the Conservative party being more like David Cameron and less like Suella Braverman.” However, Streeting indicated Labour shared responsibility for the tone of debate, saying there was “plenty of blame to go around” for a situation in which the clock had been turned back after years of progress on LGBTQ+ issues. He said the country needed a more “thoughtful and inclusive” conversation about trans rights, and regretted some of the language he had used on the topic in the past. Streeting said his own “wake-up call” had been talking to women in the Labour party who were LGBTQ+ allies and stood up against transphobia but had been reluctant to raise concerns about women’s sex-based rights: “They said to me they felt silenced. That can’t be a good thing and it’s led to a more toxic debate and conversation.” But he added: “I understand why trans people are frightened at the moment. There has been an utterly toxic political backdrop in our country that has seen a rise in trans hate crime and has made the job of the Cass review more challenging. “Trans activists have been questioning the motivation [of the report] and fearing whether or not this is going to be a watershed moment that makes things better, or makes things worse. “It has got to be a watershed moment that makes things better for trans people and for young people who may be questioning their gender identity.” Streeting said he could understand why there was “a degree of scepticism” among trans people as they had “been failed so many times before”. There should be a more robust evidence base, shorter waiting times, sufficient mental health support and holistic care, he said. A Labour government would force all seven adult gender dysphoria clinics to hand over data that six of them refused to share with researchers helping draw up best practice guidelines for the Cass review. “It is crucial data for understanding the journey that people go on throughout the gender identity pathway and it’s crucial for informing our understanding the evidence base we need, to make sure that trans people are getting great healthcare,” Streeting said. In the meantime, the clinics should publicly explain their decision to withhold data, he said. “We just can’t have this free-for-all when people decide when they are or aren’t going to cooperate with an NHS England review. That’s not acceptable, especially on a topic as important as this.”