Back in 2009, very few people would have heard of "gender identity".

Even fewer would have known that Welsh health services had started making referrals to the NHS’ gender identity development service in England, located then at the Tavistock and Portman NHS Foundation Trust.

That year the trust received fewer than 60 referrals for children and young people from across England and Wales. But demand surged and by 2022, more than 5,000 children and young people were being referred to gender identity clinics which had sprung up across England.

What was happening? Where was this demand coming from? Why were almost three quarters of referrals female? Why were so many children? Why did an unusually large number also have a diagnosis of autism?

For years, parents, teachers, clinicians, women’s-rights groups and others across the UK have campaigned to raise these questions and more.

In Wales, they were often silenced. Professionals and parents alike told their fears were baseless, bigoted and even "hateful".

The Welsh Government brushed off concerns and embedded these principles in their own official plans and school curriculum.

Thanks to the work of groups like Merched Cymru, we now know the effect in Wales: children have been started on the journey of changing their gender ("transitioning") in school without reference to their parents. And that is still happening in schools, in Wales, today.

Amid the noise, a review was commissioned by NHS England into the medical treatment of gender-questioning children in England and Wales - the Cass Review.

It's now time for policymakers to respond.

The 398-page report highlights the dangers of prescribing untested and irreversible drugs to young people.

The report found that healthcare professionals have not asked the right questions. They have instead sought to propagate a dangerous political ideology at the cost of safeguarding and evidence.

It concludes there has clearly been a significant failing in our healthcare services to protect the most vulnerable patients.

The Cass review also warns against teachers making premature and what amount to clinical decisions about the children they are supposed to be safeguarding. It is clear in its findings: social transitioning in schools is a precursor to irreversible medical intervention.

And yet here in Wales, an affirmative approach to gender dysphoria is woven throughout the Welsh Government’s own compulsory Relationships and Sexuality Education Code and guidance.

So what needs to happen?

First, in schools, the UK government is developing its own transgender guidance and will now take into consideration these most recent findings. We urge the Welsh Government to withdraw its own guidance for schools immediately and carry out an urgent review of it.

Compulsory and relevant elements of the RSE curriculum on gender and gender identity must also be withdrawn by the Welsh Government for review. Likewise schools in Wales must be directed to carry out an urgent review of all materials, activities and policies relevant to RSE and guidance for trans pupils.

Second, with respect to health, NHS England has already made the landmark decision to stop the routine prescription of puberty blockers to children with gender dysphoria. It announced it would also be stopping under 18s from accessing adult gender services, and has called for an urgent review on clinical policy for cross-sex hormones. Both are happening with immediate effect and without delay.

However, NHS Wales must also carry out an immediate review.

Third, the Welsh Government made a commitment to “consider options for the development of a gender service for young people in Wales” in its LGBTQ+ Action Plan launched in February 2023. We have heard from colleagues, professionals and parents across Wales who are deeply concerned by such a commitment to expand their gender service for adults and develop this service for under 18s. To do so now would be irresponsible and dangerous. The action plan needs to be reviewed.

The response from the Welsh Government has been muted to the point of silence. In the Senedd the Welsh Government has refused a request to make a statement on the issue and a Topical Question has been rejected.

The Welsh press and media must answer for themselves what they have been looking at and where their focus has been. It has not been on children's wellbeing and safeguarding and the concerns of many parents across Wales.

This is a national scandal unfolding before us.

The Cass Commission had just one thing at its heart: to help youngsters thrive in life and achieve their ambitions.

Children and young people deserve nothing less. And teachers, parents and clinicians in Wales want to know what will be done to rectify and bring the significant failings Dr Cass has identified to an end.

The Secretary of State for Health has pledged urgent and effective action. She said she will be working closely with NHS England “to root out the ideology that has caused so much unnecessary harm”.

My question is: will the Welsh Government do the same?