Chamber and committees

That is very helpful. Thank you very much.

We should be indebted to Dr Hilary Cass for the sensitive way that she has approached the issue. The fact that she has taken the time to come to Scotland to answer detailed questions is to her credit. It is a watershed moment.

However, Dr Cass has highlighted the Government’s lack of urgency in acting on the report. The methodical and thorough way in which she has examined the issues around gender identity services will serve not only to protect more young people from harm but to demonstrate that there are many different pathways for young people who are distressed about different aspects of their lives that are related to gender identity.

I agree that waiting times for gender healthcare are unacceptably long. However, I do not believe that there is any excuse not to implement the report’s recommendations in full. As Jackie Baillie said in her opening speech, Government ministers have behaved as though the findings have just arrived, but anyone who has been following the review in the press over the past two or three years will have been fully aware of the whistleblowing around the Tavistock clinic and the follow-on report by Dr Cass, so it should have come as no surprise to the Government.

The review report highlights the lack of evidence and raises concerns about the potential harm of treatments—particularly puberty blockers and hormone therapies. Others have pointed out that those are major and life-altering interventions. The report states:

“we have no good evidence on the long-term outcomes of interventions to manage gender-related distress.”

It is deeply worrying that this was allowed to happen in our NHS, which offered experimental treatment to vulnerable children without having proper evidence for its safety. When giving evidence to the Health, Social Care and Sport Committee yesterday, Dr Cass said that the issue of puberty blockers has become “almost totemic” and that it has prevented us from looking at other ways of managing young people’s distress, which is important.

Other leading figures share Dr Cass’s view. The editor-in-chief of The BMJ, Kamran Abbasi, noted:

“A spiralling interventionist approach, in the context of an evidence void, amounted to overmedicalising care for vulnerable young people.”

I am pleased that Dr Cass has flagged up the issue of children being socially transitioned in schools without parental involvement. As she has said, it is not helpful to young people to create an adversarial system.

We need to look at the bigger picture. Almost two thirds of referrals to the gender identity development service in London in recent years have been for teenage girls, so more questions need to be asked about why a higher portion of girls is presenting with gender dysphoria. Based on Dr Cass’s recommendations, we should not make any assumptions about the complex picture until we know the facts.

The Cass review is robust, independent research, which, importantly, is informed by the views of people with lived experience. Gender medicine is built on “shaky foundations”, and it is deeply worrying for child welfare. I urge the Government to get on with implementing the Cass recommendations now.

I will.

Scottish Labour will support the amendment to the business motion, because we believe that there should be a statement from the Lord Advocate, and I want to say why. There is emerging evidence that the Crown Office knew or ought to have known that the Horizon system was questionable, and we still do not have answers on that.

We obviously need to see the details of the bill, but we will support any attempts to overturn convictions. However, it will not be enough for victims simply to have their convictions overturned. In fact, in the Sheriff Appeal Court this week, there were six cases in which it was deemed that the Horizon evidence was not corroboration, so those cases were overturned. Victims will want accountability for the full timeline in relation to who took decisions and why better decisions were not made, because what happened resulted in the prosecutions in the first place. I think that victims would want a statement followed by detailed questions and answers.

Apologies, Presiding Officer—I do not want to speak at the moment.

[Made a request to intervene.]

The member will be aware that there was a five-year period in which the suspicions about the Horizon system were known. He will also be aware that no victims were contacted who had previously been prosecuted. Does the member agree that, given its actions, the Crown Office, which should have known through the Second Sight Investigations report that there were system flaws, should be fully accountable to this Parliament?

Labour is happy to support the amendment to the business motion.

Will the member take an intervention?

I agree with what Jackson Carlaw said about the importance of the Citizen Participation and Public Petitions Committee in his excellent speech today, and I wish him well with his endeavours to enable young Callum to visit Bute house.

A miscarriage is one of the hardest things that a woman might ever have to go through, but it does not bear thinking about that that miscarriage could be caused by the violence of a partner. I, too, join others in welcoming to the public gallery Nicola Murray, the petitioner who brought the issue to the petitions committee and the Parliament. She is absolutely right when she says that the system fails victims and that it fails victims of domestic violence.

As we have discussed before across the parties, male violence is already a scar on society. It is even more shocking when men commit violence on pregnant women, and the law must be able to deal with those men. The pain and worry of protecting yourself as well as the child that you are carrying is unimaginable.

I, too, was surprised to learn that domestic violence often increases when a woman is pregnant or even begins at that time. That is true for women from all backgrounds, not just those from socially disadvantaged backgrounds. Pregnancy is an especially dangerous time for women who are in an abusive relationship. As we know, abuse is based on power and control, and it is common for an abusive partner to become resentful or jealous, resulting in further escalation of violence. A woman is more vulnerable when she is pregnant; the abuser knows that and uses it to gain more control.

The World Health Organization tells us that one in three women worldwide have experienced physical or sexual violence at the hands of an intimate partner. Sometimes, pregnancy alters the pattern of assault, with pregnant women more likely to be struck on the abdomen or have multiple sites of injury. Women who experience domestic abuse when they are pregnant are much more likely to have babies born prematurely or with a low birth weight, both of which are leading causes of neonatal mortality.

Between 2017 and 2021, more than 7,000 domestic incidents in which the victims were identified as being pregnant were reported to Police Scotland; that equates to four women every day. However, that number is likely to be far lower than the reality; many pregnant women are scared to report abuse, because they worry that their child might end up being taken into care. In fact, it is estimated that fewer than one in five cases of domestic abuse are reported to the police, so we need more deterrence, and I agree with Pam Gosal on that point.

As well as the interventions that the national health service already provides for victims of domestic abuse, we need tough sentences for those abusers who cause miscarriage when a woman is pregnant.

Scottish Labour supported the Domestic Abuse (Scotland) Act 2018 as a key means of introducing tough sentences for those who are convicted of abusing their partners or ex-partners.

I want to address the question of the law, as the cabinet secretary also did. Scots law is different in nature to English and Welsh law. We have a common-law system for the courts to consider issues such as miscarriage or forced termination as a serious aggravation of domestic abuse when sentencing, and they can take into account harm to children. The question that we need to examine is whether the law is being used to its full effect.

I agree with others that the loss of a child caused by violence should be led as evidence in any court case. We need to be clear that it is a crime in itself, but the question is whether Scots law adequately covers it, or whether there is scope for further exploration if it does not. Jamie Greene made a point about the importance of the Sentencing Council addressing that in its guidance.

The petition proposes a specific offence with regard to an unborn victim of violence similar to England, Wales and Northern Ireland, but England has a much more statutory and rigid system of law than Scotland. A specific offence, such as the crime of child destruction, would have to be proved separately from the original charge. It is not clear to me how successful that has been in England and Wales but, in legal terms, a clear causal link would need to be proved in those cases. Arguably, in Scots law, the burden of proof is lesser.

The petition raises a hugely important subject, which is that the loss of a wanted pregnancy is a unique and traumatic kind of harm to women, distinct from the injury suffered during an attack. The debate is an important opportunity to explore whether there are gaps in our law. As is clear, the petition has not been through a subject committee. Today is about examining the preliminary issues and deciding whether there is scope for the Parliament to do further work.

In my papers, it says:

“In 2022, males were twice as likely to have a drug misuse death as females. Most of the decrease in the past year was in males.”

I thought that you said that there was a changing pattern with regard to men and women.