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Critical thinking and open debate are pillars of scientific and medical research. Yet 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.

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.

“In most areas of health, medical researchers have freedom to answer questions to problems without fear of judgment,” said Dr Channa Jayasena, a consultant in reproductive endocrinology at Imperial College London. “I’ve never quite known a field where the risks are also in how you’re seen and your beliefs. You have to be careful about what you say both in and out of the workplace.”

Her conclusion was echoed by doctors, academic researchers and scientists, who have said this climate has had a chilling effect on research in an area that is in desperate need of better evidence.