"I thought it would be couple of afternoons a month for six months and then I could go home and get on with my retirement," she said, laughing wryly.
The work has placed her at the vortex of a debate she describes as toxic, politicised and ideological.
Cass's review is written in a calmly clinical tone but there are moments when her anger about how NHS England has cared for a generation of vulnerable children is barely disguised.
Clinicians have become "fearful". The available evidence is "poor". Her efforts to conduct a vital and comprehensive study into the outcomes of all 9,000 children and adolescents treated at the Tavistock and Portman gender identity development service clinic between 2009 and 2020 were "thwarted".
She knows her recommendations will be hugely controversial and that some children waiting for treatment will be dismayed by her conclusions, but she is adamant that she has young people's best interests at heart.
"We've let them down because the research isn't good enough and we haven't got good data," she said.
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