Reflections, Reconciliation & Repsychopathologization | Beyond Gender 2025 Year in Review
1 January 2026
Global
Stella O'Malley, Mia Hughes and Dr Bret Alderman review the landmark gender-policy events of 2025 — Trump's executive orders, the US HHS report, the For Women Scotland Supreme Court ruling and the UK's puberty-blockers clinical trial. For Ireland, where the HSE's gender services and the 2015 Gender Recognition Act sit at the intersection of these international pressures, the episode maps what shifted, what held and what still needs to change.
In a year that saw the political and clinical ground shift beneath gender medicine on three continents, the three hosts of Beyond Gender — Stella O'Malley, Mia Hughes and Dr Bret Alderman — sit down to take stock. The 2025 year-in-review episode moves through the headline events: executive orders from the new Trump administration, a significant report from the US Department of Health and Human Services, a landmark UK Supreme Court ruling on the legal definition of sex and the launch of a formal clinical trial of puberty blockers in the United Kingdom. In the United States, executive orders issued shortly after Donald Trump's return to the presidency directed federal agencies to recognise only two biological sexes and to curtail gender-related medical interventions for minors in federally funded programmes. An accompanying report from the Department of Health and Human Services concluded that the evidence base for paediatric gender medicine is weak and that systematic reviews do not support confident claims of benefit. The hosts weigh what those documents actually say — and note that similar evidence-based critiques had already been arriving from European clinical reviews. The For Women Scotland ruling, handed down by the UK Supreme Court in 2025, confirmed that the word "woman" in British equality legislation refers to biological sex, not certificated gender. For Ireland, the implications are notable. The Gender Recognition Act 2015 allows individuals to obtain a gender recognition certificate through statutory self-declaration with no medical requirement, and Irish law does not share the same statutory definition tested in Scotland. The ruling has renewed domestic debate about where Irish law stands on sex-based rights, particularly in single-sex spaces and publicly funded services. The launch of a randomised controlled trial of puberty blockers in the United Kingdom — a direct consequence of the Cass Review's 2024 recommendation that clinical evidence be gathered rigorously rather than assumed — represents a significant turning point. Ireland's child gender service, currently operating through Linn Dara CAMHS and transitioning to a new National Gender Service model, has historically tracked NHS guidance closely. The HSE paused puberty-blocker prescribing for new patients in the wake of the Cass Review; the UK trial will now determine whether the evidence needed to justify resuming that practice can actually be produced. Against this backdrop of European and American reappraisal, the hosts examine Canada, which has moved in the opposite direction, continuing to expand access to gender-related treatments and resisting calls for independent clinical review. The contrast is instructive for Irish policymakers watching how jurisdictions that embedded gender-identity ideology most firmly into healthcare guidelines are now finding it hardest to change course — a pattern with direct relevance as Ireland develops its own national model of care. Looking to 2026, the hosts address what the episode calls repsychopathologization — the growing professional argument that gender dysphoria, particularly in adolescents with complex mental-health presentations, requires psychological understanding rather than fast-tracked medical intervention. For Ireland, where waiting lists for gender services remain long and the therapeutic infrastructure is under-resourced, this is not merely an ideological question. The evidence gathered in 2025 makes the case that assessment, talk therapy and time are not obstacles to good care — they are the foundation of it.
