Rethinking Youth Gender Medicine with Dr Louise Irvine
18 June 2026
With Dr Louise Irvine
UK
Dr Louise Irvine, a UK GP and Co-Chair of the Clinical Advisory Network on Sex and Gender (CAN-SG), joins the podcast to examine what went wrong in youth gender medicine — and what evidence-based care should look like. From the WellBN clinic investigation to NHS institutional capture and puberty blocker research gaps, the episode maps the clinical failures now being reckoned with in the UK and increasingly relevant to how Ireland is developing its own gender services.
Dr Louise Irvine brings a clinical perspective that is increasingly rare in discussions about youth gender medicine: that of a practising GP who has worked in training other doctors and who asks basic questions about evidence and ethics. As Co-Chair of the Clinical Advisory Network on Sex and Gender, she has been at the centre of efforts to bring medical caution back into a field that, as this episode documents, moved far ahead of the science. The conversation with Stella O'Malley, Mia Hughes and Dr Bret Alderman covers the upcoming CAN-SG conference in London, the recent WellBN clinic investigation, and the broader question of how health institutions came to adopt a model of care that has since come under severe scrutiny. The CAN-SG conference, titled "Rethinking Youth Gender Medicine," is designed to address the full range of issues: aetiology — that is, why young people are presenting with gender distress in the first place — as well as the evidence base for medical interventions, ethical frameworks, and what clinical practice should actually look like. The fact that such a conference needs to be organised at all is itself telling. For years, questioning the standard pathway — social affirmation, then puberty blockers, then cross-sex hormones — was treated within medical circles as ethically suspect rather than scientifically necessary. The WellBN clinic, a private UK gender service, features prominently in the episode. An investigation into its practices is part of a wider reckoning with how private providers filled the gap left when NHS waiting lists for the Gender Identity Development Service became unmanageable. That combination — lengthy public waits, eager private providers and a strong ideological consensus — created conditions in which safeguarding was systematically deprioritised. Dr Irvine describes how institutional capture, rather than individual bad actors, is the more accurate account of what happened within the NHS and the wider clinical landscape. The episode also addresses the puberty blocker trial that the NHS launched in the wake of the Cass Review, and what genuine research into paediatric gender medicine would need to look like. The conversation covers data linkage — the long-term tracking of outcomes for young people who did and did not proceed with medical pathways — as a minimum requirement for any honest claim to evidence-based practice. The phrase "tooth fairy science," drawn from a talk by Helen Joyce referenced in the episode, captures what had previously been passing for research: studies that assumed the conclusion before the data were gathered. From an Irish perspective, these questions are not abstract. The HSE's gender identity services have been shaped by the same clinical culture that took hold in the NHS, and Ireland has produced nothing equivalent to the Cass Review. There is no public record of outcomes for the young people who have passed through Irish gender services, and the institutional pressures Dr Irvine describes — on clinicians to affirm, on researchers to stay quiet, on institutions to avoid scrutiny — did not stop at the Irish Sea. The evidence-driven analysis that CAN-SG is now working to establish in the UK is precisely the standard that Irish clinicians, policymakers and parents should be demanding here.
