The Truth Gender Clinicians Tried to Ignore - Dr Susan Bradley (#43)
16 October 2025
With Dr Susan Bradley
North America
Dr Susan Bradley co-founded Canada's first paediatric gender clinic in 1975 and treated more than four hundred children over five decades. She now says the clinical model she helped build caused serious harm. Her evidence — that most gender-dysphoric children desisted and grew up gay or lesbian, that puberty blockers are not reversible, and that dissenting clinicians were professionally destroyed — has direct implications for Ireland, where the HSE gender pathway developed within the same international framework and where conversion therapy legislation now shapes what clinicians are permitted to do.
Dr Susan Bradley co-founded the first paediatric gender clinic in Toronto in 1975 and later chaired the DSM-IV committee on gender-related conditions. Over nearly five decades she treated more than four hundred gender-dysphoric children. That history makes her not a fringe voice but one of the founding architects of the clinical model that spread internationally — including to Ireland, where the HSE's gender services developed within a framework shaped by protocols with roots in that same North American tradition. Bradley's long-term observations contradicted the direction the field eventually took. Among children who came through her clinic without medical intervention, the great majority grew up to identify as gay or lesbian rather than as transgender. She describes one patient, referred to as Frankie, who arrived at age nine convinced he wanted to be a girl and who later told her simply: he was gay. What resolved it was not clinical technique but belonging — finding a community and someone who loved him. Bradley argues this pattern was not exceptional but representative, and that it was being deliberately set aside as the field moved toward earlier and more extensive medicalisation. On puberty blockers, her position is direct: she does not believe they are reversible. The Dutch clinic and endocrinologists presented the treatment as a pause when it was introduced internationally, but the outcomes do not support that framing. Once children begin blockers, close to ninety per cent proceed to cross-sex hormones. Ireland's own gender pathway — shaped, like services across the English-speaking world, by the Dutch Protocol — faces the same question Bradley poses: whether a treatment described as a cautious holding measure was functioning in practice as a medical conveyor belt toward permanent intervention. The silencing of dissenting clinicians is central to Bradley's account. In 2015, her colleague Ken Zucker was dismissed from the Centre for Addiction and Mental Health in Toronto after activist groups accused his clinic of practising conversion therapy. The accusation was later found to be without foundation, and CAMH eventually apologised and paid Zucker $586,000 in settlement. Ireland has since enacted its own legislation in this area, and the boundary between watchful waiting — which Bradley considers sound clinical care — and what the law designates as prohibited practice remains a live question for Irish therapists, psychiatrists, and GPs working with gender-dysphoric young people. Two further observations from Bradley's clinical work carry particular weight. Research shows that trans-identified adults are three to six times more likely to be autistic than the general population, a pattern she documented long before it appeared prominently in the literature. She also describes following one patient over forty years: a person who transitioned at eighteen in the late 1970s, married, and then — widowed at seventy — spent twenty thousand dollars on further surgery, still feeling that something was not right. For Irish clinicians, parents, and the HSE professionals who manage referral decisions, these are the long-term outcomes that informed consent conversations must address.
