Why Anorexia is Just Like Gender Dysphoria...? A Conversation with Deanne Jade
30 July 2026
With Deanne Jade
UK
Psychologist Deanne Jade, founder of the National Centre for Eating Disorders and a member of Thoughtful Therapists, argues that anorexia and gender dysphoria share a clinical architecture: both involve overvalued beliefs about the body sustained by social reinforcement. The conversation is directly relevant to the Irish context, where HSE paediatric gender services remain under review, CAMHS teams encounter high rates of co-occurring autism in gender-referred young people, and clear assessment guidelines are absent. Jade's case for gradual, thorough assessment challenges the affirmation-only model that has shaped clinical practice in Ireland and elsewhere.
Deanne Jade is a psychologist and the founder of the National Centre for Eating Disorders, one of the most established specialist services of its kind in the UK. She is also a member of Thoughtful Therapists, a network of clinicians who advocate for careful, evidence-based practice when working with people presenting with gender distress. Her dual expertise places her in a distinctive position to examine how different conditions that centre on the body are understood, reinforced and treated. The central clinical argument Jade develops is that anorexia and gender dysphoria share a common architecture. Both involve an overvalued idea — a fixed belief about the body or the self that becomes progressively resistant to examination. Both can be sustained and intensified by social environments that validate the belief rather than interrogate it. And in both conditions, the person experiencing distress may attribute all of their suffering to one explanation while other factors — trauma, attachment difficulties, anxiety — remain unaddressed and untreated. The concept of monomania, or fixation, runs through Jade's analysis. When a person's identity and emotional life become entirely organised around a single explanatory framework, any clinical intervention that challenges that framework can feel threatening rather than therapeutic. Jade argues this dynamic is well recognised in eating-disorder practice, where patients routinely insist that weight and food are the only relevant concerns, and that it appears with comparable regularity in gender-distressed presentations. Understanding this parallel is important for any clinician attempting to engage meaningfully with either group. The episode also addresses the relationship between autism, ARFID and gender presentations — a connection with particular relevance to Ireland. CAMHS services across the country are seeing elevated rates of co-occurring autism among young people referred for gender concerns, and the capacity to carry out the kind of thorough, unhurried assessment that Jade describes remains constrained. Whether gender distress is primary, or whether it is one expression of broader developmental, sensory or social difficulties, is rarely a question that can be answered quickly or in isolation. Jade further examines how encouragement and the physical alteration of the body can function as reinforcing mechanisms in both conditions. In anorexia, visible weight loss can elicit responses from others that deepen the behaviour. In gender dysphoria, affirmation and, ultimately, medical intervention can similarly consolidate a framework before its foundations have been properly examined. The social dimensions — comparison, competition, a drive toward purity or control — are explored as features common to both presentations rather than as incidental to them. For those following developments in Irish gender medicine, this conversation provides a clinically grounded framework for understanding what thorough assessment actually requires. The HSE's paediatric gender service has been subject to ongoing review, and Ireland has yet to establish clear, evidence-based guidelines governing how presentations of gender dysphoria in minors should be assessed. Jade's position — that overvalued beliefs require patient and skilled challenge rather than immediate validation, and that the overlap with eating disorders and autism demands specialist knowledge — speaks directly to those unresolved questions.
