An Interview with Marcus Evans: the Gender Crisis – a Psychodynamic Approach

On July 28, 2022 – between this episode’s recording on June 13, and its release on September 5 – the Tavistock GIDS center was ordered to close by Spring 2023. This news came in the wake of the findings of the Cass Review, in which Dr. Hilary Cass systematically evaluated the clinic’s treatment protocols and found them unsafe. Marcus and Susan are part of the reason that Dr. Cass began her review.

In this conversation, Marcus and I discuss the Tavistock’s long history of ignoring these alarms that have finally reached a turning point. We discuss appropriate, evidence-based, non-invasive approaches to treating gender-related distress, and how these compare with the politicized, experimental, invasive, practices that have become the norm. Marcus expresses his concerns about crucial lacks: of checks and balances, follow-up, honest conversations about suicide risk, and data on long-term outcomes. And we explore concepts from psychodynamic theory, such as the role that projective identification and the splitting off of cognitive dissonance play in power struggles between adolescents and the adults who care for them.

Marcus Evans is a British psychoanalyst, author, and one of the first whistleblowers at the Tavistock GIDS clinic. Before retiring from the NHS, he was first a psychiatric nurse and then an adult psychotherapist in the NHS for 40 years. Marcus has a particular interest in the application of psychoanalytic thinking in mental health settings. He was a founding member of the Fitzjohn’s service for the treatment of patients with severe and enduring mental health issues and personality disorders, and a clinical lead in the adult and adolescent services for five years. He is the author of three books: Making Room for Madness in Mental Health;Psychoanalytic Thinking in Mental Health Settings; and Gender Dysphoria: A Therapeutic Model for Working with Children, Adolescents and Young Adults, which he wrote in conjunction with his wife Susan Evans.

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