Preamble
In the following article, Jaco van Zyl returns to review the contents of the recent Winter Issue of the Irish Journal of Counselling and Psychotherapy: LGBTQ+ Special Edition. In Part 1 he focused on an article on polyamory by Wickremasinghe (2024), in this second part, he subjects O’Dowd’s (2024) essay – ‘Providing therapeutic space to trans and non-binary clients’ – to a thorough critical analysis.
Introduction
Obviously it is both dangerous and difficult to be a spoil-sport or kill-joy… Now, whenever illusion is activated, Freud and Freudian psychoanalysis are characterized as ‘spoil-sports.’ They represent a flaw in the illusion and, as such, must be attacked, as must also all other manifestations of [reason]. In Fact, they are attacked… with a violence that is in direct proportion to the extent that they were previously felt to shore up the illusion.
(Chasseguet-Smirgel, 1986, p. 18)
Foundational to our understanding of psychological functioning and psychological suffering is the notion of conflict between what we desire and the realities we are faced with. From the earliest psychological writings—and vastly elaborated upon later—psychological suffering has been ascribed to mainly two processes: first, to the misalignment between wishes and unforgiving reality, creating frustration; and second, to maladaptive defences that either fail to adequately alleviate the frustration or further complicate matters by creating unforeseen ways of suffering.
An environment oriented toward attunement and reality integration is crucial to help the child with psychological development. Early in the child’s development, imagination and pretend play are used to explore and distinguish between what is imaginary and what is real. United in helping their children integrate the demands of reality, good-enough parents intuitively play along, knowing that the child can explore imagined outcomes, possible worlds, and ways of being while keeping the real world intact as something secure to return to. This interactive distinction between the magical world of imagination and the demands of the real world is crucial in achieving several psychological milestones, namely empathy, perspective-taking, and—very importantly—symbolic representation.
Symbolic representation is the ability to appreciate that one thing can stand for something else. That is the basis for using and understanding language and its range of nuance and metaphor. The same goes for emotional symbolisation. As the young child matures, they learn that things have emotional representation, and that emotional representation can be modified to align better with reality.
Failure to achieve symbolic representation results in a phenomenon where a maturing child or adult engages in symbolic equivalence, where they emotionally relate to something or someone as the thing-in-itself, without imaginary and symbolic distinction. This difficulty with reality integration can show up as strong emotional interference and resistance to reality adaptation. In severe cases, this impairment can significantly stifle daily functioning and healthy maturation.
Symbolic equivalence vs. symbolic representation is a significant symptom of the severe disorders of the self (borderline, schizoid, and narcissistic personality pathologies), post-traumatic stress disorder, and severe-level autism (rigid, literalistic symbolisation). People who function at the level of symbolic equivalence exhibit relational patterns that are heavily influenced by projective enactments. The extent of disruption in people’s personal, family, and occupational lives is proportional to the ubiquity of unthinking projective enactments as preferred defensive manoeuvres in response to frustrations with reality.
Responsible and ethical therapy of such individuals—minors in particular—includes a commitment to reality orientation, a patient endurance of their projective enactments in therapy, and the skilful facilitation of a therapeutic process in which experiences are elaborated and modified. The aim of these techniques is to help distressed patients to think about the way things are represented in their minds. Psychological distress is, in the most simple terms, an ailment of not-thinking. Learning to integrate reality and to modulate emotional interference with reality-relating is the basis for psychological health, relational success, and properly functioning societies.
With the above principles in mind, let’s turn to the second article I will subject to critical interrogation, from the Winter edition of the Irish Journal of Counselling and Psychotherapy (O’Dowd, 2024)
Framing and arguments
The author introduces her article by reflecting on her own history working with “trans clients.” She describes herself as “cisgender” and bemoans her own and others’ “cissexism,” defined as the notion that “cisgender identities, expressions, and embodiments are more natural and legitimate than those of trans people” (p. 21). She declares that all gender identities are “normal,” and claims that there have always been “transgender and gender-diverse people within humanity.” To support her unquestioning (and unthinking) approach to gender identity issues, she includes the experience of a trans-identified adult male who transitioned while in fourth class (approximately 9–10 years old!). She uses her experience with this client as the basis to declare that being trans is “joyful and liberating[,]” amidst a culture and environment full of disinformation, misinformation, discrimination, and hostility.
The only piece of nuanced, clinical consideration in this introduction—despite ideological jargon and concepts—is in this paragraph:
“Early experiences around gender may have developmental and traumatic impacts. These may be intertwined and connected with elements unconnected to gender. Clients who are trans or gender-diverse often present with life issues unrelated to their gender, just as cisgender clients do” (p. 22).
From just these early paragraphs, we detect the author’s own unquestioned, implicit beliefs around transgender issues: trans-identifying people are seen as a gender-type “species,” whose transgenderism ought to be treated with unquestioning acceptance as a natural variation of health[.] Failure to do so amounts to “cissexism,” which contributes to the unnecessary suffering of people “who feel that the gender in which they were registered at birth is not congruent with their own sense of self” (p. 22). The frame for the rest of the article is therefore set, and clear lines are drawn between what type of interrogation is permitted and what taboos are relegated to the realm of not-thinking. With this introduction, she clearly maps the territory of her article using ideology-specific jargon, moralising permissions and taboos, and a rhetorical strategy that frames the current issues around the transgender phenomenon within the paranoid oppressor/oppressed binary split. This she does while simultaneously urging others “to be open and not make assumptions,” or to avoid “binary thinking” (p. 22).
The article continues, mentioning how societal, institutional, and relational acceptance of trans and gender-diverse identities has improved over the past number of years, a claim supported by several surveys. But what follows is a slew of criticisms based on perceptual distortions that contradict any appreciation for the freedoms transgender people have enjoyed in Western society. In fact, criticism and gratitude—the psychologically more mature, ambivalent position—cannot co-exist in a world of binary splits. Resorting to the paranoid binary between a suffering, helpless, and innocent victim class (trans and gender-diverse people) and a cruel and hostile oppressor class (evil Western society), the author makes several points that deserve much-needed scrutiny. I will list some of her most emphatic claims and test these against reality—hostility to which lies at the core of trans ideology and activism.
The author first explores the “barriers to and inadequacy of healthcare” in Ireland, where “[y]oung people and adults are deprived of medical interventions that would support them living in their authentic gender identity” (p. 22). She quotes the vision of an Irish-based trans activist group, Trans Health Care Action, to bolster her attack on the Cass Review and on organisations committed to a strictly evidence-based approach to addressing the needs of trans-identified young people and adults. With the certainty of a true believer, she states that “the [Cass Review] has been subject to criticism and rejection internationally, including in a study by Irish experts (Noone et al., 2024), and by Yale Law and Medical Schools” (p. 23). Criticism and rejection by some (notably ideologically committed activist-academics in Ireland and the US) are vastly overstated with cocksure certainty to achieve a specific effect.
She then does something that is unacceptable in professional discourse: the author resorts to libellous character assassination of people she disagrees with:
“Groups such as SEGM, consulted by the Cass Review, and Genspect—both categorised by the Southern Poverty Law Centre as ‘hate groups’ for their anti-trans stances—advocate that no medical treatment should be available to transgender people until age 25” (p. 23).
Later in the article, she names Stella O’Malley as the founder of Genspect. She resumes with more thought-terminating paranoia in her oppressor/oppressed binary:
“Trans people, and family members, who may also be our clients, fear existing and even further restrictions on trans healthcare, leading to very considerable anxiety, frustration and dread” (p. 24).
Using research that admits “[the change to the ICD-11 classification of transgenderism under mental and behavioural disorders] represents the culmination of decades of activism and follows several political human rights stances” (Beleige et al., 2022)—including the infamous Yogyakarta Principles—she frames her next attack on two diagnoses that pose a serious challenge to her ideology. These diagnoses reflect the sudden increase in declarations of trans-identification (particularly among adolescent girls) and the highly eroticised trans-identification among some men: namely Rapid-Onset Gender Dysphoria (ROGD) and autogynephilia, respectively.
The author argues that both ROGD and autogynephilia are “unsupported by research or evidence, rejected by experts, and potentially damaging to transgender clients” (p. 24). She lists the APA, WPATH, the American Psychiatric Association, and “59 other medical organisations” that reject the “theory of ROGD… created by Lisa Littman” and refers to a study in the Journal of Pediatrics “that found no evidence for ROGD’s existence.”
According to the author, autogynephilia is another “controversial” diagnosis “developed by Dr Ray Blanchard, who chaired the working group for DSMV [sic].” Even though WPATH (ironically, in whose Standards of Care ‘eunuch’ made it as a gender identity) argued against its inclusion, she states that it nevertheless was. Continuing the catastrophe fabrication along oppressor/oppressed binaries, she states that AGP is merely used “as an insult to trans women on social media, and as a reason why they should be excluded and marginalised,” subjected to “extremely negative and violent attitudes… while believing the ‘diagnosis’ to be credible” (p. 24).
Her final points include the old trope many distressed and worried parents have had to endure for years, until it was finally exposed as the most abusive and alienating form of manipulation, captured in the maxim, Would you rather have a live son or a dead daughter? (Hart, 2016). The author details the “high rate of suicidal ideation and attempts by trans and gender-diverse people, significantly higher than among cisgender peers.” She warns against minimising the risk of suicide and offers the only possible mitigation: “family support or an affirming school,” as opposed to the doubling of suicide risk “when family rejection is experienced” (p. 25).
Lastly, O’Dowd focuses on conversion therapy, “the term for therapy that assumes certain sexual orientations or gender identities are inferior to others, and seeks to change them on that basis,” as defined in the Irish Memorandum of Understanding on Conversion Therapy (College of Psychiatrists of Ireland et al., 2024). She acknowledges that some prefer to exclude gender identity from conversion therapy protections but then appeals to authority by stating how “the MOU from the three largest psychological health organisations in Ireland powerfully contradicts this view.”
Amidst more alarmist language, more thought-terminating threats, more paranoid binaries of oppressors and victims, and more cherry-picking of activist positions as authoritative research, she concludes with what has become contemporary neotherapy:
“Our role is to support our clients to flourish and to maintain and increase their well-being. Whatever our own gender identity, by challenging our own absorbed cissexism, being accurately informed and providing an empathic and affirming therapeutic space, we can best serve transgender and gender-diverse people and their families” (p. 26).
How does this trans-promotional piece measure up to reality? Let’s see.
At war with reality
As with the previous article in which I critique the proposal that polyamory is psychologically healthy and harmless to children and communities, there is hardly anything of psychological value in this article. It reads as a trans apologetics piece, where the only hint of nuance is the brief admission of the growing acceptance of trans and gender-diverse identities. It thereafter quickly devolves into an unthinking fantasy piece of paranoid binaries, libellous slander and blatant exaggerations, complete with activist jargon.
Thought-terminating jargon
Throughout this article, it is unclear what the author means by referring to “gender.” As with most rapidly mutating memes, “gender” has become a fuzzball term, used interchangeably with gender expression, gender identification, and gender identity. One would expect this to be the case in unmonitored non-specialist discourse, but hardly in an academic article. It has become commonplace to hear that sex is the biology with which you were born, while gender is the semiotics of sex: language, behaviour, images, etc. signifying which sex you are. In a piece discussing therapy with “transgender and non-binary clients,” it is rather odd that there is no psychological interrogation of the phenomenon that some people’s sense of self is incongruent with their birth sex, and a source of deep distress. For example, identification is a psychological process all healthy individuals engage with spontaneously. The target of our identifications can be a pet, a story character, a parent, and someone of either sex. Temperament, personality, and various interests influence a person’s identification preferences and gender expression. None of these processes are necessarily distressing. It becomes psychologically significant when a child disavows their sexed body and disidentifies with their sex (whatever that means to the child) as part of their sense of self. Such disavowal ought to be explored and understood (See Van Zyl, 2024; Evans & Evans, 2023). It is on record that such exploration leads to improved symbol formation, and in the majority of cases, to the resolution of gender distress (Drummond et al., 2008; Singh et al., 2021; Steensma et al., 2013).
Rather, with non-negotiable and thought-terminating certainty, the author emphasises that transgenderism is “as ‘normal’ as cisgender identity or expression” (p. 21), “healthy, normal and to be celebrated” (p. 24) and to live as their “authentic” selves and gender identities (pp. 21, 22). No interrogation, no critical reflection, or curiosity about these statements. Because in a world of ideological taboos, interrogation is considered anathema.
Ideology dictates permissible “evidence”
When fantasy gets elevated to the status of overvalued ideas, reality is engaged with in predictable ways: promote what resonates with the fantasy and repudiate what contradicts it. Uncompelling criticism from obscure activist sources would be more than enough to the True Believer to keep the overvalued idea securely intact. Contrary to her overstated claims about the Cass Review, criticism per se does not disprove or debunk a study, especially not the best, most elaborate investigation ever to be done on gender medicine (Cass, 2024). The Yale Report, which O’Dowd is quoting from, is a non-peer-reviewed patchwork which has come under severe criticism for its misrepresentations and inaccurate claims (see excellent critiques here, here and here). Appreciating the danger of such activist critiques posing as serious scholarship, McDeavitt, Cohn and Levine (2025) fact-checked the Yale Report and found it to be “inaccurate, [lacking] essential clarification/ contextualization. This finding should alert clinicians, academics, parents, and patients to appraise these papers with considerable caution, a practice which should also be applied to appraisals of existing and future papers published in this field.”
Apparently our author is loath to come close to such damning critiques of her activist-scholars’ work, let alone seriously investigate these. She would much rather leave the impression that the Cass Review has been completely discredited by everyone. Reality is, however that it is in line with, and an improvement on both the Finnish and Swedish treatment guidelines which also take a very cautious approach to medicalisation, and recommend psychosocial interventions as preferred treatment. The findings of the Cass review were also independently confirmed by two systematic reviews and meta-analyses from Canada, showing the lack of “certainty of the evidence about the effects of puberty blockers [and gender affirming hormone therapy] in individuals experiencing GD” (Miroshnychenko, et al., 2025a & 20205b). Furthermore, there has been a wide endorsement of the Cass Review, including the UK’s Labour Party, currently in power, UK’s Royal College of Psychiatrists, Association of Clinical Psychologists UK, GIDS psychiatrist David Bell, the UK’s Royal College of GPs, Equality and Human Rights Commission, the European Society of Child and Adolescent Psychiatry, and others. In fact, the recommended exploratory position, as opposed to the affirmative, has been adopted in various countries, including Chile, Denmark, Norway, New Zealand, and recently, the United States.
In addition to the highly dubious relationship with reality, those who aggressively defend overvalued ideas oftentimes resort to character savaging and demonisation. We are emerging from a period when trans activists and allies have taken the lead in terrorising and cancelling campaigns. Doctrine above all, to those who are ideologically committed, and heretics be damned. In a stunning display of this mindset, O’Dowd resorts to libellous slander as a means to discredit those who disagree with her: She depicts SEGM (Society for Evidence-based Gender Medicine), Genspect and Genspect’s founder, Stella O’Malley, as hate groups. These two organisations are fully aligned with the Cass Review as well as other reputable guidelines, such as the mentioned Finnish and Swedish guidelines. Stella O’Malley was herself gender dysphoric (GD) as an adolescent, she is a published author and expert on GD and has published several peer reviewed journal articles. This character assassination of the said organisations and individual is one of the most malicious I have seen over the past several years. This tactic has become a favourite modus operandi that radical trans-activists resort to – and get away with – while simultaneously pretending to be victims. Vicious cry-bullies for victims, perhaps. We recall how Ken Zucker was hounded out of his Centre for Addiction and Mental Health in Toronto years ago. More recently, Kathleen Stock was forced out of her teaching position at the University of Essex, for holding trans-critical views. Dishonourably, the IACP and the editors of the IJCP seem to possess the same instinctive proclivities.
Coerce, if necessary
Those of us who work with gender-dysphoric young people and their families, know the worry and panic these parents have for their children. By the time their child makes their declaration of a trans-identity, they have been secretly enduring psychological distress for a significant period, and have been thoroughly groomed online, including scripted explanations and suspicion about their parents and loved ones. The pain in parents’ voices and on their faces reminds me of the early stages of the Covid-19 pandemic when loved ones found out that they tested positive for the infection. This psychogenic epidemic calls for very difficult manoeuvring, and there is no guarantee that one’s child will survive with their mental and physical health intact, let alone their loving relationships and identity.
There is therefore hardly anything more devious and reproachable than to paralyse parents and strip them of all their protective armour, than to scare them with suicide. This has been a favourite tactic of online groomers, activists and gender-identity practitioners in the mental health space. The tactic is to coax disorientated parents into yielding all their protective defences, and to surrender their distressed child to strangers ready to fast-track them through invasive surgical and medical procedures associated with severe health risks (Domini et al., 2024).
The truth is, however, that transitioning does not necessarily reduce suicidality (Ruuska et al., 2024), and both Cass and Prof. Louis Appleby have warned against using suicide as “a slogan or a means to winning an argument,” as doing so is “insensitive, distressing and dangerous, and goes against guidance on safe reporting of suicide” (Appleby, 2024). It boggles the mind how this article passed scrutiny and got published, based on this clear directive alone.
Disavowal of social contagion
After years of activist pressure, unchecked influence and performative self-examination, it comes as no surprise that the largest, most influential and politically connected organisations would protest any threat to their transgender doctrine. One such threat is the phenomenon of Rapid-Onset Gender Dysphoria, coined by Dr. Lisa Littman. What O’Dowd does not seem to know – or if she did, preferred not to include it in her apologetics piece – is the research by Diaz and Bailey (2023), pointing to further 1 655 possible cases of ROGD. As with the Littman (2018) study which suggests a socially contagious syndrome, the affected youths were disproportionately female (75%), many of whom had pre-existing mental health issues, and were more likely to socially and medically transition. A majority reported having friends contemporaneously coming out as transgender and the psychological deterioration, as opposed to improvement in majority of cases, following social transitioning.
The controversy around ROGD paints a bleak picture of the state of young people’s mental health in general, and the immense suffering of ROGD teens in particular, which is vastly different from the rose-coloured glasses of it being “joyful and liberation,” or “a celebration of their authentic gender.” It is also an indictment of the said organisations, as they have failed to recognise the social scourge upon our young people, while other clinicians have. Dr David Bell and his concerned colleagues at the GIDS in England who raised the alarm regarding the spike in referrals for gender dysphoria treatment, observed trends in their patient cohort strikingly similar to Littman, Diaz and Bailey’s observations. The classical hockey-stick graph included in the Cass Review captures the sudden large-scale rate of trans identification in their patient referrals, characteristic of social contagion.
Not only the clinicians in the UK, but also the Finnish clinicians observed this trend. In 2015 Rittakerttu Kaltiala-Heino and colleagues published a paper noting the “increasing numbers of adolescents present in adolescent gender identity services, desiring sex reassignment.” They highlighted “the number of referrals [exceeding] expectations in light of epidemiological knowledge. Natal girls were markedly overrepresented among applicants. Severe psychopathology preceding onset of gender dysphoria was common” (Kaltiala-Heino, 2015). This rapid increase in gender dysphoria among distressed young people was observed elsewhere in the world, with the same characteristics described in the Littman and Diaz and Bailey studies. O’Dowd and the ideologically-committed organisations she references can repudiate the ROGD diagnosis all they like – it’s a diagnosis that has written itself.
Similarly, despite the protestations of WPATH and other LGBTQ+ activist groups, the evidence in support of autogynephilia as a specifier to transvestic fetishism was strong enough to be included in the DSM-5. Blanchard was not the first clinician to observe and describe what is today broadly called autogynephilia. In reality, autogynephilia was observed and described as early as the late 19th and early 20th centuries by German physician Magnus Hirschfeld (1868-1935), who coined the term transvestism in 1910. Sexologist Havelock Ellis (1859 – 1939) also described this phenomenon and called it eonism or sexo-aesthetic inversion in describing autogynephilia. Other clinicians of the past who alluded to or elaborated on autogynephilia include Otto Fenichel, Kurt Freund and colleagues, and H. Taylor Buckner (Blanchard, 2005). Autogynephilia was included in the DSM-IV-TR as an erotic feature of both gender identity disorder and transvestic fetishism and made it as a specifier in the DSM-5 to transvestic fetishism.
Therefore, other than the impression this author is trying to create about Rapid-Onset Gender Dysphoria and autogynephilia, in reality, the former is a widely observed phenomenon that has the characteristics of a psychogenic epidemic; the latter is a well-described phenomenon with a deep history.
What should strike the reader as ironic in the above polemic, is O’Dowd’s selective, yet totalising appeals to authority. She stacks her disputation of ROGD by appealing to the American Psychiatric Association, the APA and WPATH, but disavows the authority of the American Psychiatric Association and APA in their inclusion of autogynephilia as a specifier in the DSM-5. With the latter, she prefers the diagnostic criticism of autogynephilia and ROGD by WPATH, but the same discredited and unethical WPATH (Hughes, 2024) O’Dowd is holding in such high regard, have dubiously included eunuch as a gender identity in their recent SOC-8, and have removed all age-restrictions for even the most invasive medical interventions on minors as well as the disturbing revelation that these changes came about due to political overreach by former Health Secretary, Adm. Rachel Levine, a trans-identified man himself. Such preference-based cherry-picking does not belong in academic journals demanding the respect of their readers.
Memorandum of misunderstanding
The CTA has been a vocal critic of the Irish Memorandum of Understanding on Conversion Therapy (see here and here). The document is an embarrassing hodgepodge of incoherencies based on dubious activist-type “research,” moral panic, idea laundering and concept creep, reckless safeguarding failure, and dogmatic moralisations. The unwarranted expansion of “conversion therapy” to go beyond sexual orientation demonstrates the extent to which ideologues are prepared to deceive and leverage social sensitivities to push their agenda. This MoU is practically inoperable, and fails to acknowledge
- the differences between sexual orientation and gender dysphoria,
- differences in presentation between the sexes and age groups,
- a developmental understanding of identity formation,
- the troubling presence of erotic aspects in trans-identification,
- social and pornographic influence on these presentations,
- and distinct treatment outcomes of patients who may be struggling with sexual orientation conflicts and gender dysphoria.
The MoU does concede to exploratory psychotherapy, which is a softer stance than what most activist gender-identity practitioners would prefer. The author has endorsed this MoU with its concession to exploratory therapy, and yet, she demonises the very organisations and individuals who have always promoted an exploratory-type approach to addressing gender distress. Supporting a document while condemning those who enact what it permits, belies a pretence of even-handedness so ubiquitous among those who lack reflexive capacity in their uncritical stance of doctrinal certainty.
Concluding remarks
Returning to the fundamentals of psychological health and well-being—as individuals, families, and societies—what is crucial to our survival is gaining mastery over external realities. Ideology can lull us into a slumber or a sense of omnipotence, seducing us into believing that we can cheat reality. Sadly, the anti-civilisationist theories of Critical Social Justice—particularly gender ideology and queer theory—have done exactly that. They have developed into an elaborate system of pseudo-logical and pseudo-scientific tenets that have captured the minds of those whose own psychologies resonate most with gender ideology’s psychological infrastructure.
The psychology underlying this ideology is essentially envious: if one condition has the privilege of being declared “normal,” then every other condition must also be declared normal. Or, if objective truth enjoys greater epistemological weight than personal preference, then we must find a way to delegitimise objective truth, declare it “socially constructed,” and demote it to the same status as personal preference. This same psychology carries a paranoid militancy, destroying anything—even the welfare of children—that threatens to deprive the ideologue of unmediated gratification. It comes as no surprise, then, that the characteristics of this psychological profile mirror those found in severe personality pathology.
Because external reality potentially threatens a person’s unchallenged claims to truth, it is experienced as hostile. In this state, what is healthy is trashed as worthless; what is demonstrably harmful is inverted as glorious; and whoever stands in opposition to this distortion is attacked and targeted for destruction (Chasseguet-Smirgel, 1986). This article on the transing of children demonstrates the extreme lengths to which some are willing to go to twist reality into the mould of their desires. Instead of helping individuals recognise how emotional distress is displaced and projected onto their sexed bodies (a well-known manifestation of symbolic equivalence), these gender practitioners collude with and fortify these destructive defences, foreclosing symbolic elaboration. Rather than supporting young people in elaborating their experiences and modifying their symbolic representations, they join them in manipulating their physicality, their households, their schools, and friendships—all to commit to a lie. The necessary confrontation with reality is merely postponed, and the “solutions” they propose plant the seeds of catastrophic collapse in the years to come.
Of all the things they could possibly declare war against, militant gender ideologues have chosen reality as their enemy. And of all people they could conscript as foot soldiers and human shields in their perverse war, they have chosen children. In 10 or 15 years from now, we will see women in their 30s with mastectomy scars, aged like 50-year-old males, some on crutches or in wheelchairs due to the effects of puberty blockers, still sounding like adolescent boys. We will recall this horrific period when mass delusion captured the mental faculties of adolescent girls and boys, their teachers, and—most alarmingly—their therapists.
We will remember those who were vilified, like this article has done, cancelled and hounded like animals for helping children reckon with reality. We will remember the gaslighting, the collusion, the deceptive use of language, and the perverse greed disguised as “compassion.” We will mourn the victims who were deceived by activists and organisations like WPATH and the Endocrine Society. And we will remember—with horror—the therapists, physicians, psychological organisations, and journals that celebrated what may well become recognised as the greatest, most heinous medical scandal in human history.
References
Appleby, L. (2024). Review of suicides and gender dysphoria at the Tavistock and Portman NHS Foundation Trust: independent report. https://www.gov.uk/government/publications/review-of-suicides-and-gender-dysphoria-at-the-tavistock-and-portman-nhs-foundation-trust/review-of-suicides-and-gender-dysphoria-at-the-tavistock-and-portman-nhs-foundation-trust-independent-report.
Baleige, A., de la Chenelière, M., Dassonneville, C., & Martin, M. J. (2022). Following ICD-11, Rebuilding Mental Health Care for Transgender Persons: Leads from Field Experimentations in Lille, France. Transgender health, 7(1), 1–6. https://doi.org/10.1089/trgh.2020.0143.
Blanchard, R (2005). Early History of the Concept of Autogynephilia. Archives of Sexual Behaviour, 34, 439–446. https://doi.org/10.1007/s10508-005-4343-8
Cass, H. (2024, April). Independent review of gender identity services for children and young people. https://cass.independent-review.uk/home/publications/final-report/.
College of Psychiatrists of Ireland, Psychological Society of Ireland, & Irish Association for Counselling and Psychotherapy. (2024, July 12). Memorandum of Understanding on Conversion Therapy on the Island of Ireland. https://iacp.ie/page/art/1019/0.
Domini, M., Scatigno, A. L., Pasquali, M. F., Bergante, C., Gariboldi, F., & Gardella, B. (2024). Pelvic floor and sexual dysfuctions after genital gender-affirming surgery: a systematic review and meta-analysis. Journal of Sexual Medicine. DOI:10.1093/jsxmed/qdae146.
Drummond, K. D., Bradley, S. J., Peterson-Badali, M. & Zucker, K. J. (2008). A follow-up study of girls with gender identity disorder. Developmental Psychology, 44(1), 34 – 35.
Evans, S., & Evans, M. (2023). Gender Dysphoria. A Therapeutic Model for Working with Children, Adolescents and Young Adults. Phoenix Publishing House.
Hart, A. (2016, February 28). Did we want a living son or a dead daughter. Irish Independent. Retrieved May 2, 2025, from https://www.independent.ie/life/family/did-we-want-a-living-son-or-dead-daughter/34486569.html.
Hughes, M. (2024). The WPATH files. Pseudoscientific surgical and hormonal experiments on children, adolescents, and vulnerable adults. Environmental Progress. https://environmentalprogress.org/big-news/wpath-files
Kaltiala-Heino, R., Sumia, M., Työläjärvi, M., & Lindberg, N. (2015). Two years of gender identity service for minors: overrepresentation of natal girls with severe problems in adolescent development. Child and adolescent psychiatry and mental health, 9(9). https://doi.org/10.1186/s13034-015-0042-y.
Littman, L. (2018). Parent reports of adolescents and young adults perceived to show signs of a rapid onset of gender dysphoria. PLoS ONE 13(8): e0202330. https://doi.org/10.1371/journal.pone.0202330.
Miroshnychenko A., Ibrahim, S., Roldan, Y., Kulatunga-Moruzi, C., Monante, S., Couban, R., Guyatt, G., Brignardello-Petersen, R. (2025a). Puberty blockers for gender dysphoria in youth: A systematic review and meta-analysis. Archives of Disease in Childhood, 110. 429-436. https://doi.org/10.1136/archdischild-2024-327909.
Miroshnychenko A., Ibrahim, S., Roldan, Y., Kulatunga-Moruzi, C., Monante, S., Couban, R., Guyatt, G., Brignardello-Petersen, R. (2025b). Gender affirming hormone therapy for individuals with gender dysphoria aged <26 years: a systematic review and meta-analysis. Archives of Disease in Childhood, 110. 437-445. https://doi.org/10.1136/archdischild-2024-327921.O’Dowd, L. (2024). Providing therapeutic space to transgender and non-binary clients. The Irish Journal of Counselling and Psychotherapy, 24(4), pp. 21 – 27.
Ruuska, S. M., Tuisku, K., Holttinen, T., & Kaltiala, R. (2024). All-cause and suicide mortalities among adolescents and young adults who contacted specialised gender identity services in Finland in 1996-2019: a register study. BMJ Mental Health, 27(1), e300940. https://doi.org/10.1136/bmjment-2023-300940.
Singh, D., Bradley, S., & Zucker, K. (2021). A follow-up study of boys with gender identity disorder. Frontiers of Psychiatry.
Steensma, T. D., McGuire, J. K., Kreukels, B. P. C., Beekman, A. J., & Cohen-Kettenis, P. T. (2013). Factors associated with desistence and persistence of childhood gender dysphoria: a quantitative follow-up study. Journal of Academic Child Adolescent Psychiatry, 52(6), 582 – 590.
Van Zyl, J. (2024). Formulating gender dysphoria as an affective-perceptual disturbance involving the body. Psychodynamic Practice, 1–17. https://doi.org/10.1080/14753634.2024.2371655.
Wickremasinghe, D. (2024). Boundless love: Overcoming shame in polyamory. The Irish Journal of Counselling and Psychotherapy, 24(4), pp. 10 – 14.
By Jaco van Zyl, MA (Clinical Psychology), a South Africa-trained clinical psychologist and psychoanalytic psychotherapist in Ireland. Informed by the historical and contemporary political challenges of his home country, Jaco uses a psychoanalytic lens to explore the psychology of groups, the function of ideology, and of adopted narratives and rituals within political and ideological movements. He is a co-director of Critical Therapy Antidote, a co-host of the CTA podcast, and has written articles for Merion West, Critical Therapy Antidote, Genspect and the Journal for Psychodynamic Psychotherapy.
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