The Care Quality Commission investigation of the Tavistock Gender Identity Development Service (GIDS) and its subsequent closure provided a watershed moment in the bitter, ongoing fightback against gender identity ideology within UK healthcare. The importance of the closure of the Tavistock GIDS is equalled only by the recent UK Supreme Court clarification of the binary, biological nature of sex in applying the Equality Act 2010. Two recent articles by Mary MacCallum Sullivan and June Campbell from ScotPAG (2025) provide a useful and challenging approach to making sense of the harsh reality of this ideological capture and the subsequent moral collapse of key National Health Service (NHS) and other therapy institutions in our midst.
Mary MacCallum Sullivan focuses particularly on the damaging impact of Equality, Diversity and Inclusion on the new Partnership of Counselling and Psychotherapy Bodies (formerly SCOPED). The latter is a cross-professional framework introducing a new hierarchy for therapy training, skills and employment. June Campbell, a retired Psychoanalytic Psychotherapist, and formerly leading NHS clinician, reminds us of the valuable insights to be gained from a psychoanalytic perspective in analysing the seemingly unstoppable process of ideological capture. She usefully refers us back to the classic paper by Isabel Menzies Lyth (1960) on unconscious institutional defences against anxiety. Peter Jenkins responds here by looking at some of the key points to be made about psychoanalysis as a potential rallying point for the fightback against gender identity ideology.
CQC reports into Tavistock Gender Clinic
The phasing out of the GIDS was inevitable after the scathing Care Quality Commission (CQC) investigation report of 2021. The GIDS closure also coincided with the move post-Cass to provide regional, multi-disciplinary healthcare, with the emphasis on psychological rather than pharmacological interventions for gender dysphoric children. However, even the timing of the GIDS closure begs some unanswered questions about the role of the CQC report and about the general, systemic failure of regulatory organisations in general.
The CQC had previously investigated the GIDS in 2016, as part of an overall investigation of the broader Tavistock and Portman Clinic, which included adult gender services. The 2016 CQC Report had given the GIDS a glowing report at that time. However, nothing substantial had really changed in terms of internal GIDS operations or management between 2016 and 2021. If the GIDS was correctly deemed to be ‘inadequate’ in 2021, then presumably it had also been ‘inadequate’, if subject to the very same standards, back in 2016? The only real factor that was different was the shattering global impact in 2020 of the judicial review of the GIDS. This legal challenge by Keira Bell, a detransitioner, and others, had exposed a critical lack of compelling evidence for the GIDS’ overall gender affirmative approach. It had also revealed the GIDS’ cavalier application of the Gillick principle authorising children’s allegedly informed consent to non-reversible drugs. In reality, these drugs actually annihilated any prospect of children experiencing a normal puberty. It fast-forwarded them to the next phase of the gender transition escalator, namely cross-sex hormones.
Civil law and resistance to gender ideology
The impact of the Keira Bell judicial review in 2020 points towards a major theme in any attempt to understand the takeover of NHS and other major institutions. This is the crucial impact of the law as a set of external rules and rationality, which is capable of holding institutional capture to account. Gender identity ideology has been extremely successful since the turn of the century in subverting all major sectors of public life, and the private and commercial sectors to boot. However, it has signally failed to make significant inroads into subverting the main institutions of civil law, that is since its high-water mark of the widely misrepresented Gender Recognition Act 0f 2004.
Civil law rests on unshakeably binary foundations. Cases are heard on the basis of evidence and decided ‘on the balance of probabilities. The claim for the primacy of ‘lived experience’ has predictably found little support so far within the civil courts. The alleged absence of ‘lived experience’ will thus be unlikely to fire up a credible challenge to the UK Supreme Court judgment, if this is ever taken to the European Court of Human Rights in Strasbourg. Meanwhile, there has been a quietly growing tranche of successful cases in defence of the right to free speech on gender issues, following Forstater. These civil claims have shown that the claims of alleged transphobia and its apparently even more evil twin, hate crime, have failed to convince judges in an unprecedented 83% of cases brought in Employment Tribunals (Birchall & Phoenix, 2024).
Psychoanalysis and whistleblowing
At one level, psychoanalysis may have a lot to offer in terms of critiquing the crucial takeover of the GIDS, in terms of the latter’s apparently irrational focus on medical transition, and its ultimate closure. Again, the impact of legal process has been a major factor here, in the form of whistleblowing disclosures protected by law. As June Campbell points out, many of these were brought by concerned practitioners from a psychoanalytic background, including Sue Evans (psychoanalytic psychotherapist), Dr Az Hakeem, (psychoanalytic psychotherapist and group analyst), Marcus Evans (psychoanalyst), and Dr David Bell (psychoanalyst). To this auspicious list could also be added the successful whistleblowing case brought by Sonia Appleby, safeguarding lead at the GIDS and, in addition, a member of British Psychoanalytic Council.
At its core, psychoanalysis is geared to exploring the unknown, and possibly unconscious factors which may underpin those more consciously presented aspects of the client’s known experience. Psychoanalytic therapists may be more likely, by virtue of their training and orientation, to wish to explore these potentially influential aspects of the client’s experience. This may be their preferred therapeutic approach, rather than simply to adopt and affirm the client’s own self-diagnosis of an incongruent gender identity. Research does suggest that psychoanalytic therapists may be much less inclined than humanistic practitioners to automatically adopt a gender identity affirming approach towards their gender questioning clients (Mollitt, 2022). Recent psychoanalytic contributions have explored the value of working with unconscious factors in this respect (Van Zyl, 2024). The impressive DHHP (2025) overview of gender identity healthcare in the US provides further evidence of the proven value of psychoanalytic approaches in addressing client concerns about gender identity.
Limits to psychoanalysis as critique of the GIDS
However, the psychoanalytic approach towards organisational analysis perhaps has its own definite flaws and limitations, in terms of providing a complete analysis of the ideological takeover of the Tavistock. The collection of essays celebrating the Tavistock’s centenary carried nary a whisper of self-critique concerning the GIDS, which was ironically just about to be exposed and to fall heavily from grace (Waddell & Kraemer, 2020). The original niche, highly specialist model of gender identity medicine pioneered by Di Ceglie, had long been totally supplanted by the time this volume appeared, by another brasher and overly self -confident model, according to Hannah Barnes’ incisive account. So, despite their possession of the formidable models for organisational analysis available to the authors, the overall tone of contributions within the Tavistock centenary volume unfortunately remained one of self-congratulation, rather than of self-critique.
In addition, while psychoanalytic analysis make work well at the level of a given institution, it seems to have much less persuasive power when explaining ideological and policy capture at a macro- or societal level. Gender identity ideology has infected not just the Tavistock and Portman Clinics, both for adults and for children, but also the parent NHS Foundation, and even most sectors of the NHS itself, including NHS England and NHS Scotland. Given that it has radically infiltrated civil society by storm, it may be much more productive to now characterise gender identity ideology as a post-liberal, regressive political movement of a new type. To understand this new anti-scientific, anti-rationalist movement will also require a thorough-going political analysis, in addition to recognising the useful insights to be drawn from psychoanalysis
Time to settle accounts with the MOU
Finally, the psychoanalytic profession in the UK is clearly still in thrall to gender identity ideology in one major respect. The British Psychoanalytic Council and the Anna Freud National Centre for Children and Families, both prestigious representatives of the psychoanalytic tradition, remain as committed signatories to the Memorandum of Understanding on Conversion Therapy (MOU, 2024). The MOU is a confused and confusing document, carefully designed to avoid expressing open support for gender identity affirmative therapy. However, the MOU was heavily implicated in the widespread adoption of this form of therapy at the GIDS. In fact, there remains a continuing remarkable absence of evidence for the effectiveness of gender identity affirmative therapy in both the UK and US. If anything, the Tavistock GIDS really stands as an instructive case study illustrating the resounding failure of gender identity affirming therapy, other than in in terms of its role as a swift and efficient portal guiding clients towards medical transition (Jenkins, 2021).
The MOU is hesitant, if not openly hostile (as in its evidence to the Scottish Parliament in 2021) in its stance towards exploratory therapy, which is surely a central component of the psychoanalytic approach. The MOU also now stands in direct opposition to the Cass Review, following the lead given here by its key influencers in the World Professional Association for Transgender Health (WPATH). The psychoanalytic movement needs to carry out a full-scale review of its continued commitment to the MOU. It needs to build on the rumblings of dissent already apparent in its ranks several years ago, and to seriously consider withdrawing from the MOU. The United Kingdom Council for Psychotherapy has already done so, in order to limit its exposure to legal jeopardy and to avoid an untenable rise in spiralling indemnity insurance costs. The psychoanalytic movement needs to act now and withdraw from the MOU as a matter of urgency, in order to redeem its former standing within the therapeutic professions and within wider society.
References
Barnes, H. (2023) Time to think: The inside story of the collapse of the Tavistock’s Gender Service for Children. London: Swift.
Birchall, R. and Phoenix, J. (2024) Don’t Get Caught Out: A Summary of Gender Critical Belief Discrimination Employment Tribunal Judgments. Occasional Paper. Employment and Justice Series. School of Law, University of Reading.
Campbell, J. (2025) Organisational muddle and gender ideology. Part 2 – A psychoanalytic view. Scottish Professionals Advising on Gender (ScotPAG). https://www.scotpag.com/post/organisational-muddle-and-gender-ideology
Care Quality Commission (CQC) (2016) Tavistock and Portman NHS Foundation Trust: Quality Report. https://www.cqc.org.uk/provider/RNK/reports
Care Quality Commission (CQC) (2021) Tavistock and Portman Clinic Inspection Report. https://www.cqc.org.uk/provider/RNK/inspection-summary#genderis
Department of Human and Health Services (DHHP) (2025) Treatment for Pediatric Gender Dysphoria.https://opa.hhs.gov/sites/default/files/2025-05/gender-dysphoria-report.pdf
Jenkins, P. (2021) Calibrating Gillick in the age of gender wars: Part 2: The curious case of the Tavistock. Critical Therapy Antidote: https://criticaltherapyantidote.org/2022/01/02/calibrating-gillick-in-the-age-of-gender-wars-part-2-the-curious-case-of-the-tavistock/
MacCallum Sullivan, M. (2025) Institutional Capture – a social and psychoanalytic analysis (Part 1). Scottish Professionals Advising on Gender (ScotPAG). https://www.scotpag.com/post/institutional-capture-a-social-and-psychoanalytic-analysis-part-1
Memorandum of Understanding on Conversion Therapy (MOU) (2024) https://www.bacp.co.uk/events-and-resources/ethics-and-standards/mou
Menzies Lyth, I. (1960) Social systems as a defence against anxiety. Human Relations. 13, 95-121. Lythp439.opd.pdf
Mollitt, P.C. (2022) Exploring cisgender therapists’ attitudes towards, and experiences of, working with trans people in the United Kingdom, Counselling and Psychotherapy Research. 22: 1013-1029. https://doi.org/10.1002/capr.12559
Scottish Parliament: Equalities, Human Rights and Civil Justice Committee (2021) Conversion Therapy. 21 September. Column 30. https://www.parliament.scot/chamber-and-committees/committees/committee-official-reports/ehrcj-21-09-2021?meeting=13321
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
Waddell, M. and Kraemer, S. (Eds) (2020) The Tavistock Century: 2020 Vision. London: Karnac. https://www.google.gr/books/edition/The_Tavistock_Century/gZwAEAAAQBAJ?hl=en&gbpv=1&printsec=frontcover
Legal references
Mrs S Appleby v The Tavistock and Portman NHS Foundation Trust: 2204772/2021 – Final Judgment. https://assets.publishing.service.gov.uk/media/6149eb48d3bf7f05ac396f79/Ms_S_Appleby__vs___Tavistock_and_Portman_NHS_Foundation_Trust.pdf
Maya Forstater v CGD Europe and others (2021) UKEAT/0105/20/JOJ https://www.gov.uk/employment-appeal-tribunal-decisions/maya-forstater-v-cgd-europeand-others-ukeat-slash-0105-slash-20-slash-joj
Gillick v. West Norfolk AHA [1985] 3 All ER 402; [1986] AC 112 https://www.bailii.org/uk/cases/UKHL/1985/7.html
R (Quincy Bell) and A v. Tavistock and Portman NHS Trust, and others [2020] EWHC 3274 https://www.judiciary.uk/judgments/r-on-the-application-of-quincy-bell-and-a-v-tavistock-and-portman-nhs-trust-and-others/
By Peter Jenkins, counsellor, supervisor, trainer and researcher in the UK. He has been a member of both the BACP Professional Conduct Committee and the UKCP Ethics Committee. He has published a number of books on legal aspects of therapy, including Professional Practice in Counselling and Psychotherapy: Ethics and the Law (Sage, 2017). https://us.sagepub.com/en-us/nam/author/peter-jenkins
Peter is also a member of Thoughtful Therapists. His critique of the Memorandum of Understanding on Conversion Therapy was described as ‘instrumental’ in persuading the UKCP Board of the case for leaving the MOU in 2024.
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