Reflections, Reconciliation & Repsychopathologization | Beyond Gender 2025 Year in Review
1 January 2026
Global
The three hosts of Beyond Gender look back on a landmark year for the gender debate, with particular relevance for Britain. The For Women Scotland ruling, the NHS puberty blockers trial, and the continuing fallout from the Cass Review all feature in a wide-ranging conversation that also takes in American policy shifts and Canada's resistance to change. For British listeners, 2025 was a year in which institutional momentum began, haltingly, to shift — and Stella, Mia, and Bret weigh what that means for 2026.
As 2025 drew to a close, Stella O'Malley, Mia Hughes, and Dr Bret Alderman sat down to take stock of a year that produced some of the most consequential developments in the gender medicine debate since the Cass Review. Their conversation ranges across continents, but for British listeners, several moments stand out as directly relevant to the NHS, to the courts, and to the schools where these arguments are still being quietly fought. The For Women Scotland ruling looms large in the discussion. The UK Supreme Court's confirmation that the legal definition of woman under the Equality Act refers to biological sex was a watershed moment, with implications stretching from single-sex hospital wards to sport, from domestic violence shelters to the ongoing struggle over who controls the language of policy. Stella, Mia, and Bret reflect on what the ruling signals about the broader cultural and legal direction of travel in Britain — and why it matters that the highest court in the land was willing to say clearly what many institutions had spent years declining to acknowledge. The hosts also turn to the NHS puberty blockers trial — the randomised controlled study commissioned in the wake of the Cass Review — and what its very existence represents. After years of a clinical regime in which blockers were routinely prescribed without robust evidence, the shift to treating this as a genuine research question rather than a settled matter of affirmation is itself significant. Whether the trial will be properly completed, and whether its findings will be acted upon, remain open questions that the hosts press with some urgency. Beyond Britain, the year brought seismic change in the United States, with executive orders reshaping federal policy on gender medicine and a major report from the Department of Health and Human Services adding to the growing international literature questioning the evidence base for paediatric transition. The hosts examine what these American shifts mean in practice and whether they create political permission for other governments to follow. Against this, Canada's continued resistance to reform serves as a reminder that institutional entrenchment can be formidable even when the evidence is moving decisively in one direction. The episode's title points to a concept the hosts find genuinely significant: repsychopathologization. This is not a return to stigma but a recognition that gender dysphoria — particularly in young people — warrants serious psychological investigation rather than rapid medical intervention. For a post-Tavistock NHS now rebuilding its approach through regional services and a renewed emphasis on therapeutic care, this framing has direct practical relevance. Stella's perspective as a practising psychotherapist gives the thread particular weight. Looking ahead to 2026, the hosts are honest about what remains broken. Waiting lists are long, training for clinicians working with gender-distressed young people is inconsistent, and the cultural pressures on schools, GP surgeries, and families have not evaporated. But the conversation ends with something that was harder to claim in earlier years: a genuine sense that the debate has shifted, that evidence is being heard, and that the ground beneath the ideology of gender affirmation has begun, at last, to move.
