Reflections, Reconciliation & Repsychopathologization | Beyond Gender 2025 Year in Review
1 January 2026
Global
Stella O'Malley joins Mia Hughes and Dr Bret Alderman to take stock of a watershed year. From Trump's executive orders and the HHS report to the For Women Scotland ruling and the UK's puberty blockers reassessment, 2025 saw the international tide turn in ways Ireland has yet to fully reckon with. Stella, as an Irish psychotherapist who has watched the affirmation-only model take hold here, brings a clear-eyed perspective on what these global developments mean for Irish healthcare, Irish families and the professionals trying to navigate an ideologically charged landscape without adequate guidance.
As 2025 drew to a close, Stella O'Malley sat down with her co-hosts Mia Hughes and Dr Bret Alderman to do what any honest practitioner must eventually do: take stock. The result is a wide-ranging conversation that moves from the corridors of the US federal government to the UK Supreme Court, from debates over paediatric gender services to Canada's stubborn resistance to the accumulating evidence. It is also, for Irish listeners, a mirror held up to a country still trying to decide which direction it is facing. The American developments loom large. Trump's executive orders on gender and the subsequent Health and Human Services report marked a significant moment in federal policy, signalling that the medical consensus being exported from US gender clinics for the past decade was not as settled as its advocates had claimed. For Ireland, which has absorbed much of the ideological framing that shaped those clinics, these shifts are not merely foreign news. They raise pointed questions about the foundations of the approach being taken here. The For Women Scotland ruling and the UK's ongoing reassessment of puberty blockers sit even closer to home. The Scottish Supreme Court judgment on the legal meaning of 'woman' has direct relevance to Irish debates about single-sex services, legal protections and the rights of women in public life. Meanwhile, the evidence emerging from the UK's careful review of paediatric gender medicine is precisely the evidence that should be shaping decisions within the Irish health service. That it has not yet done so in any decisive way is a concern that runs through this conversation. Canada's position occupies a darker corner of the episode. Where several European health authorities have pulled back from early medical transition for children and reoriented toward more cautious, psychological approaches, Canada has largely continued to expand its services. The hosts examine why some systems prove capable of changing course when the data changes and why others appear unable or unwilling to do so. The lessons are relevant for Ireland, where institutional momentum can be powerful and where the political cost of reversing course is rarely borne by those who set the original direction. The episode's title gestures toward something Stella, as a practising Irish psychotherapist, returns to throughout: what was lost when psychological enquiry was sidelined in favour of affirmation-only approaches. The argument is not that distress should be pathologised, but that it should be taken seriously — investigated and worked through in the consulting room rather than fast-tracked onto a medical pathway. For Irish therapists, GPs and school counsellors who have found themselves without clear guidance, this framing offers both a critique and a direction forward. What the episode ultimately provides is perspective. 2025 was a year in which the international picture shifted more than many thought possible. Whether Ireland chooses to learn from that shift, or whether 2026 becomes another year of institutional delay, is a question that lands squarely with Irish policymakers, health service leaders and the professional bodies that advise them.
