REPATH LAUNCH
15 September 2026
Global
Stella O'Malley and Mia Hughes mark the launch of REPATH — Genspect's Re-psychopathologisation Campaign — calling on clinicians and policymakers to restore thorough psychiatric assessment before any gender-related intervention. For Ireland, where the HSE is still shaping its approach to gender dysphoria in young people, REPATH lands as a direct challenge to affirmation-only protocols and an argument for the evidence-based, exploratory psychotherapy Stella has long championed in her Dublin practice.
This episode marks something significant: the formal launch of REPATH, a new campaign from Genspect that challenges the affirmation-first model that has come to dominate gender clinics across the English-speaking world. Stella O'Malley, Dublin-based psychotherapist and one of the most prominent Irish voices in this debate, joins her co-host Mia Hughes to explain what REPATH is, what it demands, and why its timing matters. REPATH stands for Re-psychopathologisation, and the name is deliberately chosen. The campaign's core argument is that transgender ideation — the psychological process by which a person comes to identify as the opposite sex — has been prematurely removed from the domain of psychiatry and psychology. Young people presenting at gender clinics have routinely received affirmation and, in many cases, medical intervention, without the kind of thorough differential diagnosis that would be standard for any other presenting condition. REPATH calls for that to change, insisting that careful psychological assessment must come first. Crucially, the campaign makes a careful distinction. It is not calling for the pathologisation of gender non-conformity — children who push against stereotyped sex roles. The target is the clinical assumption that when a young person says they are in the wrong body, the right response is automatic affirmation rather than patient psychological exploration. That distinction matters enormously in Ireland, where discussions of gender identity in clinical and school settings can quickly become politically charged and where nuance is often the first casualty. For Irish healthcare professionals, REPATH's launch raises direct and urgent questions. The HSE is still shaping its framework for the assessment and care of young people with gender dysphoria, and the clinical culture it adopts will shape outcomes for thousands of Irish children and adolescents. If affirmation-first approaches are embedded in HSE protocols without adequate provision for differential diagnosis, the same harms documented in Britain's Cass Review could take root here. REPATH asks Irish clinicians to consider whether their training and institutional pressures are allowing them to conduct genuinely open, thorough assessments. Stella O'Malley's presence at the centre of this launch gives it particular resonance for Irish listeners. As a practising psychotherapist working with young people and families navigating gender distress, she has seen what happens when the exploratory work is bypassed. Her perspective — grounded in therapeutic practice rather than ideology — is precisely what this debate needs. Mia Hughes brings the research dimension, ensuring the clinical argument is anchored in the growing body of evidence from countries that have already begun to reverse affirmation-only policies. For parents, teachers and healthcare workers in Ireland wondering what good care looks like, this episode offers a clear framework. REPATH is not a call to dismiss the distress of young people questioning their gender. It is a call to take that distress seriously enough to investigate its roots rather than route it straight towards a medical pathway. That, Stella and Mia argue, is what genuine care demands — and it is a standard Ireland should hold itself to.
