Reflections, Reconciliation & Repsychopathologization | Beyond Gender 2025 Year in Review
1 January 2026
Global
The three hosts of Beyond Gender take stock of 2025, a year marked by significant legal, clinical and policy ruptures across the Anglophone world. Trump's executive orders, a major HHS evidence review, the For Women Scotland Supreme Court ruling, and the United Kingdom's long-awaited puberty blockers trial each shifted the terrain. The episode asks which of these shifts will hold, which institutions are still resisting the evidence, and what the unfinished work of 2026 looks like.
Few years in recent memory have produced as many concrete, documentable turning points in the debate over gender medicine and gender policy as 2025. The hosts of Beyond Gender — psychotherapist Stella O'Malley, researcher Mia Hughes, and psychologist Dr Bret Alderman — use this year-in-review episode to map those turning points against the evidence base that produced them, asking not just what happened but why it happened and what the gaps still are. In the United States, a series of executive orders from the Trump administration directed federal agencies to restrict gender-related medical interventions for minors, and the Department of Health and Human Services subsequently released a comprehensive evidence review examining the clinical basis for those interventions. The HHS report attracted immediate controversy, but its core argument — that the evidentiary foundation for paediatric gender medicine is weaker than proponents have claimed — echoed conclusions already reached by systematic reviews in Sweden, Finland, England and Denmark. The hosts consider what it means for a federal government to formally adopt a position that several European health authorities had quietly reached years earlier. In the United Kingdom, the For Women Scotland case reached the Supreme Court, which ruled on the legal definition of woman under the Equality Act. The ruling has direct implications for single-sex services, data collection and the legal architecture that underpins protections for women across Britain. The episode situates this decision within the longer arc of litigation and legislative debate that has unfolded since the 2018 Gender Recognition Act consultation, treating it as a case study in how courts, rather than legislatures, have often been forced to provide the clarity that policy processes failed to deliver. Also in the United Kingdom, movement on a randomised controlled trial of puberty blockers marks a significant methodological moment. The absence of robust trial data had been a central criticism of the clinical consensus that drove prescription growth through the 2010s. The Cass Review had flagged the evidence gap explicitly. The hosts discuss what it means that a trial is now underway and what standards of evidence should govern any future return of these treatments to routine clinical practice. Canada presents the counterpoint. Despite the international trend toward restriction and evidence scrutiny, Canadian institutions have largely maintained or expanded access, and the political and professional response to dissenting voices has remained hostile. The hosts examine why Canada appears to be on a divergent path and what combination of institutional, legal and cultural factors sustains that divergence even as the evidence landscape shifts elsewhere. The episode closes with a candid assessment of what is still broken: the professional bodies that have not updated their guidance, the clinicians who remain subject to pressure for non-conformity, and the young people — detransitioners among them — whose experiences have yet to be formally incorporated into clinical learning. Reconciliation, in the hosts' framing, is not a political settlement but an epistemic one: a return to the standards of evidence and care that were suspended during a period of ideological capture, and the hard institutional work required to rebuild them.
