Gender: A Wider Lens
Gender: A Wider Lens
27 - Behind the Curtain: Psychotherapy for Gender Dysphoria with Sue and Marcus Evans

27 - Behind the Curtain: Psychotherapy for Gender Dysphoria with Sue and Marcus Evans


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Marcus and Sue Evans both worked as clinicians in the Tavistock Centre in London for many years. Noticing red flags since the early 2000s, Sue was the first whistle-blower in the Tavistock Centre and Marcus resigned as its governor because the concerns raised by therapists, parents, and managers were systematically dismissed. Marcus and Sue have recently released their book Gender Dysphoria: A Therapeutic Model for Working with Children, Adolescents and Young Adults. They join us to discuss the tasks of adolescents, family dynamics, and how important it is to explore questions about gender dysphoria as part of a more holistic approach to clinical care because nobody yet has all the final answers.


Gender Dysphoria: A Therapeutic Model for Working with Children, Adolescents and Young Adults

Authors: Susan Evans and Marcus Evans

“Freedom to Think: the need for thorough assessment and treatment of gender dysphoric children” by Marcus Evans

“First do no harm: A new model for treating trans-identified children”

Interview with Marcus Evans:

Sue Quoted in the Guardian:

An overview of the Judicial Review and court decision about puberty blockers

Extended Notes

  • How did Sue get into gender dysphoria?

  • Being involved in this work for many years now, Sue was concerned that children were being medicalized too quickly.

  • It is clear that there needs to be more research in this area and the subject needs to be understood more before we prescribe children with puberty blockers.

  • How did Marcus get into gender dysphoria?

  • In 2006, Sue and Marcus were raising clinical concerns about the effects of puberty blockers. It was tough. Their opinions were unpopular.

  • Marcus retired in 2018 and became a staff governor. He received a letter from 10 parents that were concerned that their children weren’t psychologically examined properly for their gender dysphoria. They felt the whole process was too rushed.

  • After digging deeper into the issues, Marcus felt he had to resign because he disagreed with how his organization was handling the issue. He was terrified his career was going to end.

  • In any other illness or mental health issue, there is an open discussion on what are the best options out there for the patient, but when it comes to gender-questioning teens, that conversation is quickly shut down.

  • We all still have a lot to learn. We should be able to ask smart questions to find the right answers.

  • Sue knew that management was not going to take their child safeguarding concerns that were being raised by the parents and by the clinicians.

  • Sue tried to gather expert witnesses to help bring more clarity around the issue, but not a lot of people were willing to step up in the UK.

  • In the end, what was the outcome of this case that Sue was working on?

  • Marcus was shocked to find out that the most at-risk kids did not have regular follow-ups.

  • The situation in Tavistock was complex. They had relatively inexperienced staff dealing with complex clinician situations.

  • How did the book get started?

  • Sue and Marcus received overwhelmingly positive support from families who finally found professionals who wanted more information about these treatment drugs.

  • We need to take a broader look at the child and how they interact with their family, friends, and how they self-reflect.

  • Why and how did Sue and Marcus pick their target demographics (young children) to study and examine for their book?

  • Many of these children are fearful of their own sexuality.

  • There’s no harm in being curious about external and internal factors at play as to why a child might have gender dysphoria.

  • What are the two biggest challenges in adolescence?

  • This is a unique time in history. Young people have the internet and can easily be influenced by it.

  • Parents and children have been frightened into an “it’s now or never” mentality when it comes to transitioning.

This podcast is partially sponsored by ReIME, Rethink Identity Medicine Ethics:

Learn more about our show:

Gender: A Wider Lens
Gender: A Wider Lens
Therapists Stella O’Malley and Sasha Ayad explore diverse perspectives through a psychological lens, fostering open dialogue on gender identity, transition, and the transgender umbrella. Their work with gender dysphoric clients and unique experiences yield an informed outlook delving into gender's psychological nuances. Interviews with clinicians, academics, transgender individuals, parents, detransitioners, and others touched by gender provide varied insights and intimate inquiry into the taboo yet relevant topic.