Why Anorexia is Just Like Gender Dysphoria...? A Conversation with Deanne Jade
Deanne Jade, psychologist and founder of the National Centre for Eating Disorders, brings a clinical framework rarely applied to gender medicine: the insight that eating disorders and gender dysphoria can function as socially reinforced, overvalued beliefs that resist ordinary questioning. For Irish therapists working without national guidance, for families struggling to understand a child's distress, and for a healthcare system still defining its approach, her decades of experience in treating eating disorders offers a principled, evidence-based alternative to the rapid-affirmation model. Stella O'Malley brings an Irish clinical perspective to a conversation that is essential for anyone navigating these questions in Ireland today.
Deanne Jade is a psychologist and the founder of the National Centre for Eating Disorders, with decades of clinical experience in helping people recover from conditions that medicine has often struggled to treat well. She is also a member of Thoughtful Therapists, a network of clinicians who have raised serious concerns about the dominant approach to gender-questioning young people. In this episode she joins Stella O'Malley, Mia Hughes and Dr Bret Alderman to explore what she calls the golden thread connecting eating disorders, self-harm and gender dysphoria — a thread she argues runs through the way each of these presentations can become self-reinforcing when met with affirmation rather than careful clinical enquiry. The concept of overvalued beliefs is central to the conversation. Jade describes how a young person's distress can crystallise around a single, intensely held idea — about body weight, body shape, or body sex — in a way that resists ordinary questioning and crowds out almost everything else in their sense of self. She is careful not to flatten the differences between these conditions, but she draws on hard-won clinical experience in eating disorders to argue that thorough and gradual assessment, rather than rapid affirmation, consistently produces better outcomes. That lesson took decades to establish in the eating disorders field, and she believes gender medicine is in danger of repeating earlier mistakes. This matters acutely in Ireland. Irish therapists and counsellors are working largely without clear national guidance on how to respond to young people presenting with gender distress, and many report feeling pressure to affirm rather than explore. Jade's framework — grounded in the treatment of eating disorders — offers a principled alternative: take the distress seriously, resist the urge to confirm the first explanation a young person offers, and give the assessment the time it deserves. For Irish clinicians navigating these cases, and for the ongoing debates about gender healthcare in Leinster House, this episode contributes something that remains in short supply: evidence-based caution, clearly articulated. The episode also examines the particular vulnerability of autistic young people, touching on ARFID as a related presentation, and explores how competitive dynamics, social comparison and a drive toward purity or distinction can sustain these conditions once they take hold. The overlap between autism and gender-questioning is well documented in Irish clinical settings, and Jade's analysis of that intersection is detailed and carefully reasoned. For Irish parents trying to understand why their child seems so certain that a physical intervention will resolve deep psychological distress, her perspective — compassionate but unflinching — offers a rare and genuinely useful clarity.
