Landmark Essays
Some publications have had an important influence on public and professional discussion despite not being peer-reviewed.
These essays present the clinical thinking behind our work in an accessible form and have helped shape wider conversations about psychotherapy, identity development and the care of children and young people experiencing gender distress.
Together, they bridge the gap between academic research and public understanding.
Why I Resigned from Tavistock: Trans-Identified Children Need Therapy, Not Just 'Affirmation'
Author: Marcus Evans
Written following my resignation from the Board of Governors of the Tavistock and Portman NHS Foundation Trust, this essay explains the clinical and ethical concerns that led to my decision. It argues that children and adolescents experiencing gender distress deserve comprehensive psychological assessment and exploratory psychotherapy rather than an approach driven primarily by affirmation.
The article became one of the earliest and most widely read accounts from a clinician explaining concerns about the direction of the Tavistock Gender Identity Development Service.
First, Do No Harm: A New Model for Treating Trans-Identified Children
Author: Marcus Evans & Susan Evans
Published in Quillette, this essay introduced the therapeutic model that was subsequently developed in our book Gender Dysphoria: A Therapeutic Model for Working with Children, Adolescents and Young Adults.
It explains why careful developmental assessment, family involvement and exploratory psychotherapy provide a thoughtful alternative to approaches centred primarily on affirmation or early medical intervention.
Gender Transition and Desistance in Teenage Girls: Two Psychotherapeutic Case Studies
Author: Marcus Evans and Susan Evans
Using two psychotherapeutic case studies, this essay explores the developmental pathways of young women who experienced gender distress but later desisted from transition.
It illustrates the importance of understanding the emotional, relational and developmental context of gender distress and demonstrates how psychotherapy can create the space for psychological growth without assuming a predetermined outcome.
Why These Essays Matter
These essays complement our books and peer-reviewed publications by making psychoanalytic thinking accessible to a wider audience.
They have been widely read by clinicians, parents, journalists, researchers and policymakers, helping to foster informed discussion about gender identity, psychotherapy and the importance of careful psychological assessment.
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