How Activism Is Replacing Clinical Judgment in Psychology - JD Haltigan (#6)
27 March 2025
With J.D. Haltigan
Global
The Cass Review concluded that diagnostic rigour had been subordinated to ideological certainty within UK gender services. Developmental psychologist J.D. Haltigan offers an account from within North American academia of the professional mechanisms behind that failure — how activist frameworks captured clinical psychology, eroded diagnostic standards, and normalised presentations that warranted careful assessment. His analysis provides essential context for understanding how similar pressures shaped NHS gender medicine, and why restoring scientific independence in clinical practice matters.
J.D. Haltigan is a developmental psychologist who left academic institutions after concluding that the professional environment had become hostile to honest scientific inquiry. In conversation with Stella O'Malley and Bret Alderman, he traces how, particularly from around 2016, ideological commitments began to displace the empirical standards that clinical psychology had long depended on. The discussion centres on what Haltigan describes as the capture of psychology by activist frameworks. Where clinicians were once trained to weigh competing explanations and maintain diagnostic rigour, the field has increasingly moved towards validating patients' self-reported identities as the primary clinical consideration. This shift has been framed in the language of compassion and anti-stigma work, making challenge professionally and socially costly. The result is a discipline in which scepticism has been recast as bias, and where departing from approved positions risks serious career consequences. Haltigan develops the concept of pathology normalisation: the deliberate removal of clinical categories in the name of destigmatisation. His argument is that stripping out the diagnostic vocabulary clinicians use to identify distress does not help vulnerable people — it removes the tools needed to treat them. For children presenting with gender-related distress, the consequences are direct. When significant discomfort is reframed as a healthy variant of human experience rather than a clinical presentation requiring careful assessment, the process of differential diagnosis is short-circuited and protective scrutiny disappears. The episode also examines the changing culture of psychology, with Haltigan noting a growing emphasis on emotional attunement at the expense of analytical rigour. He is not arguing against empathy in clinical work, but against empathy as a replacement for structured assessment. The conversation further addresses how social media has reshaped adolescent identity formation, enabling young people to construct multiple online identities and encounter communities that actively encourage radical self-reinvention — dynamics that can accelerate distress in vulnerable adolescents who might benefit from more cautious, exploratory clinical approaches. The UK evidence base lends Haltigan's analysis considerable weight. The Cass Review, published in April 2024, found that the evidence underpinning gender-affirming medical pathways for children was substantially weaker than had been publicly claimed, that diagnostic processes had been inadequate, and that the clinical culture at the Gender Identity Development Service had discouraged the kind of open professional questioning that good medicine requires. NHS England subsequently withdrew puberty blockers from routine clinical use for under-eighteens outside research settings. Haltigan's account of how activist ideology came to capture a profession illuminates the conditions that allowed comparable failures to take root in Britain — and the standards of intellectual honesty that restoring trustworthy clinical practice will demand.
