Latest news with #NationalGenderService
Irish Times
26-05-2025
- Health
- Irish Times
High Court grants leave for doctors to bring action over State's transgender care policy
The High Court has permitted two medical practitioners to bring a challenge against the Health and Information Quality Authority's (Hiqa's) alleged failure to review the HSE 's care and management of services for gender 'nonconforming' children. Prof Donal O'Shea, a consultant endocrinologist at the National Gender Service (NGS) , and psychiatrist Dr Paul Moran, a consultant psychiatrist at the NGS, have brought the judicial review proceedings. On Monday, Ms Justice Mary Rose Gearty granted permission to Joe Jeffers SC and Brendan Hennessy BL, for the two doctors, to have a hearing of the case. Prof O'Shea and Dr Moran have challenged the HSE's referral of young people for assessment abroad, saying it poses a possible risk to children. READ MORE Ms Justice Gearty said she acknowledged that the case could be seen as one having 'divisive' elements. [ Affirming hormone treatment poses 'greater risk than benefit' for increasing numbers, says gender service consultant Opens in new window ] Prof O'Shea and Dr Moran have previously stated that they are not against a 'gender-affirming' model of care. The doctors have submitted that this model of care is typically found overseas, but that they have concerns over any inappropriate and irreversible medical treatment for patients presenting with gender identity issues. A review of this model impacts Ireland with more than 230 children and young people from Ireland experiencing gender dysphoria – where a person feels a mismatch between their biological sex and their gender identity that may cause unease, dissatisfaction, anxiety or depression. The applicants wrote to Hiqa, requesting it to undertake a statutory investigation, pursuant to section 9 of the Health Act, 2007 of the arrangements of the HSE for the management of gender nonconforming children's healthcare. Mr Jeffers has submitted: 'Hiqa was required to consider whether there were reasonable grounds to believe that there may be a serious risk to the health or welfare of the children receiving the relevant services. 'There is no evidence, or no sufficient evidence, in the decision letter whether Hiqa did in fact consider whether there were reasonable grounds to believe that there may be a serious risk to the health or welfare of the children receiving the relevant services.' [ Transgender woman says she was unable to receive 'basic healthcare' at Dublin hospital after gender surgery Opens in new window ] Mr Jeffers has also submitted that Hiqa had a care pathway established by the HSE, whereby Irish children are now being referred to a private clinic in Antwerp, Belgium, by a non-medically trained 'trans-activist'. 'The clinic in question is located in ZNA Hospital, Antwerp and is operated by an endocrinologist by the name of Dr Klink. The complainants allege the clinic had no 'model of care' or discernible operational guidelines, Mr Jeffers has submitted to the court. Mr Jeffers told the court the applicants have concerns about 'proper' care in Antwerp and over alleged lack of 'regulatory oversight' by health authorities in Ireland. Ms Justice Gearty granted permission for leave for review in the case on 'arguable grounds' and adjourned the matter to July.
Irish Times
18-05-2025
- Health
- Irish Times
Affirming hormone treatment poses ‘greater risk than benefit' for increasing numbers, says gender service consultant
The proportion of people for whom gender-affirming hormone treatment is a 'greater risk than benefit' is increasing, a consultant from the National Gender Service has said. Representative groups for the transgender community have said the current system is 'failing our community' and have called for a new model of care. Dr Yagoub Gader, consultant endocrinologist at St Columcilles Hospital Loughlinstown , where the national service is based, said the evidence base for transgender healthcare is 'underdeveloped' and what does exist is 'of poor quality'. 'Therefore, it is impossible to reliably quantify the potential for risk and benefit in transgender healthcare. This applies for all aspects of transgender healthcare, including hormone therapy,' he said. READ MORE Gender-affirming hormone therapy involves people taking hormones such as oestrogen, testosterone or hormone blockers to help achieve physical characteristics that are more masculine or feminine. 'We do not recommend prescribing gender affirming hormone therapy in the absence of a comprehensive, holistic, multidisciplinary assessment, or if, after such an assessment, the apparent risks exceed the apparent benefits.' Dr Gader said 'clinical complexity is greater than it has ever been before', with people presenting for assessment with multiple unaddressed clinical needs. Therefore, he said, the proportion of people who are found to have 'greater risk than benefit' at the time of assessment is 'increasing'. 'When clinical risks and/or needs are identified, they are addressed either by referral to community services, other specialist services, or by the multidisciplinary team within the NGS,' he said. His statement was made in response to a parliamentary question from Labour health spokeswoman Marie Sherlock, who said the lack of recruitment in the area since 2020 'speaks volumes about the lack of seriousness and paralysis' with which the Health Service Executive and Department of Health are treating the National Gender Service. According to Dr Gader, the waiting time for a first appointment is four years, which the consultant described as 'unacceptably long'. 'Further investment and service development is needed to shorten waiting times. Autism specific supports would also be needed,' he added. Transgender Equality Network Ireland (TENI), an advocacy group, said its position is that transgender people who want to access transgender healthcare should be able to do so in a service that is safe, informed, and in their local area. 'While the service is currently seeing individuals who were referred four years ago, the wait-list has grown considerably since,' the organisation said. As of December 2024, there were more than 2,000 people on the wait-list, and the service only took 160 people off the wait-list last year, it added. This means individuals being referred now are facing a wait of more than 10 years before their first appointment, TENI said, adding that there has been a 'breakdown of trust' between the trans community and healthcare providers. The group said the assessment process should be functioning to 'identify additional needs so that those needs can be met', but instead 'those needs become barriers to accessing care'. A spokeswoman for BelongTo, a charity for LGBTQ+ youth in Ireland, said there is 'no active health service for trans young people'. 'Trans young people and their families cannot get the information, supports and referral pathways they need to understand whether accessing gender-affirming care is the right option for them or not,' the spokeswoman said. The HSE is developing a new Model of Care for transgender healthcare.
The Journal
14-05-2025
- Health
- The Journal
Minister for Health says transgender healthcare is 'not meeting people's needs'
THE MINISTER FOR Health has said that transgender healthcare services in Ireland 'are not meeting people's needs and also not meeting their full range of needs'. Speaking in the Dáil last night, Minister Jennifer Carroll MacNeill also said 'it's for that very reason that the HSE is developing the new model of care for gender healthcare services'. This new model will be developed in a consultative way, the Minister said, 'engaging with healthcare professionals in gender healthcare, [and] stakeholders, including people with lived and living experience and the families of people who use and receive support from services'. She added that the government is committed to developing a new model of care that is based on 'clinical evidence, respect, inclusiveness and compassion'. The Minister was responding to a question from Social Democrats TD Pádraig Rice, who raised the concerns of the transgender community with the National Gender Service (NGS). He cited a recent investigative series from The Journal Investigates which he described as a 'harrowing' report into services currently available to transgender people. 'One patient described feeling traumatised after going through the services. Another one saying it felt like an interrogation, and people are being forced to go online to access HRT,' he added. He also called for the new model of care to be based on an informed consent model, in line with World Health Organisation (WHO) guidelines. Advertisement Since 2019, the WHO no longer treat being transgender as a mental or behavioural disorder. Instead, they now see it as relating to a person's sexual health. The WHO is currently developing clinical guidelines for transgender healthcare. The Minister thanked Deputy Rice for raising the 'very important perspective on the National Gender Service' in the Dáil, adding that 'a person-centred approach is what we want to get to'. She said that her Department has provided €770,000 in Budget 2025 to support the development of the new model of care. 'The clinical lead has been appointed, a cross-speciality clinical advisory group has been established, and a review of the evidence base is also underway,' she added. A community pilot project aimed at identifying 'the needs of children and young people who are gender questioning will also commence in the coming months', the Minister said. Advocates 'deeply concerned' The investigation by The Journal Investigates reported that transgender people said the questioning that takes place during NGS assessments can feel traumatic and upsetting. These questions include asking about what pornography they watch or details about their sexual lives with their partners. It also revealed how some transgender people are turning to DIY HRT , a method of accessing healthcare outside the official channels. This involves ordering hormone replacement therapy (HRT) drugs through a variety of online sources. Transgender people who move to Ireland from other countries are also being told by the NGS they must join the waitlist and go through their assessment process before accessing healthcare in Ireland. This is despite having legally changed their gender and previously accessed gender-affirming care in their home countries. Related Reads Transgender people moving to Ireland put on long waitlist for vital healthcare until assessed Transgender people turning to DIY-healthcare due to lack of trust in National Gender Service 'It left me traumatised': The barriers to accessing transgender healthcare in Ireland Responding to the investigation, the Professional Association for Trans Health Ireland (PATHI) said in a statement that it was 'deeply concerned' by the 'structural failures within Ireland's trans healthcare system'. PATHI is a group of healthcare professionals, academics, and community advocates working to advance the health, rights and wellbeing of trans and gender diverse people. The group also called for 'urgent, systemic reform to address the extensive barriers and inadequate and unsafe care faced by trans people across the country'. Ryan Goulding, a registered mental health nurse and PATHI Field Representative for Primary Health, said: 'Trans people are being left with no safe, trustworthy, or accessible options for care. This is a clinical, ethical, and structural failure that cannot continue. The way forward is clear.' It is expected that the development of the new model of care will take two years. — Conor O'Carroll is an investigative reporter with The Journal Investigates . Our investigative unit is dedicated to lifting the lid on how Ireland works. This takes time and it takes resources. 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