Tommy Broughan (Dublin Bay North, Independent)
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581. To ask the Minister for Health the way in which his Department is monitoring adherence to the guidelines by an organisation (details supplied) for transgender healthcare; the reason psychiatric diagnosis is conducted as opposed to psychosocial assessment in accordance with the guidelines; and if he will make a statement on the matter. [12499/18]

Catherine Byrne (Dublin South Central, Fine Gael)
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Transgender-specific guidelines have been developed by the World Professional Association for Transgender Health (WPATH) and the Endocrine Society.  These guidelines were devised by experts in transgender healthcare, along with members of the International Transgender, Transsexual and LGBT community.

International best practice for transgender children, adolescents and adults involves a comprehensive multi disciplinary psychosocial assessment by a multi disciplinary team and shared decision making in the best interests of the individual. Both WPATH and the Endocrine Society Guidelines 2017 specify the assessment must be carried out by a mental health professional (s) with experience in transgender health care and possess specific skills.

The emerging evidence on good outcomes following medical and/or surgical transitioning is based on use of multi-disciplinary psychosocial assessment, fulfillment of criteria for hormones and ongoing psychological support throughout the process. It is important that psychological support is available to individuals before, during and after transitioning. Informed consent is essential, whereby benefits and risks of hormone treatment and surgery are discussed with individuals seeking these interventions to try and prevent negative outcomes. Although regret rates are low, it can happen and can also lead to high levels of psychological distress.

The model of care provides the framework for the development of National Gender Clinics and MDTs for children and adults, funded by the Acute Hospitals and Mental Health Divisions of the HSE. Recruitment will commence to develop these national teams in 2018.  It is envisaged that these National Teams will be in place in 2018, pending successful recruitment campaigns.

Tommy Broughan (Dublin Bay North, Independent)
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582. To ask the Minister for Health the reason all general practitioners trained in administering hormone replacement therapy, HRT, are not working in transgender health care; the number of general practitioners that are providing health care to trans persons; and if he will make a statement on the matter. [12500/18]

Simon Harris (Wicklow, Fine Gael)
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A proposed model of care for transgender children, adolescents and adults has been developed by the HSE Quality Improvement Division. The model was developed in consultation with key treating clinicians, planners, policy makers, advocates and service users. The model outlines key services required to ensure the needs of the transgender population including children and adolescents are addressed. It details current service provision and emerging service demand in relation to adults and separately in relation to children and adolescents. It draws on evidence based international best practice and aims to build on services which already exist and develop services where deficits prevail.

A number of initiatives are supported through the Social Inclusion Services including the development of the Gender Identity Skills Training Programme for Clinicians and professionals who work with children and young persons under the age of 18 years who are experiencing gender identity related issues to include General Practitioners, CAMHS Teams, Psychologists.

In response to your queries, I have asked the HSE to respond to you directly.