Billy Kelleher (Cork North Central, Fianna Fail) | Oireachtas source

I welcome the witnesses. I have a number of questions I wish to pose for my own information rather than for any other reason. In the context of growing up in Ireland, has Ms Lacey noticed any particular changes in societal views in recent years? We are trying to build a more tolerant Republic that is respectful and open in which groups and individuals will be respected for what they are as opposed to what we would like them to be. Has she noticed any changes in this regard? If such changes have occurred, have they given people further confidence in trying to establish their identities in an open manner? When people express themselves publicly and want to address their gender variance, it falls to the HSE and others to assist them in doing so. Obviously, therefore, the issue of resources is going to be key. In that context, has Ms Lacey noticed the development of a greater level of awareness among, for example, health care professionals?

One of the matters about which I, as a layperson, would be concerned is the high level of mental health issues among people of gender variance, to which Ms Lacey referred. Ordinarily, they can become very isolated and their first port of call can be their GPs or other care professionals. Does Ms Lacey believe enough is being done to highlight the issue of gender variance among medical professionals? Is the process of understanding beginning to feed into the broader health service?

It may be an indication that I have been around these Houses for too long but I still recall a time when people - even some in my constituency - openly campaigned against the provision of assistance to those of gender variance in the form of therapy and surgical procedures. I recall people protesting to the old health boards and stating that it was a waste of resources, etc. To be truthful, what occurred was quite nasty and insidious. I hope that the position in this regard is changing and that there is greater understanding among people in general.

It was stated that 1% of the population experience transgender variance. That is a sizeable number. If we were discussing a figure of 1% in the context of another matter, it might give rise to alarm.

All the 1% figures add up quickly to many individuals and people. Is there a general recognition at the highest level in the HSE, the Department of Health and the Government that this issue is not going away and that it must be addressed and dealt with in a meaningful structured way? I am asking because the gender recognition advisory group, GRAG, has been established. Will Dr. Crowley explain whether it is established under the Department of Health or another body? Where is it established? Does the HSE sit on GRAG and, if not, why not?

One of the witnesses cited Argentina as a model for gender recognition law. Are there any other countries not necessarily nearer but with a similar legal system to ours? Are there other countries of like mind or like make-up in terms of their legal and parliamentary restructures that would serve as a good template for us to examine the options quickly, in view of the fact that we are in breach of EU and human rights law? We need to address it not only because we are in breach of the law but because it is the right thing to do. Will the witnesses cite that?

I was jotting down notes as we have been going along so I do not necessarily have anything prepared. Some years ago there was a debate about the decriminalisation of homosexuality. There have been various debates about sexuality in general in the country, about family make-up and the various forms of family. It never ceases to amaze me that we almost have to be forced to make decisions about conferring rights on people because we believe that by conferring rights on people somehow we are taking away rights from other people. I cannot understand the logic but it seems to arise frequently in our society. There is an idea that if we confer a right or entitlement on one person then we diminish another person's rights or entitlements. That is probably a statement more than a question.

My final question is for Dr. Crowley. He made reference to the HSE working, supporting and understanding. Is there capacity within the HSE at present to train clinicians and care professionals? I am not making a political point, but is it seen for what it is in terms of mental issues, therapy, counselling, surgical supports and endocrinology and everything that flows from that? Is it genuinely seen as an important issue? I thank the witnesses for their presentations.