Professor Donal O'Shea:

The important age is puberty and is the time of real distress to the individual, which is well before 16 years. The 16 to 18 age cohort is a facile constitutional argument and as to its inclusion, opinion would suggest it be changed. That is unanimous from those who have contributed and I presume that is part of the process that will feed back into the heads of the Bill. I do not particularly want to get involved in the issue of age.

Deputy Ó Ríordáin who raised the question on sporting organisations is no longer present. All sporting organisations must take a position on this. I have been involved in the International Rugby Board committee on gender dysphoria in the year running up to the women's rugby world cup. There were significant concerns about individuals of 6 ft. 10 in. who had transitioned from the male to female role running out as second rows on international teams. The sporting organisations are agitated because they need to have a position on the intersex conditions as well as gender dysphoria. The heads of the Bill is addressing whether that should be a constitutional entitlement for the sporting boards or just left up to the sporting boards. It is a real issue.

The constitutional point of view on validation is another area that must be addressed. The validation process really should not be a process, but should be a supporting statement from the practitioner who is, or has been involved in looking after the individual through some point of their journey. We have 254 patients. Some 246 patients attended the services in Loughlinstown. We would have been asked to see a certain number more than that who do not have gender dysphoria but may have been down and depressed. A personality disorder, which is totally different from gender dysphoria can have a focus on gender as an issue. An individual with a personality disorder could chose to change his or her gender by simply self declaration. The issue for the committee is the minority risk this poses in terms of the constitutionality of the birth certificate. The rate of regret among those with gender dysphoria who go through transition is very low, and there is the capacity in the legislation to change back. I would not imagine a person having to go through the process of an examination, and sitting in front of a board for acquired gender validation.

The enactment of the legislation would represent progress, but there is a clear appetite for change.