Sharon Keogan (Independent) | Oireachtas source

I welcome the witnesses and thank Dr. Muldoon for his statement this morning.

The ombudsman has the statutory obligation to serve and safeguard the children in Ireland. However, we have badly let down the children who are homeless, in poverty, awaiting timely healthcare, in State care, the migrant children who are missing and our own children who are missing. There are so many issues that I want to raise with the witnesses this morning and I hope they will bear with me because I am very passionate about some of the topics that I will speak about.

I welcome the report on the children death review in April and I want to speak about the UCD report of 2023 but I will start by asking a number of questions.

My first question is on gender self-identification and consent. In the submission to the LGBTI+ inclusion strategy, the Ombudsman for Children’s Office expressed unequivocal support for gender self-identification laws, including their extension to minors under the age of 16. Has the office considered the concerns raised regarding such laws, particularly the ability of children and adolescents to give informed consent to significant legal and medical changes?

On gender-affirming care for minors, the office voiced support for what effectively amounts to increased assess to so-called gender-affirming care for minors. Has the office considered the potential risks and long-term impact of treatments such as puberty blockers, mastectomies and hormone replacement therapy, especially given that many clinicians argue that these interventions remain experimental? Furthermore, has the office considered the implications of the irreversibility of such treatments for those who later choose to de-transition?

In 2022, the Cass review, which was an independent investigation commissioned by the NHS, found that the Tavistock gender identity development service was not a safe or viable long-term option yet over a year later, the Ombudsman for Children’s Office released a statement expressing concerns about the absence of similar services in Ireland. Has the office taken into account the findings of the Cass review and the Tavistock controversy when advocating for the establishment of such services here?

Between 2009 and 2023, as many as 240 children were referred to Tavistock by the HSE. Of those, 182 were aged 15 or younger and 58 were aged 16 or older. Twice as many girls as boys were referred and as of 2023, 72 Irish children remained on the Tavistock waiting lists. Given the growing number of individuals reporting irreversible negative outcomes post treatment, has the Ombudsman for Children’s Office undertaken or has it considered undertaking a review of the impact of those referrals?

I am shocked it actually took Professor Donal O'Shea and Dr. Paul Moran to challenge the HSE's referral of young people for assessment to this clinic. That is the role of Dr. Muldoon. It should not be left to clinicians to do this. Dr. Muldoon is there to protect these children. Has the Ombudsman for Children’s Office received any complaints about children being prematurely or inappropriately referred or assigned to gender-affirming care? Does Dr. Muldoon believe that his public position on this issue may be perceived as a bias, potentially discouraging individuals with concerns from approaching his office? For example, I was quite shocked to see that Ombudsman for Children's Office premises is shared with BelonG To, which raises questions about the office's neutrality on youth services.

On the issue of climate advocacy and budget allocations, the Ombudsman for Children’s Office annual report 2024 notes that the office advocates for the integration of children's rights into the climate action plan 2024, participation in the Eco-UNESCO Earth Gala via the youth advocacy panel, YAP, and developing the office's first ever climate action roadmap. Please give a breakdown of how much of the annual budget of the office was allocated to these activities. Does Dr. Muldoon believe that these climate-related activities fall within the core remit of his office? Given that the climate policy and the appropriate societal response remains subject to ongoing debate, does Dr. Muldoon not think that taking a public stance on such issues risks compromising the perceived neutrality of his office? Finally, does Dr. Muldoon believe that the resources allocated to climate advocacy and related events might have been more effectively applied in addressing complaints and casework, particularly given the volume and complexity of issues raised by children and families? We will start with those questions.