Ms Vanessa Lacey:

There have been changes in society since I grew up in Waterford in the 1960s. Three and a half years ago before TENI could employ people through Atlantic Philanthropies, transgender issues were probably 30 years behind lesbian and gay issues. However, I am delighted to say that we have probably caught up ten of those years in the past three and a half years and we definitely have a momentum behind us and have certainly reached a tipping point. Society's attitudes are changing as we raise awareness and that is extremely positive. One of the main components of that is a group we have created out of that. Far from being a Frankenstein's monster, it is something absolutely beautiful. I refer to the family group, TransParentCI.

There is often a question about people regretting this process. The two main reasons would be gatekeepers stopping people from access to treatment and loss of family. As I have said, I will never get my mother back and will never get her peace of mind back. However, I believe others will in future.

We do not yet have data on mean ages. Whereas two or three years ago the mean age of people attending the groups was in their 40s and female identified, now younger people are coming out all the time and their families are supporting them through the parent support group. The resources are very limited but the family, health care and education are key. If it can be addressed holistically, it is a win-win situation and can be done really cheaply. It will not cost much money at all - it is a buy-in and we can provide training as we have outlined in our submission.

The second question was on health care providers and their attitudes. I am trying to break down barriers with them by showing a human face to demystify some of the issues and I am getting people to open up a bit. I have already presented to child and adolescent mental health services - it was important to get in there - and also to paediatric endocrinology as well as other services. Some people are willing to engage and others are not. Unfortunately, engagement with the main endocrinology service in Ireland is a problem. However, there is miscommunication with biggest providers of health care to transgender people in Ireland, GPs, who cannot even get a response to a telephone call, e-mail or letter. That can have serious consequences, especially when one has all the other issues with one's family, one's life and one's children.

When the GP cannot get a response to a question about a prescription, we are talking serious business. I know at the moment members are dealing with the abortion debate which is extremely serious and I commend them on all the work they are doing on that. However, let us not allow this situation to become worse in five years' time where there is a suicide letter left because of something as simple as a communication from health care practitioners. If anything I want to leave that message here today. It is a very serious issue that needs to be addressed. Communication, collaboration and engagement are key.

Access to colleges training GPs is a problem. We need to get the doors open and provide a service. We are competent to provide very good training and have had good feedback on our training. We do baselines and evaluations at the end of it so we have a good indication we are providing that. There is transphobia in services.

That is where the Health Service Executive could come in and say we should listen to these people who are experts in their field and that this is not some sort of whim. That is a serious suggestion that can be taken from this meeting.

Suicidal factors is an extremely serious issue in that 40% of people are looking at it. Those three questions filter in to some of the questions asked by Deputy Ó Caoláin. It is serious. I do not want to sound like a parrot repeating something but it is about access to health care, legislation, transphobia, educating people and young people being unable to access hormone treatment. That happened recently where the family had to get their general practitioner to contact someone in Barcelona to get a prescription to give a hormone blocker to a child because the child was suicidal. That is a service we should provide here.

I apologise to Deputy Ó Caoláin for not mentioning the Sinn Féin Bill. I should have mentioned it but I will cheer him up now by saying-----