Emer Higgins (Dublin Mid West, Fine Gael) | Oireachtas source

I thank Deputy Hourigan for raising this important issue and for her passion, knowledge and commitment to the subject. I am taking this Topical Issue on behalf of the Minister for Health, Deputy Stephen Donnelly, who has spoken previously on the topic of gender healthcare. He has acknowledged this is a small and vulnerable group of people who need to have access to proper, appropriate and integrated care, including acute care and community care. He has also acknowledged that they do not currently have access to that in Ireland and he is determined to change that.

The HSE has appointed a new clinical lead who is overseeing a new clinical programme for gender healthcare. Over the next two years, an updated clinical model and implementation plan for gender healthcare services will be developed. Separate from that, following the publication of the interim Cass report in February 2021, the HSE’s chief clinical officer, Dr. Colm Henry, requested the HSE’s national quality and patient safety directorate to review the interim Cass report and how it applies to clinical pathways from Ireland. This HSE review of the implications of the Cass report for the provision of gender identity services for children and young people in Ireland was published in March 2023 and is available online.

Following the publication of the final report of the Cass review in April this year, Dr. Henry asked that an expert clinical group be convened within the HSE to consider the clinical implications of this final report, if any. The membership of the HSE Cass review group was convened based on their expertise and clinical leadership. It expects to complete its work shortly.

The work of the expert clinical group is specific and defined. It is independent of the HSE’s planned update of the clinical model of care for gender healthcare by the new HSE national clinical programme for gender healthcare. It is that model of care that will ultimately make recommendations on the delivery of gender healthcare services in the HSE for both adults and young people.

The development of the model of care will be informed by the best evidence-based clinical care for individuals who express gender incongruence or dysphoria. As well as reviewing the best clinical evidence available, the HSE will also incorporate input from healthcare professionals, patient advocates and those with lived experience. Stakeholder engagement will be a key element of this work and will ensure that people with lived experience will have input into the design of services and can advise on the delivery and evaluation of services. That is the message the Minister has asked me to convey today. He wishes to get across the crucial part of the development of this model of care, namely, the consultation with relevant stakeholders. The Minister is strongly of the view that we cannot have a situation where a model of care is being developed for a group of people who are not involved and whose voices are not heard. I can assure Deputy Hourigan that both the Minister and the HSE are anxious to ensure that all stakeholders are heard as part of this process.

While the model of care is being developed, people will continue to receive healthcare in the community and under the endocrinology service in the adult and paediatric centres in Ireland East Hospital Group and Children’s Health Ireland, CHI. Regarding current services, children and young people who require specialist psychological or psychiatric assessment and support are now referred to the children and young people gender national referral support service in the UK, which will triage these referrals to one of the newly developed services in London, Liverpool and Manchester. This service will work with CHI if an endocrine review is required. The adult gender service, which is based in St. Columcille’s Hospital, Loughlinstown, provides services for people over the age of 16 years. I assure the Deputy that it will be the model of care that will be making policy recommendations on the delivery of gender healthcare in the HSE.

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