Neasa Hourigan (Dublin Central, Green Party)
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6. To ask the Minister for Health the progress to re-establish the provision of transgender child and adolescent healthcare services through a clinic (details supplied) and working with Children's Health Ireland in Crumlin; and if he will make a statement on the matter. [17004/22]

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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Although I am taking this question on behalf of my colleague, Deputy Hourigan, I emphasise that trying to support young transgender people in Ireland is a strong interest of mine. When might we see the re-establishment of transgender child and adolescent mental healthcare services through the Tavistock clinic's work with Children's Health Ireland at Crumlin? This is about recognising that having access to these conversations with Tavistock is part of the mental health supports that young transgender people need at an early stage.

Frank Feighan (Sligo-Leitrim, Fine Gael)
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The programme for Government commits to create and implement a general health policy for transpeople, based on a best practice model for care in line with the World Professional Association for Transgender Health, and to deliver a framework for the development of national gender clinics and multidisciplinary teams for children and adults. The HSE is committed to building services for the transgender community in accordance with international best practice across a number of programmes, including mental health, acute hospitals and primary care. This includes a robust and agreed care pathway for young people with gender dysphoria in line with international best practice.

A decision was made by the UK clinic referenced by the Deputy to suspend new referrals for under-16s following a High Court ruling in England. This suspension impacts on patients who have historically had access to the UK service through the HSE treatment abroad scheme. The office of the national clinical advisor and group lead for mental health is involved in ongoing discussions with the HSE treatment abroad scheme in order to identify alternative gender identity clinics abroad that would facilitate referral, with particular reference to the psychology assessment component of the care pathway, pending the development of a national child and adolescent service. Fidelity to the clinical model of care approved by the HSE is essential in advance of considering alternative referral routes.

I am committed to the development by the HSE of a well-governed and patient-centred healthcare service for adults and children in the transgender community in line with the programme for Government.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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I appreciate that update. Last week, I had the pleasure of meeting Ms Sara Phillips from Transgender Equality Network Ireland, Ms Paula Fagan from LGBT Ireland and Ms Moninne Griffith from BeLonG To, an organisation that supports young lesbian, gay, bisexual, transgender, intersex, LGBTI, people, particularly with mental health, which is one of the biggest challenges when young people have questions about their gender identity or know they are not in the right gender relative to their birth sex. So much of this, and what they highlight to me, is about having open conversations, and being able to discuss this with GPs and in clinical settings. They say to me that the capacity to have these conversations about recognition, treatment with respect and treatment with dignity, along with the questions and challenges transgender people face internally, often puts off further medical decisions. Access to these conversations, especially in child and adolescent mental health services, in addition to being able to take it further through the hospital system in a respectful way, is very important.

Frank Feighan (Sligo-Leitrim, Fine Gael)
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We are committed to building services for the transgender community with the HSE in accordance with international best practice across a number of programmes. The office of the national clinical advisor and group lead for mental health is involved in ongoing discussions. I hope we will have a clearer pathway in the coming weeks and months.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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It is important to note there has been a very divisive debate in the UK about this issue over the past number of months and years.

It is a debate that has not helped anybody. What we need is a very respectful, dignified conversation supporting what is a small but significant number of people who are transgender. There does not need to be a conflict between transgender rights and gender identity rights and other sex-based rights. There is space for everybody. One set of rights does not need to displace another set of rights. We have not had that sort of conversation here. I hope it is not a feature that enters into Irish discourse where that sort of conflict is created between different groups of people or rights. There is no need for it. We had a very respectful conversation about individuals and families throughout the marriage equality referendum. Similarly, there is a sensible, common-sense, decent approach that can be taken to the legitimate questions that people have and that are raised as we look to support transgender people but also acknowledge that there is space in the equality house for everybody.

Frank Feighan (Sligo-Leitrim, Fine Gael)
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The Deputy's comments are very appropriate. She spoke about decency and people being informed. In recent years, and with the Citizens' Assembly, people have been informed. We are looking at international best practice. Many years ago, that brought in just the UK but I am sure that the HSE and all the stakeholders will be looking further afield, including the USA. We are very much committed Europeans and I am sure there is much best practice in Europe and across the world too.