Marie Sherlock (Dublin Central, Labour)
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I move:

That Dáil Éireann:

recalls that it is now a decade since the passage of the Gender Recognition Act 2015;

notes that:

— trans healthcare in Ireland is consistently ranked as the worst in Europe, with over 2,000 people on a waiting list for healthcare;

— stories from transgender people constantly highlight how Ireland's flawed healthcare system is not working, with invasive and insensitive scrutiny from the current National Gender Service; and

— the previous Programme for Government committed to a stronger model for trans healthcare in line with the World Professional Association for Transgender Health (WPATH) international best practice guidelines, but the current Programme for Government has watered down those commitments to the point where they are meaningless;

recognises that:

— there is a need to change the current approach to transgender healthcare in Ireland; and

— the Health Service Executive has initiated a new clinical programme for gender healthcare, is developing an updated clinical model, and has established a Clinical Advisory Group; and

calls on the Government to:

— provide a model of gender-affirming care in primary care settings, with a focus on General Practitioner-led (GP) care, based on informed consent as per WPATH and world Health Organization guidelines, and international best practice;

— replace the National Gender Service with a new national clinical programme for trans healthcare in Ireland, with integrated care pathways, recognising a key role for GPs, and the major need for recruitment of specialists providing gender affirming care;

— ensure that the new national clinical programme: — is developed in collaboration with transgender people;

— has specific responsibility and oversight for governance and training, alongside ensuring transgender healthcare is based on informed patient consent;

— provides comprehensive training for healthcare professionals in gender-affirming care;

— has a comprehensive network of GP's providing that care in primary care community-based settings; and

— further provides appropriate resourcing of specialist gender affirming care and the expansion of gender affirming surgical services, so that the majority of trans persons requiring surgery do not have to travel abroad; — confirm a timeline for the introduction of the new clinical programme for trans healthcare;

— establish guidance and facilities to allow for trans healthcare for young people aged under 18;

— implement a ban on conversion therapies that is inclusive of trans identities and healthcare;

— implement the recommendations of the 2018 Government Review of the Gender Recognition Act 2015, including to allow for the recognition of non-binary people and simplified non-medicalised gender recognition for young people under 18; and

— ensure that the bodily autonomy of intersex children and adults is respected.

I am very proud to be moving this motion today on behalf of the Labour Party. It is ten years since the passing of the Gender Recognition Act in 2015, and a decade since the Labour Party in government introduced legislation to formally recognise and afford dignity to trans people in this country. This came after many years of campaigning. I want to pay particular tribute to all those who fought for it over a long period of time. Today, in the Visitors Gallery, we have many guests who have been fighting for better healthcare and human rights for trans people for a long time - BeLonG To, LGBT Ireland, TENI, Trans Healthcare Action, AMLÉ, IADTSU, Mammies4TransRights, Labour LGBTQ+, Spunout, ShoutOut and those from the trans community themselves, who have come here today for this important motion.

It is fair to say that it is far from guaranteed that the 2015 legislation would be progressed so smoothly today. The war on LGBTQ+ rights has taken a devastating and disgusting turn in recent years across the world, with rising hostility by Governments in Hungary and elsewhere across eastern Europe, and attacks here at home and, indeed, within this Chamber and in the Seanad. All of this reminds us that progress cannot be taken for granted. It needs to be actively protected and supported.

For us in the Labour Party, gender recognition was only ever one part of the jigsaw. For us, a compassionate, caring system of healthcare is the other part of the social contract that we owe trans people in this country. While there are many debates about models of care and the rights and wrongs of various institutions, all we want is that young, vulnerable trans people out there are afforded compassionate, appropriate and timely healthcare.

I appreciate that the Minister of State with responsibility for mental health, Deputy Mary Butler, cannot be here today. I pay tribute to her work in this area in recent years. I very much hope that she makes progress.

I know that we stand here today very angry and distressed at what is available in this country. We are angry that vulnerable young people are being forced to wait four and a half years before they can even get an initial appointment with the National Gender Service. That is a lifetime to a young, vulnerable person who desperately needs support. We are angry that so many people had to go down the DIY route. It is estimated that some 30% are self-medicating with medicines bought on the black market, with no proper GP or clinical monitoring, and all the risks that entails. We are frustrated that so much care has been centralised through the National Gender Service here in Dublin and that GP care is non-existent in many parts of the country for trans people. We are aghast that there has been little or no recruitment since 2020.

At the heart of all of this, we are concerned about the actual model of care itself. I have spoken to a significant number of trans people in recent months about their experiences. I have also reached out to the staff of the NGS to understand their perspective on the service they provide. To be frank, the whole provision of services is an absolute mess. We desperately and urgently need a reset in how those services are provided in this country. The stakes are so high. For too many trans people, the wait time of four and a half years makes them feel like there is no service.

Is it any wonder that so many suffer crippling mental health issues because of the lack of supports? We know from research by BeLonG To and Trinity College in 2024 of the very real impact, which is summed up by that feeling of hopelessness. The lack of supports can have deadly consequences. During the summer, The Journal reported research by Trans Healthcare Ireland that 75% of trans people have self-harmed, 82% of trans people have experienced suicidal thoughts and, shockingly, 39% of trans people have had a suicide attempt. For many others, the lack of health and social support is having a devastating impact on their education, work and family and social life. That is why we in the Labour Party are bringing forward this motion today. These are our young people, sons, daughters and siblings, and, for some, it is their parents, colleagues, neighbours and friends.

I know a review of the model of care is currently under way and that the findings will be published next year. I want to set out our belief in the Labour Party about what needs to happen. We need a new model of care, a model that is rooted in informed consent, self-determination and respect for the bodily autonomy of individuals. We do not need to start from scratch. There are models out there in other countries that we can take guidance from. As the Minister knows, there is a lot of hurt and terror out there due to the assessment process and the invasive line of questioning. From a clinician’s perspective, I understand that in order to prescribe medication, there has to be a careful process but the current model is simply unacceptable. It makes no sense. We have to start trusting people when they say they are trans. We have to stop traumatising them at the assessment and stop pathologising so much of the trans experience. Yes, it is complicated, and yes, hormonal treatment may not resolve all the issues but we have to move away from what appears to be a paternalistic, judgmental model of care. We have to put forward something that puts the patient at the heart of decision-making. That involves informed consent. All too often, we hear clinicians dismissing informed consent as a person going in there and demanding whatever they believe to be appropriate. That is not what it is about. It is about seeking the appropriate hormonal treatment and being informed about the consequences - not being interrogated but being informed.

There is an irony here that people who have been living as trans for the past four years, waiting for their appointments with the National Gender Service, have had many years to think about what they are, who they are and what they need. They do not wake up some morning and say that this is what they want to be. Nothing could be further from the truth. Yet, far too often, their experience with the National Gender Service is just that.

Second, we need to ensure that multidisciplinary teams play a much greater role, in particular given the role of psychologists and medical social workers in their interaction with the National Gender Service. Third, we need a continuum of care from teenage years into adulthood. It is a huge dereliction of duty on the part of the Department of Health that there is no service at all for trans youth or adolescents in this country right now, or for their parents who want to support their children. Right now, CAMHS is the only service, and it is so wrong that children would be directed there.

We need GPs to be a critical part of the new framework. There needs to be specific training on the importance of hormonal blood tests, safe prescribing of HRT and the handling of referrals. Far too few GPs are being trained at this point in time, or are showing an interest. We need to actively ensure we have a good distribution of care across the country.

No country is perfect but we can learn a lot from Iceland, Malta, Spain and Australia. Malta is a small country like our own. It has shown the way. Its model is a de-pathologised model, building on maximising the health and psychological well-being of the individual. There is a very similar model in Iceland that operates with minimal wait times. Australia has developed a comprehensive and evidence-based model that puts significant emphasis on multidisciplinary care. It relies on the input and support of GPs, community-based healthcare and telehealth. It ensures a continuum of care, something that is so desperately lacking in Ireland.

I thank all those who have come here today. I am very proud that we in the Labour Party are bringing forward this motion. As I said earlier, I thank the Minister of State, Deputy Mary Butler, because she has played a very important role in the conversation.

I will end with the words of Sarah: "If you'd just let us live our lives in peace, with the right medication, with the right time, we would be fine".

Duncan Smith (Dublin Fingal East, Labour)
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I am delighted that we are able to bring this motion to the House today. As the Labour Party health spokesperson in the last Dáil, I was privileged to receive a number of briefings and to speak to members of the trans community, a community that is so often talked about but never listened to and a community that is attacked by presidents, authors, writers and other privileged people in this world. Trans people are used as a wedge in a culture war that they want no part of. When we listen to the trans community, as we are attempting to do, what do they tell us they want? They want healthcare in their own community, which is what any group or individual would want and what any citizen deserves. That is what they want. In an era when we are trying to decongregate and decentralise and have healthcare in the community for every person and group in society, why are trans people being dealt with differently? Why are we centralising everything through the national gender service at Loughlinstown? Why can trans people not go to their GP, like the rest of us can, and get the healthcare or the direction they need?

The statistics back up this motion and show that trans healthcare in Ireland is consistently ranked as the worst in Europe. There are over 2,000 people on a waiting list. Quite frankly, it is absolutely shameful. When I raised this issue with the previous Minister for Health, Stephen Donnelly, he agreed with the view that creating a model of care without involving the people directly impacted is neither best practice nor logical but that is what happened with the trans community. Its members have not been listened to or engaged with properly in terms of what is best for them in the context of their own healthcare.

We say, and it is Government policy, that ultimately the State aims to introduce universal healthcare through Sláintecare. One of the most important pull factors towards a universal healthcare system is equality of the care that is provided. A model of care in a universal system that does not hold closely the value of equality is not worth delivering. We have serious concerns about how transgender healthcare is delivered. I would openly label the national gender health service as wholly inadequate in its delivery of services, and that is being polite. The reality is that the inadequate access to healthcare that trans people in this country are getting is only compounding the existing challenges they face and perpetuating the cycle of marginalisation that they unfairly and unnecessarily have to endure. There is international best practice that we could be following. WHO guidelines are there for a reason and it is a choice not to follow them. People in our medical system can be brilliant. Indeed, they are fantastic people but the system is not delivering for the people who need care.

One of my core beliefs is that the role of a properly functioning Labour Party in any part of the world is to stand up for the vulnerable in society, those who are marginalised and do not have a voice, be they workers or members of the trans community. We have to do that. The truth of the matter is that trans people need a voice in this Chamber and they need action from the Government. They need a healthcare system that is going to deliver for them. I want to acknowledge the work that others in this Chamber are doing. The Chief Whip, Deputy Butler, informed us yesterday that she could not be here today and while we may not agree on all of the minutiae of the issue, she is an important voice in the Government. It must be acknowledged that attacks on her from people in this Chamber have been absolutely disgraceful. We will not tolerate such behaviour towards anyone in this House.

Deputies:

Hear, hear.

Ivana Bacik (Dublin Bay South, Labour)
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I commend my colleague, Deputy Sherlock, for proposing this important motion. I welcome our visitors to the Gallery. I speak proudly in support of this motion as the leader of a party with a long track record of standing in solidarity with the LGBTQ+ community. The Labour Party has a proud record in this area. Indeed, it was one of the first parties to establish a stand-alone section. I want to pay tribute to all our great activists in Labour LGBTQ+ including people like Eddie McGuinness, Bernie Linnane, Aoife Corish, Karl Hayden and so many more who have done so much to progress LGBTQ+ rights. I am also proud that the Labour Party has never wavered or sought to punch down on trans people because we stand in solidarity with our trans and non-binary friends, neighbours, family members and colleagues. Today, as we pay tribute to their bravery, we should recall the path that brought us here. The years from 2015 to 2018 were a period of extraordinary progress in Ireland, with the Labour Party to the fore in bringing about change. Campaigners for trans rights, marriage equality, civil partnership and the repeal of the eighth amendment stood shoulder to shoulder because in Ireland we have resisted attempts from the right seeking to divide us. I speak as a proud feminist. Feminists and LGBTQ+ activists in Ireland know the real enemy. We recognise that there are conservative forces across Ireland who seek to turn back the clock on LGBTQ+ rights and women's rights and we resist those attempts.

Last month marked ten years since the passage of the Gender Recognition Act. I pay tribute to the unyielding campaigning of Free Legal Advice Centres, FLAC, the Transgender Equality Network Ireland, TENI, and so many others and the courage of people like Dr. Lydia Foy, who we recently honoured at our Labour Party conference. For the Labour Party's part, the former Minister, Joan Burton, and the former Minister of State, Kevin Humphreys, were key to passing the law because they saw the need for change. Ten years on, much unfinished work remains, particularly when it comes to the provision of gender-affirming healthcare. When it comes to trans rights in healthcare, many of the 2018 review's recommendations still sit on a shelf, including recognition for non-binary people, the need for care at home, and protections for the bodily autonomy of intersex people. I am sure the Minister is aware that intersex people remain invisible in Irish law, unlike in Iceland, as Deputy Sherlock has said, where strong protections exist.

In 2022 Ireland was found to have the worst trans healthcare in Europe. Many of these failings reflect wider systemic issues in the health service which will be very familiar to the Minister and to all of us here including overcentralisation, lengthening waiting lists and regional inequalities but the consequences for trans people can be particularly severe. Trans people have the longest known wait times in Europe. People can be left waiting for three, five and sometimes even ten years and one in five trans adults seeking a referral from their GP never receives one. When access is granted, the process can be invasive, pathologising and contrary to a human-rights based, informed-consent model. These are not abstract policy questions as our listeners in the Gallery know. These are personal and human rights issues and they affect real people. Plenty of people of every gender identity need access to HRT and primary care that is local and integrated. In that sense, this motion is not just about strengthening our health system for trans people but about strengthening it for everyone.

Finally, I wish to speak in support of the motion's call to ban so-called conversion therapy. This is a vitally important aspect of the motion. I co-sponsored legislation with former Senator Fintan Warfield some years ago on this issue and did so proudly. We need movement on it. The notion that so-called therapy could end up doing damage to a client must be tackled. I appreciate that complexities mire the issue of designating the profession of counsellor but the Minister must act with urgency on this. It is nearly a decade since a Labour Party Minister, Brendan Howlin, introduced legislation to regulate rogue crisis pregnancy agencies. We have seen quite a number of Governments falling since the commitment was made to give statutory protection to the title of counsellor. We need to see movement on this and the legislation must have a cross-Border element. The cross-Border nature of these deeply harmful and damaging practices needs urgent attention.

We have made great strides in the past. Between 2015 and 2018 we saw significant, progressive changes for women and for the LGBTQ+ community. On this, the tenth anniversary of the Gender Recognition Act, we need to see more done to address the serious shortcomings in the model of care for trans people.

Ciarán Ahern (Dublin South West, Labour)
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I formally second the motion. We all would have hoped that ten years on from the Gender Recognition Act, we would be a lot further along in ensuring that trans people can get the care they need and deserve but progress has stalled when it comes to truly vindicating trans people's right to be themselves. In a country that has proudly made such strides forward in so many ways, it is utterly shameful that we are ranked the worst in Europe in terms of trans healthcare. The national gender service, as Deputy Sherlock and others have said, is not fit for purpose. I have heard from trans people that its approach is invasive, demeaning, insensitive and ultimately leaves them feeling they have to prove who they are and justify their existence. An article in The Journal earlier this year featured interviews with trans people who felt traumatised by their experience with the national gender service. Is that the kind of healthcare we want to deliver to anyone in Ireland? Do we want to be the kind of society that leaves people who are in need of care traumatised? This motion calls for an informed-consent model. This is the way forward. Such a model includes trans people, does not presume that their identity is something that must be interrogated and supports them in transitioning to who they really are.

We need to situate this in the broader context of how discourse around gender issues and trans rights has developed in the last number of years. We are in a very concerning place. Hate directed towards members of the LGBTQ+ community is on the rise. The level of vitriol towards trans people is particularly vicious, enabled and encouraged by influential and powerful figures globally. Certain Members of this House also have a lot to answer for as they seek to engage in imported culture wars.

Conor Sheehan (Limerick City, Labour)
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Hear, hear.

Ciarán Ahern (Dublin South West, Labour)
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I was struck by Kathy Sheridan's piece in The Irish Times last week because it summed up my feelings perfectly.

She spoke about the absence of kindness in debates around trans people. I hate to use the word "debate" when speaking about the rights of people. This is a group of people - less than 1% of our population - that amounts to an absolutely tiny cohort of marginalised and often vulnerable people. Regardless of how few trans people there are in Ireland or elsewhere, every single one deserves the respect, empathy and dignity we would all hope to receive.

I want Ireland to be a beacon of kindness and compassion towards trans people. I want us to reject the cruel, regressive and bigoted rhetoric that we have seen levelled against trans people here and elsewhere. The Gender Recognition Act was not perfect, but it was a good first step. It sailed through these Houses almost ten years ago, almost without a whimper, much to the credit of the then Minister, Joan Burton, and the then Minister of State, Kevin Humphreys. How is it that, ten years later, the discourse around these matters has become one of such intolerance and exclusion? Trans people have always existed and will always exist. They deserve to live happy and fulfilling lives on the same terms as the rest of us. If we are to really vindicate trans people's rights to be themselves, then we need to put the provisions of the motion into action. I commend the motion to the House.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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I sincerely thank Deputies from the Labour Party for raising this important issue. It is an area on which I and the Minister of State, Deputy Butler, are placing a strong and deliberate focus. As I listen to Deputies from the Labour Party going back over the history of this, I recall that they did so in partnership with Fine Gael and that we stood together to introduce many important social changes. In many respects, it might have been slightly harder for Fine Gael to do that with the Labour Party. A broad balance that changed in society achieved the changes we all wanted to make, which brought about a much more compassionate society for women and LGBT people. I am very proud of that work.

I sat beside Deputy Frank Feighan and recalled having a debate with him before I became Minister when he was a Minister of State in the Department of Health. The debate in question took place in March 2022. I asked him what we were doing to support transgender people in terms of healthcare. I decried in particular the divisive debate that seemed to be seeping across from the United Kingdom at that time. We could see it coming. I recall speaking with trans people prior to that debate, who told me about the fearful things that were being touted at that time, namely that people would come into changing rooms, for example, and dress up as men. We all know the sheer nonsense that a man would dress up as a woman and come into a changing room for the purposes of attacking me, as though with all of the conversations we have had about femicide in this room we ever needed a man to dress up to attack a woman. Did you ever hear such nonsense? Did you ever have examples of it from any time since the Gender Recognition Act was passed? A different movement seeped in somehow in 2021 and 2022 and changed the narrative. It made the narrative cruel for trans people and other people. I have never understood why that happened. I always regretted that such attitudes seeped over here. I hope we can stand together to take steps that help to seep that away and remove any of that divisiveness from the House, as Labour Party Deputies have said.

Notwithstanding the divisiveness in the debate and our desire to set that aside, I recognise that we have an awful lot of work to do on healthcare. I have worked with LGBT Ireland, TENI, BeLonG To and Spunout for many years. I was the vice chair of the Fine Gael LGBTI group. I stand alongside the Minister of State, Deputy Butler, who is a leading advocate for change in the approach to healthcare to bring about much more inclusive, compassionate and respectful healthcare provision for gender-diverse people.

Let me be very clear, even if I do not get to all of the points in my speech, that the Minister of State, Deputy Butler, and I are standing together to work in a very practical and pragmatic way to try to re-situate the balance, the dynamic and the compassion in healthcare for gender-diverse people. Along with the Minister of State and the Government more broadly, I recognise that gender diversity is absolutely part of the human experience and that gender-diverse people should be respected in their identities and in their right to express themselves. They may choose to transition from the gender assigned to them at birth to being recognised and identified as another gender. Of course that is what the Act we are celebrating ten years of does today. They may also explore their gender and socially or legally transition without needing healthcare services.

Some people, including children and young people, may experience gender dysphoria, which refers to the psychological distress that results from an incongruence between one's sex assigned at birth and one's gender identity. In that respect, we, first and foremost, try to address many of those psychological, anxiety and mental health needs young children have. The debate has swung as though people are trying to treat them in one way when, in fact, they are trying to treat anxiety and psychological distress in the first instance, as is completely appropriate.

Nevertheless, the Minister of State, Deputy Butler, and I are determined to ensure that a comprehensive, appropriate and integrated gender healthcare service is available for those individuals who require it. The Government is committed to ensuring that people of all ages have access to appropriate pathways to gender healthcare for them at the time and space they are in and that they are treated with kindness, dignity and compassion.

As in other countries, it is true to say that demand for gender-affirming healthcare services has risen significantly. The Minister of State, Deputy Butler, and I fully accept and acknowledge that the current public services are not meeting people's full range of needs. We also recognise the urgent need to establish more appropriate and comprehensive services. It is in that context that the HSE has established a new national clinical programme for gender healthcare to develop an updated clinical model of care. The Minister of State, Deputy Butler, and I take a very direct interest in the work that is going on there and the stages and reflections happening throughout the development of that model of care. It aims to design clinical pathways to deliver safe and effective health and social care services for those seeking gender-affirming services. This work will also inform an implementation plan for its delivery. My Department has provided funding of €770,000 for the development of the model of care for 2025 and the work is expected to conclude in 2026.

The approach to developing the model of care is clear and well established. It involves reviewing the best available clinical evidence, as well as incorporating insights from healthcare professionals, patient advocates and individuals with lived experience. The model of care will consider all available information. It will not be aligned with any one study, report or one way of thinking. The Minister of State, Deputy Butler, and I are very alive to the considerations that have to inform a fully comprehensive analysis.

A cross-speciality clinic advisory group, which was established in collaboration with the RCPI and convened in June 2025, is supporting the design and development of the model of care. In addition, a working group, comprising several representatives with direct lived experience, has been formed and its first meeting was last week. The groups are a standard component of all medical models of care. The clinical advisory group operates as an independent body within the RCPI, reviewing proposals drafted by the working group to ensure they are clinically safe.

To advance the model of care, the HSE has commenced a systematic review of the evidence base with respect to coexisting clinical needs in gender-diverse people, with support from the HSE library service. The interim results of that review were made available for public consultation in August this year. The HSE is now reviewing the submissions and completing the evidence review.

A key aspect of the development process is stakeholder and public consultation. We want to get people's views. Incorporating the views of people with lived and living experience is absolutely essential in any medical model of care that is going to be effective, grounded in evidence and compassionate. Their insights will illuminate gaps that clinical data alone cannot capture, such as the emotional, cultural and practical challenges that people face when navigating any healthcare service, including gender healthcare services.

It is crucial that we avoid developing a model of care for a group of people without involving them and considering their perspectives. Their input is indispensable, and the Minister of State, Deputy Butler, and I are firmly committed to ensuring that stakeholders are heard and actively involved in the process. I want to assure the transgender community that all efforts were made to hear from you, that we want to hear from you and we are trying, in every way, to incorporate your perspective directly into the development of the model of care, as we do with every other model of care, as is appropriate.

It is our sincere hope and expectation that this approach will not only strengthen the relevance and inclusivity of the final model but could also lead to improved outcomes by ensuring services genuinely reflect the needs of the populations they are designed to serve. It is a complex process. HSE and Department officials will work closely together to do it quickly, transparently and effectively. Given that it will take some time to complete the work, the Minister of State, Deputy Butler, and I have requested that the HSE examine all avenues to improve interim care options while the model of care is being developed.

In terms of the proposals on conversion practices, I want to emphasise that the programme for Government contains a commitment to advance legislation to ban conversion practices. Very clearly, it is for the Department of Children, Equality and Disability to deal with this, and it has been carefully reviewing key policy principles to underpin it and to ensure individuals are protected from harmful conversion practices, while safeguarding access to necessary and appropriate services for those seeking support.

It is true that, as Deputy Bacik has said, there is complexity to some of the regulation around counsellors and psychologists. We are going through that with CORU. It is very important that these professions are regulated to a particular standard, as would be expected. That work is progressing. I might speak to the Deputy about it separately.

In relation to gender recognition, the Minister for children published the national LGBTIQ+ inclusion strategy in June 2025 along with the associated plan for 2025 and 2026. The remaining actions from the gender recognition review of 2025 are included in that strategy. A steering committee has been established comprising all of the important representatives. The Department of Social Protection will be participating and progressing relevant actions in line with its strategy and action plan. The national strategy also includes a commitment in the first action plan to develop national clinical guidelines for medical nursing and health and social care professionals delivering paediatric care to infants, children and young people with differences in sexual development. These are due to be published in quarter 2 of 2026.

I am glad to have the opportunity to discuss this issue this morning. Ten years on, it is appropriate to recognise the work that has been done by so many people in this House to advance equality. As we all know, equality is a broad house. Advancing one person's equality beyond where it has been in the past does not mean taking from somebody else's. I reflect in particular on Deputy Bacik's point about feminism and equality more broadly. There is no threat to me or to the Deputy as feminists in advancing somebody else's equality. That is the way we have all come to our work here and I hope it is the way we will continue to work here. I hope we will stand together to continue to work for a compassionate and inclusive society, as we have done over the last ten years.

Gerald Nash (Louth, Labour)
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At the outset, I will say to the Minister that words count and leadership matters. I thank the Minister for calling out the inhumanity and cruelty that is so sadly being imported into this country and mimicked by some of those who should know better. Those people need to act and behave with more responsibility in respect of their fellow citizens.

As with everyone else in our State, the level of access trans people have to healthcare depends at least in part on the attitude of their medical professionals. We cannot allow that to continue to be the case. Care is not consistent. For example, in my office, we have been dealing with the case of a trans woman who transitioned nine years ago and was discharged from the national gender service post surgery with instructions for her GP to manage her ongoing hormone therapy. That was all fine until she decided to move and had to register with a new GP, who simply refused to continue prescribing HRT unless she saw an endocrinologist, despite her having a stable and long-term prescription. As one can imagine, this threw this woman into a cycle of health roadblocks and frustration. Her new GP refused to prescribe HRT and passed the buck to an endocrinologist. In turn, the endocrinologist at her new hospital passed the buck and demanded unredacted psychiatric reports from almost a decade ago that included all kinds of deeply private and traumatic details of her history.

This is not an isolated case. It is all too common and it is not on. Barrier after barrier was put in front of this trans woman to simply continue the treatment she had been properly prescribed for the previous nine years simply because she decided to move to a new area. Doctors are judging patients when they should be caring for them. She tells me that if she does not continue her hormonal treatment, she risks a range of severe health risks ranging from osteoporosis to cardiovascular issues, depression and cognitive decline. Like many caught in the same position, she is actively considering sourcing her hormones online, with all of the risk and lack of regulation that entails. That is not something anyone can stand over but she is being driven to at least consider doing it. There can be no postcode lottery when it comes to access to healthcare, nor can it depend on the whim of any one medical professional.

As the Minister has heard from my colleagues, this one case is unfortunately broadly representative of many people's struggles to access basic decent healthcare with dignity and equality. As was said earlier, our record in this country in this area is appalling. We are well behind our European neighbours. We need to do better, as the Minister and the Minister of State, Deputy Butler, have acknowledged. This is not only a trans issue; it is a human rights issue. We either believe in equal access to appropriate healthcare for all our citizens or we do not. Rights are not to be debated. They are inherent. The Minister accepts that the situation needs to change. She has outlined the process we are in at the moment. This is welcome. We in Labour will work with her to deliver a better system of healthcare for trans people in our society, the kind of system this Republic and its citizens demand.

Alan Kelly (Tipperary North, Labour)
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The Labour Party has a very strong tradition in this area. I am the only remaining Member who was a Cabinet Minister in the Government that brought in the Gender Recognition Act 2015, although my party colleague Deputy Nash was a Minister of State attending Cabinet. The Minister has spoken. Words are one thing but it has now been ten years and actions are now far more important than words to many people across this country who are in real need of compassion, support and a pathway to healthcare to help them. To speak frankly, what is going on in our country in this area is not compassionate.

The pathways we all hear about through our work with a great many people, including some of those in the Gallery, and the stories we hear from them are simply not acceptable. The way trans people are being treated in healthcare, the inconsistency in that treatment, the invasive way in which they are being questioned, the process they have to go through to get healthcare, those abroad having to start the process of invasive questioning all over again, and, as my colleague has mentioned, the issues that arise when people change healthcare professional are all completely wrong. The inconsistency, the lack of decency and the manner in which people are being treated really need to change in a fundamental way.

To put it simply, the national gender service is not fit for purpose. That needs to be said. It needs to be completely and utterly changed. In our country, those who are strong enough will fight and go through this current system, but those who are not strong enough will not. That is a huge issue. While supports to help people are provided through various organisations, through ourselves and so on, many people will unfortunately just not face into it. There is another very pertinent point that needs to be made. If you have financial well-being and capacity, you may be able to get through this a lot more easily than those who do not. In a republic, that is also unacceptable. While I welcome the Minister's words, I have to tell her straight that she will be judged by her actions and not by her words.

Eoghan Kenny (Cork North-Central, Labour)
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I am delighted to speak on this motion. It is timely in that it has been only a matter of weeks since we had homophobic attacks on the streets of my home city of Cork. This behaviour is repulsive and should be roundly condemned by all in this House. No one should walk our streets in fear, no matter who they are.

One of the best things this Government could do to address issues of homophobia and transphobia would be to address the shortcomings in our public services. If our State treats the LGBTQI+ community with less regard and less focus, this lesser regard will be mirrored in our society. We see big gaps in the provision of healthcare services and it is no different for trans people. In 2024, we had the longest known waiting times in Europe for trans healthcare. Even people who were receiving gender-affirming healthcare in other countries and then move to Ireland must go through the initial process before accessing the same services here. The reliance on private healthcare either via the national gender service or as an alternative to it creates class disparities and puts further financial pressure on trans people.

I also want to speak to the broader issue of transphobia and transphobic abuse in Ireland and further afield. I do not understand where the hatred of trans people and the scaremongering about them come from. There is no need for this level of hatred. Trans people simply want to live their lives happy and comfortable in themselves. They want dignity and respect. They want to be able to receive healthcare just like anyone else. This year, we celebrate the tenth anniversary of the Gender Recognition Act. It is a progressive beacon to Europe and the rest of the world.

It shows that we can be progressive, inclusive and ahead of the curve. I must call out the nonsense we hear when we raise trans issues, particularly from Deputies in certain quarters of this House, on the Independent Ireland benches.

Duncan Smith (Dublin Fingal East, Labour)
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Hear, hear.

Eoghan Kenny (Cork North-Central, Labour)
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It has been suggested that this motion is not called for and that other, more important issues should be raised. To that, I tell Deputies to look around them. This is a big Chamber with over 170 Deputies. The spectrum of issues we all raise is massive. I have spent my time in this Dáil raising various issues that affect this country. I would never suggest that one of these issues is more important than another because any one of those issues is the biggest issue someone in this country is facing today. It was referenced that our party has somehow turned its back on the people we represent. What a stupid comment. Every single one of my colleagues sitting around me and our councillors in local authorities know exactly the issues facing people across this country. Trans healthcare is an issue. The difference between our party and theirs is that we are not afraid to stand up to support marginalised trans people. They are, because bigotry outweighs genuine concerns. I do not have to put on a political caricature to pretend I understand the issues that people across this country face. Some do. In fact, the shared issues across healthcare are apparent in the motion before us. Trans people are facing severe delays and regional inequalities just like many cisgender people across the country trying to access healthcare. Trans healthcare in Ireland is not up to standard and it is vital that these issues are raised in this House. This House is representative of the people of Ireland, and trans people in Ireland are just as entitled to have their public services and the lack thereof raised in this Parliament. The Labour Party will never apologise for standing up for the most marginalised in our society. I urge our colleagues across this House to support the motion.

Jen Cummins (Dublin South Central, Social Democrats)
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I welcome the members of the finance committee from Greenland, who have just arrived in the viewing Gallery.

David Cullinane (Waterford, Sinn Fein)
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I welcome the opportunity to set out Sinn Féin's position on gender identity and trans healthcare. I welcome all of the guests in the Public Gallery as well. Too many trans people in Ireland are being left waiting years for care. This is not about numbers or statistics. It is about people's lives, well-being and dignity being put on hold. The delays, the uncertainty and the sense of being bounced around a system that is not fit for purpose cause real harm and distress. We cannot, should not and will not stand over that.

Let us be clear about the scale of the crisis. Trans people in this State can be left waiting years and years for appropriate healthcare - not days, weeks or months but years. I know of some people who were on waiting lists for 14 years or more. Over 2,000 people are now on a waiting list for gender identity healthcare. The national gender service in 2024 had a wait time that could range from between three and ten years and, as I said, I know of people who have waited longer. This is the reality that trans people and their families are living right now, and we should and must say it plainly. Those waits are completely unacceptable. They are a form of denying healthcare by delay. They push people into a prolonged period of uncertainty, distress and avoidable harm. What does it mean to a person who is added to a long list? It means that if a trans person is added to a list today, they tell us and they feel genuinely a sense of hopelessness. They know they are going onto a list where they may not ever be seen or will certainly not be seen for years. It leaves them in limbo and without adequate supports in the meantime.

This cannot be described as a humane system. In fact, it is the opposite. It is not a healthcare system worthy of the name and is certainly not an equal system. I say clearly that Sinn Féin approaches this issue from a foundation of equality, rights and compassion. Trans people are entitled to live safely and openly, to have their identities respected and to access healthcare on the same basis as everyone else. Our health policy in Sinn Féin is explicit about that. We recognise transgender people's right to recognition and to the best possible supports and care.

We recognise that healthcare is a fundamental right for every citizen, including trans people, and we recognise that adult trans people must be able to access evidence-based gender-affirming care in a timely and respectful way. For me, this point really matters. Appropriate healthcare is not some optional extra. For many trans people, gender-affirming healthcare supports their physical health, their mental health and their ability to participate in daily life. When people can access timely and well-supported care, it is in the best interests of that person, their families and society as a whole, but it also improves outcomes. This is what evidence-based healthcare is meant to do - help people to live healthier, safer and more fulfilling lives. We approach this as we should approach every healthcare issue, from the standpoint of need, evidence and human dignity.

I support reform in this area, as does my party, and I support a new model of care for gender identity services. I want to see an holistic, properly resourced, modern service that is safe, accessible and delivered closer to people in their own communities. I support an expanded role in primary care in this area, but I also know it has to be resourced to meet the needs of the trans community. We want waiting lists to be cut dramatically. We want more specialist capacity, more trained clinicians and clear national pathways so that people are not left in limbo. That has to mean concrete change, not some vague aspiration as was talked about earlier. It has to be mean properly staffing specialist teams so that the national gender service is no longer a barrier to care. It has to mean regional and community-based healthcare so that care is not centralised into a single overstretched pathway that simply does not work. It means equipping primary care with training, clinical guidance and the resources needed to support trans people safely and respectfully from the first point of contact. For many trans people, that is not the case, and they are not treated with respect. It also means publishing clear national standards so that people are not left guessing how the system works or where they stand within it. We would not accept that in any other part of the health service.

I recognise that a clinical review of the model of care is under way and I commend everybody involved in that. I have also met senior officials involved in this area, so I know there is a significant body of work under way. I welcome that. It is crucial that this review, and any review, into gender identity services and healthcare be carried out on the basis of genuine consultation and listening to the lived experience of the trans community. This review must be completed and its findings, where appropriate, implemented. However, we cannot allow review to become a substitute for action. I welcome the Minister's comments that interim measures can and should be taken as we await a new model of care. I understand that will take some time, but we can take steps now to improve the situation because the situation right now, today, is unacceptable. We need reform urgently. We also need investment and delivery, because any plan is only worth the investment that is behind it.

I also underline the importance of listening. Consultation cannot be a box-ticking exercise. Trans people are experts in their own lives. They know where a pathway breaks down. They know what it feels like to be delayed, dismissed or treated as if their reality is up for debate. If we want a service that works, we must build that service with the people who rely on it. Listening also means recognising the emotional aspect of their lived experience. When trans people tell us the current pathway feels like gatekeeping, which it is, and feels unsafe, which for many it is, and feels designed to slow down rather than support them, we do not and should not argue that out with them. We have to accept what has been said, learn from it and fix it. At the same time, reform has to be done right. Healthcare must be guided by clinicians and grounded in evidence. The pathway for any person must be respectful and dignified but also clinically robust. I do not see this as a contradiction. The Minister made similar points earlier. It is what good healthcare looks like. Some people experience the current system as gatekeeping, as I said, and certainly distressing and very slow. We must listen to this, and we must act. I hear that clearly. I have met many trans people, groups that represent trans people and others. Those experiences we hear have to shape how services change. They have to be at the heart of how those services change.

Clinical assessment is a legitimate and necessary part of healthcare, especially where decisions involve life-altering or irreversible interventions. This is not about denying care and should not be about that. It is about ensuring the right care delivered safely for each person. Part of having a respectful debate is being honest about what good healthcare requires. This is why my party takes a measured position on the model of care. Informed consent is an essential principle in healthcare. People, of course, must have autonomy, clear information and real choice, and today trans people very clearly do not have that.

It must never be the case that someone is put through needless barriers or treated without respect. However, informed consent on its own cannot replace clinical judgment. The best approach from my perspective is shared decision-making where a person's autonomy is, of course, fully respected and clinicians still determine what is clinically appropriate and safe. This is how we build services that are both compassionate, which they should be, and clinically sound, which they should be. It means clear timely information. It means assessments that are designed not to delay but to improve. It means clinicians who understand trans lives and people, and provide care without stigma.

I also want to address the important issue of international standards, which is subject to ongoing debate. I share the ambition to align Ireland with best practice which is what we should always do in any element of healthcare. However, we must be honest that there is active international clinical debate about elements of care particularly for young people. I do not believe we should lock Ireland into any one international model uncritically. Our job is to ensure that the Irish model, our model, is evidenced based, listens to the lived reality of trans people, is guided by clinicians and built on the outcome of Ireland's own ongoing review, alongside evolving international evidence. It should never be about resisting progress. It must be about ensuring progress is durable and safe for all. Respectful dialogue matters here which is why we need discussion that is calm, evidence based and rooted in rights. Trans people deserve to be heard in that debate. Families deserve clarity. Clinicians deserve space to do their job properly and society as a whole deserves public discussion that is humane, truthful and responsible.

We need to be especially careful with children and adolescents. I recognise the profound distress that some young people experience. We recognise the services for young people are inadequate and need urgent development because nobody benefits from a vacuum of care which is what exists at the moment. Under-18 pathways must be built with stronger safeguards, specialist oversight and an evidence-led approach reflecting the seriousness and complexity of these decisions. Our position is to ensure that the care offered is the most protective and clinically sound pathway possible. We also understand the impact that these long waiting times can have on the mental health of young people. We need services that are available, safe, specialised and properly supported. Those services need to respond quickly while ensuring appropriate safeguards.

The motion also refers to conversion therapy. Sinn Féin supports an effective ban on conversion therapy, including coercive practices targeting trans people. This is a rights and protections issue. Legislation must be drafted precisely and clearly. It must target abusive or ideological conversion practices while not creating unintended consequences that criminalise legitimate clinical practice or parents supporting a child through distress. I believe that a strong ban is achievable, desirable and should be put in place. It must be tightly drawn so that it protects people and supports appropriate healthcare.

On the wider issue of legal recognition, we must be clear that the proposals set out in this motion go well beyond healthcare - I am sure the authors would agree with that. They raise serious legal and policy issues that have to be properly worked through. In particular extending legal recognition to minors and introducing new statutory categories for non-binary recognition cannot be treated as add-ons to a health debate. These are changes with broad implications for law, education, data systems and the rights of others. They require very detailed legislation and careful whole-of-government consideration. We will not support sweeping legal changes brought forward without fully considering all potential consequences. Recognition matters and dignity matters but so do clarity and legal certainty. If reform was or is being considered in this area, it must form part of a separate robust piece of work that can be properly and fully scrutinised rather than through a healthcare motion.

For me the central point is this. Ireland's gender-identity services are failing people. They are certainly failing the trans community and others. This failure is not abstract as was said earlier. It is measured in years of waiting, in distress and in lives put on hold. We need to support a new holistic model of care that is property resourced, clinically led, community delivered and grounded in rights and compassion. We support timely evidence-based gender-affirming care for adults. We support making the system more respectful, more assessable and far faster than it is today. We insist that reform must also be safe evidence based and built with appropriate safeguards for young people.

I say to the Government that we have to stop the drift. We need to complete the review and not to rush it because it is important work. We must listen to the trans community. We also have to listen to clinicians. We have to publish clear guidelines and timelines, and expand capacity now. This is an urgent issue now for people. We need to train and recruit clinicians who understand the needs of trans people and build a modern service that trans people in Ireland deserve. I think we can do this with empathy, with respect and with a commitment to healthcare that is both compassionate and safe.

I will finish where I began with people living this reality. Behind every number that we talk about is a person waiting for a first appointment, a person trying to get on with their education or job, a person trying to hold a relationship together, a person doing their best to stay well, a person just trying to live their life. A system that constantly delays and tells them they have to wait, in some cases for 14 years, is clearly not acceptable. It does not have to be this way. I believe we have the ability in this country to build a modern service fit for purpose. What we lack is urgency. We certainly need the resources and the capacity put into the system. Our message today from my perspective is clear and simple, and needs to be said in that way. I insist on reform that is rights based, properly funded, clinically safe and genuinely shaped by the lived experience of trans people.

Pádraig Rice (Cork South-Central, Social Democrats)
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I thank the Labour Party for tabling the motion today and for giving us the time to debate this really important issue. I stand here today in defence of trans rights, trans equality and ultimately trans liberation. This is a crucial issue and one that we need to dedicate time and effort to during this Oireachtas term. As the Minister will know, this was one of the first issues I raised with her during my priority questions because for me this is a crucial issue and one that we need to work together on to deliver for trans, non-binary and intersex people in Ireland.

The Minister needs some time and support to develop a model of care and to get this right. It is really welcome that there has been good engagement so far with clinicians, with stakeholders and with the community. I think the interim measures that have been introduced are welcome but we need to see more work.

In the minutes afforded to me, I want to talk about who we are talking about, what we are talking about, where we are talking about it, when and why. When we talk about trans people, we are talking about our friends, family and colleagues. We are talking about people who work here in Leinster House. We are talking about the postman, the nurse, the teacher, the doctor. We are talking about everyday regular Irish citizens who are looking for recognition, for rights, for equality and just to be able to live their lives in an ordinary way like anybody else.

We are also talking about a very small minority - about 1% of population, if not less. This is a group that has existed in every society across time. It has existed in Irish society going back through history, as is being uncovered now through trans history projects. It is also a group that has been consistently demonised and attacked in the most outrageous way.

We must call out people who come into parliaments like this and demonise and attack a small minority group. It is outrageous and is a terrible place to be attacking a weak and vulnerable minority to try to look strong but actually it is just very weak.

In many ways, many of the attacks are very predictable. If we look across Europe, we see what is being said in other countries and the kinds of attacks we see on the LGBT community more broadly happened in other countries first. It is a far-right movement. The same attacks and lines are rehashed here in press releases, using the same language, words and playbook. They are also using the same play book from the 1980s. They are now saying the same things they said about gay and lesbian people in the 1980s about trans people. They will not get away with it. We will stand up against it because it is utterly outrageous.

With regard to the substance of what we are talking about, we are talking about people getting access to: gender-affirming care to alleviate gender dysphoria and improve their lives, hormones, surgery and mental health supports, where they need it in a timely and, as I said, lifesaving way. At the moment, we have one clinic in the National Gender Service in Loughlinstown. It is fair to say the system is broken, not working and failing people every single day in this country. As mentioned, there are 2,000 people on the waiting list. A study by Belong To, Being LGBTQ+ in Ireland 2024, found that one in three people waits at least three years for their first appointment. If we had any other service across the country where people had to wait three years to get their first appointment, there would be utter outrage in this Chamber. People are waiting years upon years, sitting delayed. Some people reported waiting up to ten or 13 years. The system is absolutely broken and needs to be fixed.

This morning, before I came in here, I was on Instagram and I came across released audio of someone’s clinical experience. I ask the Minister to listen to that audio because the kinds of questions that this individual was asked by a clinician are absolutely shocking. It would turn your stomach listening to the way invasive questions were asked and the way in which this person was treated by a clinician in our National Gender Service. It is absolutely outrageous and it should be setting off alarm bells. This is why we need to see urgent reform. It is why I fully support a new model of care based on informed consent and international best practice.

We need a regionalised service across the country in each of the health regions. We need it delivered in primary care and have GPs involved. GPs currently prescribe hormones to a lot of people, including older people, people with menopause symptoms and older men, who are prescribed hormone testosterone. GPs do this and they could do this for trans people as well. We need regional clinics where people can be given individualised care plans and then discharged back to the primary care services. We also need a national clinical programme for trans healthcare in partnership with the trans community. This would be a body responsible for governance, training, professional development of practitioners, policy and procedures.

We need to look at international best practice and what international guidelines are saying. We know what the World Health Organization has said in this regard. In 2009, the WHO reclassified trans healthcare as part of central health rather than mental health. WHO stated: "This reflects current knowledge that trans-related and gender diverse identities are not conditions of mental ill-health, and that classifying them as such [causes] enormous stigma." Australia, New Zealand, Iceland, Malta, Canada and parts of the US have implemented this change but Ireland has not. The new sexual health strategy published in June is almost silent on trans healthcare. At best, there are only passing references to trans people. We should integrate trans healthcare into our sexual health services. They exist across the country and they are trusted by the community. People access these services already. These services need investment and support and, as we build a model of care, delivering it alongside sexual health services is the way to go.

With regard to timelines, we need action as soon as possible. As I said at the start, the Minister needs time to get this right but that time cannot run on and on. We need action in the next year or so and we will continue to apply pressure to see that delivered. It is concerning that there was a commitment in the 2020 programme for Government that was not delivered on. I know there is another commitment in this programme for Government. We cannot have another commitment again in the next one going undelivered. We have to get this right. It has to be done in the lifetime of this Oireachtas. The Minister will have our full support in getting there and I know she will have it from colleagues as well. It is important we progress that.

Crucially, as to why we want to do this, we know that trans healthcare services are lifesaving. In 2013, TENI found that access to trans healthcare results in lower rates of self-harm, suicidality, depression and anxiety. It found that 78% of trans people considered suicide but after they accessed trans healthcare, it dropped to 4%. We will, therefore, save lives by doing this. This is why it is crucially important and those people who come in here to attack this for political gain are going to cost lives and they need to know that. This is crucially important. We absolutely need to get this right.

Beyond that, I support the calls on conversion practice and intersex rights. We need to set the goal of this to be the best place in Ireland to be LGTBQI+.

Sinéad Gibney (Dublin Rathdown, Social Democrats)
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I thank the Labour Party for bringing forward this motion and the opportunity to speak to this incredibly important issue. I will use three slogans to shape my contribution. The first is "Trans rights are human rights." The reason I wish to delve into this a bit more is the Minister referenced equality a lot in her contribution. As a professional in the human rights and equality sphere, I have thought a lot about how human rights and equality interact. The reality is that until everybody’s healthcare needs are met, we cannot say that healthcare is a right that is realised in this country. That is what we mean when we say that equality, as the Minister said, is broad. It has to reach everyone. If we want to say that healthcare is a right, it has to be provided for every single individual group. The reality for trans people in Ireland is that outcomes are worse compared with everyone else in the cis population across a multitude of areas. For healthcare, it is absolutely crucial because for so many trans people, healthcare provides the actual self-realisation of their identity. We are ten years on now from the Gender Recognition Act. When I was working in the human rights space, we were heralded as so progressive to do that but, unfortunately, all of the other areas that helped to realise the rights of trans people have not been met.

The second slogan I wish to talk about is “nothing about us without us”. There are five words I want to imprint on the Minister’s brain, namely, patient-led, informed consent model. That is what the community and trans people are looking for to allow them to access their healthcare in a dignified way that does not push them into the grey market because of the difficulty of getting drugs or cause that indignity of the questions that are asked of people in those sessions. We need to make that shift mentally as a society, as we did with abortion. When abortion was seen as a part of healthcare, it meant that it was no longer weaponised on a moral battleground. Similarly, for trans healthcare, we need to do the same thing because that is what it is; it is healthcare. It is ridiculous, for example, that, as a menopausal woman, I can access the hormones I need but the very same product is not provided to a trans woman because she is a trans woman.

The final slogan I wish to mention is simply “trans pride”, because so often in these debates – debate is the wrong word when we are talking about rights, as others have said – but trans pride says to me is that we need to celebrate our trans community. I hosted a public meeting recently in my constituency, which I framed as a trans appreciation and information evening. I did that for two reasons: first, to celebrate diversity and inclusion in our society and, second, because it cannot be weaponised. If someone were to come out and say that trans appreciation is wrong, just like we hear people say trans healthcare and trans people’s participation in sports are wrong, then that person is simply transphobic and I will not tolerate that. We need to be political leaders. It is not an easy area. It is divisive and I appreciate and recognise that. The Minister is proving to be a Minister who is not afraid to ruffle feathers, so I urge her to be the same in this area and show the political leadership that the trans community needs.

Roderic O'Gorman (Dublin West, Green Party)
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I thank the Labour Party for tabling this motion. I am happy to speak in support of it. I am glad the Minister is here giving her time to the debate. It is so important that we have this debate and do not shy away from addressing the issue of trans healthcare, particularly in these times of increasing hatred. Trans people are looking to politicians more than ever to see someone articulate their needs and rights. Regrettably, we know the discourse has absolutely been saturated by toxicity, lies, fallacies, misrepresentations and a focus on marginal arguments. Often, there is a focus on the circus antics of online clowns. This is all ably facilitated by social media companies. It is hard to think of another group in society right now who have been as maligned as trans people. That is a shame on all of us. When we step away from the rantings of that online mob, however, we immediately see how real people approach a minority who they see denied their basic care, that is, with empathy, respect and a desire to remove obstacles to happiness. Fundamentally, we need a reset in the debate, which centres the debate on those basics of human decency. Trans people are equal citizens in our Republic. They are our siblings, friends and neighbours. They do not receive a level of even basic medical care, medical care that is well established in other jurisdictions and provided there for the best interests of individuals.

The motion calls for a model that can work, is accessible and will allow trans adults, with best interest focus and clinical guidance, to make their own decisions about their future, knowing that whatever they choose, the State will support them, their clinicians will guide them and care options will be available to them here in this country. I can see no conflict or no moral wrong that can come from enabling a tiny minority to live freely.

I have recently heard a small but growing voice that says gay men and lesbians should oppose any focus on the rights of trans people and that supporting them supposedly puts our hard-won progress in jeopardy. I say an absolute "No" to that argument. I have no time for it and I think it is predicated on a view that an equal place must be earned. It also very conveniently forgets that much of the language being used against the trans community now is the exact same language that was used in the eighties and nineties against the gay community and which, unfortunately, is seeping into the discourse today.

I thank the Labour Party for bringing forward the motion enabling this important debate on trans healthcare. I look forward to supporting it in the vote tonight.

Paul Murphy (Dublin South West, Solidarity)
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I thank the Labour Party for bringing forward this important motion. We in People Before Profit will, of course, support it. My thanks also for the tireless activism of many trans activists, including those in Transgress the NGS, Trans Healthcare Action and TENI, who are pushing for rights to mean something and for decent healthcare in this country for trans people. Last weekend, I saw a TD who wanted the public to pay for a €1,000 La-Z-Boy chair for him suggesting that investing in trans healthcare is a waste of resources. If investing in healthcare is not a good use of resources, I do not know what is. Perhaps we should just get La-Z-Boy chairs instead of healthcare.

It should be clear to anyone paying attention that the Government is no friend, or certainly no guaranteed friend, of trans people. We see the dog-whistling that is going on in terms of migrants, asylum seekers in particular, and any marginalised group. It may be that the formerly progressive face of Fianna Fáil and Fine Gael has been abandoned. That is why the activism from below pushing for rights to mean something and for decent healthcare is so important to understanding that an injury to one is an injury to all and that in fighting for trans healthcare, we are fighting for a decent national health service that provides quality public healthcare for everybody in this country, regardless of their particular needs.

The truth is Ireland is failing badly. We are the worst country in the European Union for availability and accessibility of transgender healthcare. We have one gender clinic offering transgender healthcare to adults in Ireland and that is the self-appointed national gender service based in St. Columcille's Hospital in Loughlinstown. It has wait lists over ten years long and sees fewer than 160 people a year. The NGS and its model of care were not approved by the HSE or the Department of Health. The service's name was chosen by itself. It is a clinic within the Ireland East Hospital Group, not a national clinic.

It is no surprise that there were no trans voices involved in the creation of the NGS. Those running it do trans people a disservice by lobbying against any reform of this broken system that treats trans healthcare as something to be restricted and pathologised. In this clinic, transgender people must undergo a dehumanising and humiliating assessment process. They are asked inappropriate and invasive questions that have very little to do with gender identity or medical transition. In some instances, trans people have been denied important gender-affirming healthcare if they were diagnosed with ADHD or autism or for not answering inappropriate and sexualised questions in a way deemed correct by the clinic.

Yesterday, Transgress the NGS put online an interview, the existence of which I knew of but had not seen until then. It is shocking in terms of how invasive and inappropriate the questions being asked are. This should not be happening in a proper national gender service. These are some of the questions asked of someone seeking bottom surgery:

Can I ask you a bit about your mental illness?

When was the most serious episode of mental illness that you had?

Were you drinking at the time?

What type of drink do you like?

On Tinder, what was your profile then?

Were you experiencing a lot of erections?

What else did you experience in terms of sex drive?

Can you describe what it is about your penis and balls you notice or don't like?

Are you happy receiving as well as giving?

Are you capable of receiving an orgasm?

Would you use a strap-on or sex toys?

This is not the type of approach we should have. We should have an informed, consent-based transgender healthcare model led by GPs and nursing staff in primary care. We should look to Catalonia, which has an informed consent model in primary care that has been successfully in use since 2012, with a 36-day waiting list and 71% of adults receiving HRT on the first appointment, compared with the decade-long waiting list trans people face in Ireland.

Ruth Coppinger (Dublin West, Solidarity)
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I am glad I made it for the end of the debate. This is a critically important issue for the many people waiting 13 years, on average, for a health service. We have the worst trans healthcare in the EU. I was listening to the debate on my way here. I welcome the motion and thank the Labour Party for putting it forward.

Trans people are a minority who are being disgracefully targeted, picked on, scapegoated and used to divide people. This is being done by the far right, obviously, but mainstream politicians are leaning into it because it is a difficult issue for them to tackle with people given that the gender binary, the traditional family and all those issues are promoted in society. I urge the Minister of State with responsibility for mental health to move on this. In a previous debate, she talked about her personal experience. I ask her to act. She has personal knowledge of the difficulty this is causing.

I have a few points to make about informed consent versus clinicians. I was one of the people in here practically every week demanding change on abortion rights. I was one of very few TDs, to be frank; others then followed. Repeal was not won by doctors in this country at all. They came on board much later. They came on board when women, young people and LGBT+ people put it on the agenda with a mass popular movement. Then they came on board. It is similar with trans healthcare. I heard Sinn Féin Deputies talking in riddles a few minutes ago. I will demystify the riddle for them. The abortion pill was discovered by women in Latin America who were taking it to bring about miscarriages. It then became mainstream. It is similar with trans healthcare now. Young people are being forced to access hormones themselves because their doctors are not helping them. We need a directive issued by the Minister instructing every doctor to help people with blood tests and things like that.

I say to the Sinn Féin Members not to wait for clinicians. It is trans people themselves who understand their needs and the Deputies to my left need to listen to that. They are not listening in the North; they need to listen in the South. The same goes for all the parties. For the minority over there, I would not waste my time. They are going to continue to pick on trans people. We must be to the forefront in defending them.

Peadar Tóibín (Meath West, Aontú)
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Aontú believes in a compassionate, pluralist Republic. We believe all citizens are equal and should be valued no matter their identify, religion or orientation. Everybody should be treated on the basis of their individual character. Gender dysphoria is real, it is not easy for anybody and citizens who have gender dysphoria should be treated with respect and decency.

It is also really important that, as a society, we base our approach on science and evidence. For far too long, this debate in this Chamber has been driven by ideology, and that ideology has been damaging to both children and women. Evidence and science are not optional extras. They are critical in the development of a just and fair society. A woman is a female adult. That sentence is based on logic, science and evidence. It is a sentence that comes with ease to most citizens in this country but, incredibly, very few TDs in this Chamber are able to say it.

Over the past ten years, this Government, its predecessors and campaigning groups have embarked on a significant campaign of social engineering.

Incredibly, the Government has tried to delete the word "woman" from many different aspects of society. It has even tried to delete the word "woman" from maternity legislation. The HSE has used words like "chestfeeding" instead of "breastfeeding". Among the HSE literature, it has produced a document highlighting issues around cervical checks, saying that "people with a cervix" need to come to the HSE. Teachers have been told on in-service days not to use the words "mother" and "father" in class because it is not inclusive. The National Council for Curriculum and Assessment has links on its websites to materials for teachers that talk about not using the words "boys" and "girls" in classes for the same reason. A former Taoiseach put pressure on Irish Rugby in the Dáil to reverse its decision to make women's rugby female only, despite significant evidence that enormous damage is done by male-born players to female players in that competition. Professor Donal O'Shea of the National Gender Service, which is deeply committed to people with gender dysphoria, stated at an Oireachtas committee that activists are brainwashing politicians-----

Pádraig Rice (Cork South-Central, Social Democrats)
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Ah, Peadar, no.

Peadar Tóibín (Meath West, Aontú)
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-----and HSE management-----

Pádraig Rice (Cork South-Central, Social Democrats)
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Jesus.

Peadar Tóibín (Meath West, Aontú)
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-----when it comes to proposed new gender recognition laws.

A Deputy:

The Deputy has done so over social media.

Peadar Tóibín (Meath West, Aontú)
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Young gay and lesbian people are being told that they are not gay but that they are in the wrong body. A consequence of the Gender Recognition Act-----

Marie Sherlock (Dublin Central, Labour)
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This is disgusting.

Peadar Tóibín (Meath West, Aontú)
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-----is that it has actually allowed male-born prisoners to be put in women's prisons in this State. It is an incredible situation that we have had individuals who were jailed for horrific sexual offences being located in women's prisons. Barbie Kardashian was found guilty of threatening to kill, rape and torture his mother. Kardashian was granted a gender recognition certificate by the Department of Social Protection and he was put in a women's prison, an absolute dereliction of duty by this Government.

The Government's policy on gender affirmation is ignoring the potential comorbidities that can often exist with children and lead them to question their gender. Gender affirmation puts children on a path that can lead to chemicals, puberty blockers and irreversible surgeries and it never deals with the other comorbidities they may be dealing with. They can destroy a person's fertility and cause serious health damage, in some cases leading to children de-transitioning afterwards.

Ireland remains wedded to this policy despite the fact that most other western countries are reversing from this ideological approach. The debate in Ireland is actually stuck in the past in this regard. Most of the rest of the world is moving on. The International Olympic Committee is moving to a ban on transgender athletes competing in female Olympic events because it is deeply unfair to women. The NHS in Britain has significantly changed its approach, particularly for minors, by ending gender-affirmative care models in youth in England. The US, Denmark, Sweden and Finland have all left WPATH because WPATH is not a clinical protocol. The two most experienced clinicians involved in transgender healthcare in Ireland, Professor O'Shea and Dr. Moran, have made a formal complaint to HIQA about the HSE treatment of children with gender identity issues. They say the HSE has been directing children to potentially damaging overseas affirming services. They have been given leave to carry out a judicial review into HIQA. Logic would dictate that we would listen to that judicial review so that we can understand the best way to approach healthcare in this space.

What does it say about the echo chamber of this Dáil that practically every single other party in this Dáil will swap science and healthcare for gender ideology? What does it say when every single adult in this Dáil, other than a handful, is putting the healthcare of children at risk to follow an ideological approach? We need to make sure that science is at the heart of everything we do in terms of healthcare.

Richard O'Donoghue (Limerick County, Independent Ireland Party)
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I will start with my disappointment that people on that side of the House would turn around and say that people on this side of the House are far right or far left. I am a father. I have been heckled-----

Duncan Smith (Dublin Fingal East, Labour)
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Give us a break. You-----

Richard O'Donoghue (Limerick County, Independent Ireland Party)
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Excuse me. I did not interrupt you, so have the courtesy to shut your mouth and listen to somebody.

Richard O'Donoghue (Limerick County, Independent Ireland Party)
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That is as much as it comes to.

I am going to put something on the record very clearly to you now as well, Conor Sheehan, since you talk about Limerick and put Limerick people down. I am going to talk to you as a parent.

Marie Sherlock (Dublin Central, Labour)
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The Deputy has time to speak to the motion.

Richard O'Donoghue (Limerick County, Independent Ireland Party)
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I am going to talk to you if you may listen, but you do not listen.

Marie Sherlock (Dublin Central, Labour)
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The Deputy has time to speak to the motion.

Sorca Clarke (Longford-Westmeath, Sinn Fein)
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Deputies, please.

Richard O'Donoghue (Limerick County, Independent Ireland Party)
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Chair, these people-----

Sorca Clarke (Longford-Westmeath, Sinn Fein)
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Deputies, respect the House.

Richard O'Donoghue (Limerick County, Independent Ireland Party)
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I am going to talk to these people.

Sorca Clarke (Longford-Westmeath, Sinn Fein)
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Respect the House.

Richard O'Donoghue (Limerick County, Independent Ireland Party)
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Correct - respect. That is what I am asking for, and it is the one word I have written down here for you today. It is "respect".

Jerry Buttimer (Cork South-Central, Fine Gael)
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How about yourself, Deputy?

Richard O'Donoghue (Limerick County, Independent Ireland Party)
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I have been heckled in this House, saying I am anti-gay and anti-this.

Conor Sheehan (Limerick City, Labour)
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That is our understanding.

Richard O'Donoghue (Limerick County, Independent Ireland Party)
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Excuse me. Again, you cannot be quiet and listen to somebody else's opinion. It is called respect. I have been heckled in this House on more than one occasion, be that for my religion, for being over here, for being far right. I am going to put something very clear to you: I am a parent and a grandparent. I have a son who is gay. None of you ever said to me, "Gee, Richard, we did not know that." You do not know me but you make assumptions about people. The one thing I will do for anyone, whether they are up in the Gallery or not, whether I agree with them or not, is respect and help them every bit I can.

Marie Sherlock (Dublin Central, Labour)
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Great.

Richard O'Donoghue (Limerick County, Independent Ireland Party)
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I will respect and help people. That is my duty of care as a politician.

People then say that one of our party members made an assumption. That is his opinion. It does not have to be mine. Allow a person to have their own opinion. All I am asking for is to be able to have my own opinion. My opinion is that there are an awful lot of people out there who are scared and lack understanding. The world is changing. Friends of mine are gay, friends of mine are lesbian and friends of mine are transgender. Friends of mine are scared because their children are coming up. My job here is to help them regardless of whether I agree with them or not. The job of doctors is to help people whether they agree with them or not. Education on this is key.

As I said at the start, I have my own religion. I respect everyone else's religion, but respect mine. I have my opinion. It does not have to be the same as yours, but respect mine. At the end of the day, I am here to help, I am here to learn, I am here to give respect to whoever I can regardless of whether I agree with them or not. That is my opinion, and that is why I started off as I did. The Deputies thought I was going down a different road, but I am not.

Marie Sherlock (Dublin Central, Labour)
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What is he on about?

Richard O'Donoghue (Limerick County, Independent Ireland Party)
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This is what I am trying to say. Politicians come in here and say something sometimes for a headline. I say what I feel, being part of me. If Members do not agree with it, that is their problem.

Remember this: I went around to many houses during the election. I went to one house and a person opened the door. They were identifying as a fox. Did I respect them? Did I talk to them? Yes, I did. Did I have to agree with it? No, I did not, but I respected them and spoke to them the same as a human being.

Duncan Smith (Dublin Fingal East, Labour)
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Will the Deputy be voting for the fox-hunting Bill?

Richard O'Donoghue (Limerick County, Independent Ireland Party)
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Again, I am a believer-----

Duncan Smith (Dublin Fingal East, Labour)
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Sit down and shut your mouth. Gobshite.

Richard O'Donoghue (Limerick County, Independent Ireland Party)
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Somebody just called me a gobshite.

Duncan Smith (Dublin Fingal East, Labour)
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Speak to the motion.

Sorca Clarke (Longford-Westmeath, Sinn Fein)
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Deputy, please.

Richard O'Donoghue (Limerick County, Independent Ireland Party)
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This is the fool we are talking about. Again, a person can have an opinion.

Marie Sherlock (Dublin Central, Labour)
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Deputy, we just want to hear-----

Richard O'Donoghue (Limerick County, Independent Ireland Party)
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A person can have an opinion, and each side of this House will not allow opinion unless it is their opinion. As an adult, this is about-----

Duncan Smith (Dublin Fingal East, Labour)
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What is the Deputy's opinion? He is not speaking to the motion.

Richard O'Donoghue (Limerick County, Independent Ireland Party)
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Again, if the Deputies to my right keep interrupting, it means I am saying something that is hurting them very deeply. I have my opinion and I am here to help anyone who is in whatever situation they are in, regardless of whether I agree with it or not. This is what I am talking about. Everyone in this country deserves healthcare - end of story - regardless of their circumstances or whatever else. They deserve healthcare, and that is what the motion is about. It is about caring and giving healthcare to people regardless of what it is about.

Jerry Buttimer (Cork South-Central, Fine Gael)
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The important part we should look at is this debate is about people, first, second and third. It is not about anything else. A decade on from the passing of the Gender Recognition Act, we have a lot of road to keep going as a country. As a member of the LGBTIQ+ community, I respect everybody. Deputy O'Donoghue is right that fear is driving some of the narrative. That fear is caused by some and they have to reflect on their articulation of points.

I welcome the members in the Public Gallery and thank them for being here and for their battle in terms of trans healthcare. It is a battle they should not have to engage in. That is something we need to reflect on as a country and as a society because, as the motion before us from the Labour Party reflects, this is about stories.

The sad part is some of the comments this morning will get into the paper but the real story is about the stories of the people in the Gallery here today and their quest for healthcare. I make the point to all of us, as Members of the Oireachtas, irrespective of ideology or viewpoint, to reflect on what we articulate, how we articulate it, what we say and when we say it. I get emotional when I hear some of the inflammatory language being used. Nobody wakes up today and suddenly flicks a switch from a man to a woman or a woman to a man. It does not happen. If we are to have a debate in this House, let us do so in a manner that is honest in terms of engagement on the issue of transgender healthcare.

I pay tribute to the Minister, Deputy Carroll MacNeill, and also to the Minister of State, Deputy Butler, for her own lived experience and the way she has ensured that we can have at the heart of the Government a movement toward that piece that has been missing since the Gender Recognition Act. Members of the transgender community deserve comprehensive, respectful and integrated care and the support they need to live their lives authentically so that they can flourish. When we talk about the percentage of people or the numbers and volumes, it is actually quite small. Both the Minister, Deputy Carroll MacNeill, and the Minister of State, Deputy Butler, have openly acknowledged that the current public service in Ireland does not fully meet the needs of people seeking gender-affirming healthcare. I am glad that the Government is not opposing the Labour Party Private Members' motion today. I thank members of the Labour Party for bringing this forward.

There is a key phrase that we should focus on: gender-affirming healthcare. What Deputy Tóibín is saying is not new at all. I respect Deputy O'Donoghue. I know him to be a decent, honourable man. Let us listen to the stories as we pursue a willingness to listen to the experiences and the huge gaps in the services. Let us think about the gaps in those services. It is affecting people - an duine. People are being judged, harassed, beaten, chased, mocked, jeered and condemned by a Republic that is meant to treat all of our children equally. Leaders of Parliaments, by their words and actions, bring people. That is why this debate is important for me. We must, as a society, bring about meaningful improvements for every person who wants gender-affirming healthcare.

Deputy O'Donoghue mentioned friends of his who are transgender. They are not ogres, demons or predators. We should not have to say that. We should not have to qualify that. They are decent people. They are professionals and ordinary people trying to live their life as best they can, making a valuable contribution. I ask Members to walk in their shoes for a couple of days and see the reality of life. They are coming into your office to talk to you. They are friends of yours and they are struggling with mental health and to gain basic healthcare. For me, working with like-minded people, that diverse experience will bring about change. It will also bring about awareness.

The Deputy mentioned education. He is right. It is not education; it is raising awareness and that new clinical programme for gender healthcare. That programme must be about best practice from around the world, recognising that there has been an increase in the demand for transgender healthcare services but also reflecting a growing societal understanding of a gender diversity commitment to supporting people at every stage of their journey. That is why both the Minister, Deputy Carroll MacNeill, and the Minister of State, Deputy Butler, are steadfast in their belief that the new clinical programme will be instrumental in establishing a fair, balanced and effective system for gender-affirming healthcare in Ireland. We cannot ignore the inclusion of people with a real lived and living experience. Their viewpoint, informed by the direct personal involvement with the healthcare system is not just invaluable in shaping a model of care that is responsive, it is critical. Yes, there will be people with different viewpoints but collaboration is needed.

The process, in terms of what we are looking for, is about active engagement with healthcare professionals, advocacy organisations and other relevant stakeholders. What does it do? It brings us to a model of care that reflects the full spectrum of needs and perspectives, paving a way for a system that is both truly inclusive, effective and delivers for people who need it. Transparency is also a key principle that will underpin the programme's development. I did not hear all of the debate but I am acutely aware that information and support among gender-questioning young people and their families is one that we need to do more on. The unique challenges, navigating the complex social, emotional and medical issues in a world that is sometimes cold, where understanding and acceptance is very limited is difficult. The broader model of care must be refined to recognise the urgency of the situation. I hope the HSE will continue that.

I ask all Members to have continued collaboration based on evidence, the stories of people, their lived experience, but above all, the focus on inclusion and respect, that we can and should make a substantial and positive difference in the lives of people, particularly those we serve. The clarion call from this debate is that together, let us move forward towards a future where every member of the transgender and gender-diverse community can access the care, support and recognition they deserve, at the very least they need to continue to live their best lives. We owe them that, as members and citizens of a Republic.

Mark Wall (Kildare South, Labour)
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I start by thanking my colleague, Deputy Sherlock, for bringing forward this important motion on transgender healthcare.

Over the last number of months, I have met with a number of transgender groups that are focused on highlighting the issues they are facing in the community regarding access to safe and effective healthcare in Ireland. I thank these groups for their input into the Labour Party motion today. This is about respect. This is about helping people. When I speak with these groups, their basic ask is for access to safe healthcare. Even something as simple as a blood test is out of reach for the trans community. I have had people contact my office over the unfair treatment they face in trying to access a blood test. This is due to a direction from the national gender service, NGS, which we are told is instructing GPs to not carry out blood tests for their trans patients. This is simply discriminatory and will put the trans community at risk.

I also want to highlight an issue with the rollout of the free HRT scheme. While this is a great initiative, inequalities have arisen in misunderstandings of the scheme. There seems to be a discrepancy in the scheme as some trans women have reported accessing menopause products while others have not been so lucky. However, those who have accessed these products are now reporting differing accounts, being given free HRT one month and being asked to pay the next. There is no consistency. I ask the Minister for Health to provide some clarity and guidance on this.

At the very core of this motion is the need to provide safe and effective healthcare services that are patient informed. Many in the trans community do not feel listened to by the Government and they certainly do not feel listened to by the NGS. We need to have a new approach to health that is patient informed, uses the patient experience and is entirely centred on that experience. We need a new model of trans healthcare that is designed not just for the community, but for the members of the trans community and their families. We must stand with the trans community today and every day, as they have stood with us on many societally defining moments in the past, like the repeal of the eighth amendment and marriage equality. We must remember that there is no LGB without the T.

George Lawlor (Wexford, Labour)
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The issue we come to the Chamber to speak about today cuts to the very heart of dignity, equality and compassion. For too long, trans people in this county have been denied timely, respectful and affirming care. The word "respectful" has been used in this Chamber. When a Member of this House comments in this Chamber in an odious way against another Member, it is something we must call out and not sit idly by and listen to.

While progress has been made across Europe, Ireland continues to lag behind. It consistently ranks as the worst nation for trans healthcare among EU member states. We have so many people on waiting lists for care. Many people in the trans community have spoken of their experience of waiting over 13 or 14 years for an appointment. We can imagine the toll it takes on their lives when they have to endure years of uncertainty and a daily struggle to access basic healthcare. The message it sends is that their identity is somehow less deserving of recognition.

This is not just a healthcare issue; it is a human rights issue. The reality in Ireland is stark. We have only one dedicated gender service, which is based in Dublin, and the capacity there is overwhelmed. While other European nations have expanded community-based services, streamlined pathways and aligned with international best practice, Ireland has stood still. Ten years after the passage of the Gender Recognition Act 2015, which was a landmark moment for equality, the promise of dignity has not been matched by the delivery of care. The Labour Party has consistently fought for the most marginalised people in Ireland and trans people are no exception. The Labour Party was instrumental in passing the 2015 Act. My colleague, Deputy Sherlock, continues to raise this issue in this Chamber, demanding reform and accountability. We introduced this motion to overhaul trans healthcare and to call for accessible, timely and affirming services. It is not symbolic; it is a demand for concrete steps towards justice.

My party's history is one of standing shoulder to shoulder with those who have been silenced or sidelined. We have advanced workers' rights, championed women's equality, fought for marriage equality and campaigned for the bodily autonomy of women. The trans community has stood shoulder to shoulder with us. The Labour Party has always sought to represent those who need a voice. Today that tradition continues with trans people, who deserve not just recognition on paper but healthcare in practice. We must remember that healthcare is not a privilege; it is a right. Trans people are not asking for special treatment; they are asking for the same dignity afforded to others. They are asking for a system that sees them, hears them and supports them. So, what must be done? First, we must expand services beyond Dublin to ensure that care is accessible across the country. Second, we must reduce waiting times by investing in staff, resources and training. Third, we must align our system with international best practice. Above all, we must change the culture. Compassion must be the cornerstone of our healthcare system. That means listening to people's experiences and recognising their health and well-being.

Conor Sheehan (Limerick City, Labour)
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I am proud to stand here today as a Labour Party TD to close this motion. I commend Minister of State, Deputy Buttimer, on his very thoughtful and heartfelt contribution. It really reminded me why we are here and why we do what we do, especially compared to some of the contributions we heard before it. However, I am disappointed that this debate is coming to a conclusion at 11.45 a.m. I am disappointed by the nature of some of what Deputy Cullinane said. I am disappointed that Sinn Féin has not used its full speaking slots. I am incredibly disappointed by Aontú's contribution. I am "driven by ideology" in relation to this: my ideology is compassion, inclusion and recognising people rather than pretending they do not exist. We know we have a huge problem with male violence against women in this country. The fact of the matter is that if a woman is going to be attacked or murdered, statistically the chances are that the perpetrator will be her husband or partner. That is the person who is going to do it. It is not a trans woman. Statistically, it is not a trans woman. There has been an attempt to slur and blur the debate in this respect.

I am proud to stand here because the Labour Party has always been steadfast in its commitment to the LGBTQI+ community. I welcome all our friends here to the Gallery. I am very glad we have Mammies for Trans Rights here with us this morning. That is really important. I genuinely believe that mammies know best. Mothers know their children. They know their children's needs. They know what their children want. They know what is best for their children. All of these mothers are up in the Visitors Gallery because they want a compassionate, person-centred, informed-consent model of healthcare for their children. They want their children to be recognised. They want their children to be treated with compassion, dignity and humanity. They do not want their children to be othered. I do not like when people come into this House or other public forums and seek to other people. Regardless of whether somebody identifies as a cisgender male or a cisgender woman, or whether somebody is trans, we are all people and we have to treat people with humanity, dignity and compassion.

I am proud to stand here as a gay man, but I am very conscious of my own privilege. I am lucky to live in a society and a country that is relatively pluralist, relatively welcoming and relatively decent, albeit we obviously need to make progress. However, it is not like that for trans people. We have the worst trans healthcare in Europe and that should absolutely shame us.

The last thing I want to say here today is that the legislation around conversion therapy is on the Government's autumn priority legislation programme. We have been waiting too long.

We need to get that over the line and we need to see movement on that. I urge the Minister to take that back to her colleagues in government.

Mairéad Farrell (Galway West, Sinn Fein)
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In accordance with Standing Order 85(2), the division is postponed until the weekly division time this evening. We will now suspend until 12 noon.