Mattie McGrath (Tipperary South, Independent)
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1740. To ask the Minister for Health the background work which has been carried out by the Minister of State for Mental Health to progress trans healthcare and making endocrinology services available to children aged between 16 and 17 years of age; the State's official stance on making puberty blockers and hormone treatments available to gender questioning children; the mental health supports available to children with gender dysphoria; the engagements she has had with trans organisations (details supplied); if the critical findings of the Cass Report are being considered by her, given her efforts to deliver healthcare support for young trans people; and if she will make a statement on the matter. [58215/25]

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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As set out in the Programme for Government 2025, the Government are committed to ensuring a transgender healthcare service that is based on clinical evidence, respect, inclusiveness and compassion.

As the Deputy may be aware, a new clinical programme for gender healthcare has been initiated by the HSE, and an updated clinical model for gender healthcare services will be developed. This work will inform an implementation plan for its delivery.

As part of the development of the Model of Care, the existing and emerging evidence base, including international evidence on health outcomes, and data on the clinical needs of those presenting to clinical services over the years, will be reviewed as part of this work. The HSE commenced the systematic review on the evidence base with respect to co-existing clinical needs in gender diverse people with support from the HSE Library Service. Interim results of this review were made available for public consultation during the month of August 2025. The HSE are now reviewing any submissions and completing the evidence review of this topic.

The other main element of the work will include a review of the experience base which encompasses an understanding of the experience of service users, their families, healthcare workers in gender healthcare and other stakeholders. As this is an area of healthcare where there are many public voices, all efforts will be made to hear from those with who have lived and living experience.

As the work progresses, the HSE will be updating their findings on their website.

Developing a model of care for Gender Healthcare Services is expected to be a complex process and the HSE and department officials will work closely together to support the process, ensure transparency and keep the patient at the centre of the process.

It is important that the HSE is given time to develop a model of care that is based on the best clinical evidence and that will deliver the best outcomes for persons with gender incongruence or dysphoria.

As the Model of Care for Gender Healthcare is being developed, children and young people can access services by attending their GP who may refer the patient to their local CAMHS service. If specialised gender assessment and support is required, children can be referred by CAMHS to the UK under the Treatment Abroad Scheme (TAS) for multidisciplinary assessment. In treating children and young people, any decision is a clinical matter for the treating clinician, their patient and family.

There are three tiers of mental health service provision. Tier 1 relates to ‘mild to moderate’ mental health difficulties, where service users can access care at primary care level either through the HSE or through a range of organisations fully or partially funded by the HSE. Tier 2 relates to ‘moderate to severe’ mental health difficulties, where service users can access specialist mental health supports from CAMHS. Tier 3 relates to ‘severe and often complex’ mental health needs whereby supports are provided through the CAMHS Inpatient Units (known as Approved Centres).

The recently published HSE Child and Youth Mental Health Office Action Plan 2024 - 2027 seeks to improve leadership and management of all Youth Mental Health services.

This plan will improve all youth mental health services, including the specialist CAMHS service, to deliver services which are safer, more effective, easier to access and which offers appropriate support at all levels when needed.

The three-year Plan, which is available on the HSE website, sets out a clear roadmap to ensure children and families have equitable and timely access to high-quality mental health care, including better links with Primary Care and Disability Services, and greater use of e-mental health responses.

Socially inclusive youth mental health services is a key theme within the new Action Plan which seeks to recognise the cultural and diverse needs of the whole population, including priority groups. This medium-term action will ensure vulnerable children and young people in priority groups with mental health difficulties will have equitable access to mental health services.

In relation to puberty blockers, any decision on treating children and young people, including decisions on the use of puberty blockers, is a clinical matter for the treating clinician, their patient and family.

With regards to stakeholder engagement, as Minister for Health, I have met with a number of advocacy groups this year and I will continue to engage on this important issue. Minister Butler has also engaged on numerous occasions with various organisations and groups.

Regarding the findings of the Cass report, the final report of the Cass Review was reviewed by clinical experts within the HSE at the request of the Chief Clinical Officer. This was a specific and defined piece of work that was independent of the planned update of the HSE Clinical Model of Care for Gender Healthcare. It is the Model of Care that will ultimately make recommendations on the delivery of gender healthcare services in the HSE, for both adults and young people.