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THE MINISTER FOR Health has said that transgender healthcare services in Ireland “are not meeting people’s needs and also not meeting their full range of needs”.
Speaking in the Dáil last night, Minister Jennifer Carroll MacNeill also said “it’s for that very reason that the HSE is developing the new model of care for gender healthcare services”.
This new model will be developed in a consultative way, the Minister said, “engaging with healthcare professionals in gender healthcare, [and] stakeholders, including people with lived and living experience and the families of people who use and receive support from services”.
She added that the government is committed to developing a new model of care that is based on “clinical evidence, respect, inclusiveness and compassion”.
The Minister was responding to a question from Social Democrats TD Pádraig Rice, who raised the concerns of the transgender community with the National Gender Service (NGS).
He cited a recent investigative series from The Journal Investigates which he described as a “harrowing” report into services currently available to transgender people.
“One patient described feeling traumatised after going through the services. Another one saying it felt like an interrogation, and people are being forced to go online to access HRT,” he added.
He also called for the new model of care to be based on an informed consent model, in line with World Health Organisation (WHO) guidelines.
Since 2019, the WHO no longer treat being transgender as a mental or behavioural disorder. Instead, they now see it as relating to a person’s sexual health. The WHO is currently developing clinical guidelines for transgender healthcare.
The Minister thanked Deputy Rice for raising the “very important perspective on the National Gender Service” in the Dáil, adding that “a person-centred approach is what we want to get to”.
She said that her Department has provided €770,000 in Budget 2025 to support the development of the new model of care.
“The clinical lead has been appointed, a cross-speciality clinical advisory group has been established, and a review of the evidence base is also underway,” she added.
A community pilot project aimed at identifying “the needs of children and young people who are gender questioning will also commence in the coming months”, the Minister said.
The investigation by The Journal Investigates reported that transgender people said the questioning that takes place during NGS assessments can feel traumatic and upsetting.
These questions include asking about what pornography they watch or details about their sexual lives with their partners.
It also revealed how some transgender people are turning to DIY HRT, a method of accessing healthcare outside the official channels.
This involves ordering hormone replacement therapy (HRT) drugs through a variety of online sources.
Transgender people who move to Ireland from other countries are also being told by the NGS they must join the waitlist and go through their assessment process before accessing healthcare in Ireland.
This is despite having legally changed their gender and previously accessed gender-affirming care in their home countries.
Responding to the investigation, the Professional Association for Trans Health Ireland (PATHI) said in a statement that it was “deeply concerned” by the “structural failures within Ireland’s trans healthcare system”.
PATHI is a group of healthcare professionals, academics, and community advocates working to advance the health, rights and wellbeing of trans and gender diverse people.
The group also called for “urgent, systemic reform to address the extensive barriers and inadequate and unsafe care faced by trans people across the country”.
Ryan Goulding, a registered mental health nurse and PATHI Field Representative for Primary Health, said: “Trans people are being left with no safe, trustworthy, or accessible options for care. This is a clinical, ethical, and structural failure that cannot continue. The way forward is clear.”
It is expected that the development of the new model of care will take two years.
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Conor O’Carroll is an investigative reporter with The Journal Investigates.
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