A legal action seeking a judicial review of the State’s treatment of children with gender identity issues is due to come before the High Court shortly.
The action against the Health Information and Quality Authority (Hiqa) is being taken by Prof Donal O’Shea and psychiatrist Dr Paul Moran, a consultant psychiatrist at the National Gender Service (NGS).
Court papers were lodged on Friday, almost 18 months after Prof O’Shea and Dr Moran made a formal complaint against the Health Service Executive (HSE) with Hiqa over the HSE’s referral of young people for assessment abroad, saying it posed a risk to these children.
The Irish Times understands that the clinicians were prompted to take the High Court action over concerns about the manner in which Hiqa, the health services watchdog, handled their complaint. A letter effectively dismissing it was sent to the doctors almost three months ago.
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Prof O’Shea and Dr Moran – two of the leading experts in the area of transgender healthcare in Ireland – have stressed they are not against the “gender-affirming” model that is typically found overseas but have concerns over its link to an early readiness to begin what could be inappropriate and irreversible medical treatment for patients presenting with gender identity issues.
They have advocated for more holistic models of care when it comes to children who are questioning their gender rather than focusing on measures and treatments that are irreversible.
They are understood to be seeking a court hearing to look at setting up a judicial review as soon as the Easter legal break ends.
The HSE is developing a clinical programme for gender healthcare here and said last year that patients would continue to be assessed abroad until the service in Ireland is up and running, which was scheduled for 2026.
Just over 12 months ago, paediatrician Dr Hilary Cass published a landmark report commissioned by the NHS on gender identity services for under-18s in the UK.
It found that thousands of vulnerable children who questioned their gender identity were let down by the NHS providing unproven treatments and by the “toxicity” of the debate about trans rights.
It also concluded that the UK’s only NHS gender identity development service used puberty blockers, which prevent puberty, and cross-sex hormones, which masculinise or feminise appearances, despite there being “remarkably weak evidence” of them improving young people’s wellbeing.
The report made more than 30 recommendations. Dr Cass stressed that none were intended to undermine the validity of trans identities or to challenge people’s right to transition, but rather to improve the care of the fast-growing number of children and young people with gender-related distress.
Dr Cass said “extreme caution” should be applied when administering hormones to under-18s, that all children should be offered fertility counselling and preservation before taking a medical pathway and that follow-through services should be established for those aged 17-25.
The review, though based on UK services, impacts Ireland with more than 230 children and young people from the Republic experiencing gender dysphoria – where a person feels a mismatch between their biological sex and their gender identity to the extent that it causes unease, dissatisfaction, anxiety or depression – referred to the now closed UK-based Tavistock clinic under Ireland’s treatment abroad.
