Transgender healthcare

The National Gender Service had said it was closing its waiting list to new patients in March.

THE HSE HAS said that the National Gender Service does not have the authority to close its waiting list to new patients.

The National Gender Service (NGS) provides specialist support to people aged 17 and older who are seeking medical and surgical interventions to help them affirm their gender.

RTÉ’s Prime Time reported that the NGS is closing its waiting list to new patients on 1 March due to a lack of resources.

There are currently around 2,470 people on the waiting list and as of last month, the average waiting time for an assessment was four-and-a-half years.

In a letter to both Health Minister Jennifer Carroll MacNeill and HSE CEO Bernard Gloster, NGS chair Brian Cotter wrote that a “chronic lack of resourcing” means it “remains in a situation where we have neither the staff nor clinical space to safely and effectively provide a service.”

However, the HSE has said it informed the NGS “that they do not have the authority to close this waiting list”.

In a statement to The Journal, a spokesperson added: “The HSE has informed the NGS that under the National Waiting List Management Policy and associated HSE protocols, waiting lists may only be managed in accordance with established, documented procedures that ensure fairness, transparency, and compliance with governance standards.”

Meanwhile, the Department of Health said it was informed of the decision by the NGS yesterday.

A spokesperson said MacNeill “emphasised the importance of ensuring that health services are delivered consistently to those that need them, as is expected of all health services”.

The Department spokesperson added that MacNeill and Minister of State at the Department of Health Mary Butler “met with the HSE and officials this morning to ensure that this happens”.

‘Not fit for purpose’

The Social Democrats remarked that the proposed closure of the waiting list for new patients “will leave the trans community with even fewer avenues for care” – the NGS is the State’s only multidisciplinary clinical service for transgender healthcare.

Social Democrats health spokesperson Pádraig Rice remarked that the “trans community continues to be utterly failed by the State” and said the proposed closure of the waiting list is further evidence the NGS “is not fit for purpose”.

He also accused successive Health Ministers of “completely neglecting trans healthcare” and leaving it “on the verge of collapse”.

And while the average waiting time for an assessment is four-and-a-half years, Rice said that “community estimates say it’s likely more than a decade”.

“In what other part of the health service would that be considered acceptable? There would be uproar. Where is the Minister’s sense of urgency?”

He called on the Minister to intervene and “deliver a new model of trans healthcare”.

Meanwhile, Labour’s Health Spokesperson Marie Sherlock also called for immediate Government intervention.

Sherlock said the “current model of care has reached breaking point” and while she pointed to issues with the current model, she warned that “closing the wait lists will leave people with further uncertainty”.

Last week in the Dáil, Labour called for a “full reset” of Ireland’s model of trans healthcare and Sherlock noted that the “Government did not oppose our motion”.

“If ministers accept that change is needed, then they must follow through with action.”

Elsewhere, Sinn Féin’s spokesperson on Health David Cullinane remarked that the “current system has failed completely”.

He noted that a clinical review is currently underway but added that “it cannot become a substitute for action”.

“We need timelines, investment and decisive leadership. Trans people cannot be asked to wait any longer.”

‘Service in Collapse’

The Transgender Equality Network Ireland (TENI) remarked that the proposed closure of waiting lists “is a sign of a service in collapse”.

“Every person in Ireland understands the anxiety and frustration of a long waiting list, whether it’s for a hip replacement, a diagnostic scan, or mental health support,” said Daire Dempsey, executive director of TENI.

“For transgender people seeking essential, life-affirming care, this closure represents a devastating denial of their basic right to health.”

However, they added that “Throwing money at a system that is fundamentally flawed will not fix the problem”.

“The current model of care, which has been described as intrusive and non-person-centred, has caused a catastrophic breakdown of trust between the NGS and the community it is meant to serve.

“We need to stop patching up a failed structure and start building something new, safe, and fit for purpose.”

Earlier this year, The Journal spoke to around 20 transgender adults who highlighted traumatic experiences and long wait times with the NGS.

Activist group Transgress the NGS meanwhile remarked that the “system has long been non-functional”.

It also said that the NGS has an “inability to keep up with the waiting list due to the model of care it has adopted”.

Elsewhere, Mammies for Trans Rights remarked that “support options available in Ireland could not be more chaotic or hard to navigate”.

It has called on Ministers McNeil and Butler to “develop a system of care that is fit for purpose”.

“We ask for gender care options to be available to everyone as part of everyday healthcare services.”

-With additional reporting from Conor O’Carroll