As the Deputy will be aware, the National Gender Service communicated its decision to close the waiting list to the HSE on 10th December 2025. I was deeply concerned that health services continue to be provided to those who need them, and Minister Butler and I met with HSE officials at that time to ensure that services remained in place.
The HSE have advised the National Gender Service that they do not have the authority to close this waiting list. 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.
In addition, the Saint John of Gods Community Services also wrote to me to assure me that such a critical decision cannot be made without consideration by their Executive and Board and approval from the senior HSE management team. As such, I can confirm that the National Gender Service will continue to accept referrals for those 17 years and older. However, as demand continues to increase, there are long waiting times for the initial assessment. Currently, there are over 2000 people waiting to be seen, and waiting times stand at over four years.
In terms of resourcing, I understand that in 2019, a number of staff were hired to support the National Gender Service programme being developed in St Columcille’s Hospital. I am aware that the matter of additional staff and clinical space, to meet increased demand and to help reduce waiting times, remains under review with the HSE and HSE Dublin South-East.
The Deputy will also be aware that, as set out in the Programme for Government 2025, this Government is committed to ensuring a transgender healthcare service that is based on clinical evidence, respect, inclusiveness and compassion.
The provision of proper, appropriate and integrated gender healthcare services is something that Minister Butler and I want to ensure is in place for those who are questioning their gender identity or are experiencing gender incongruence or dysphoria.
It is in this context that the HSE has established a new National Clinical Programme for Gender Healthcare to develop an updated clinical Model of Care with the aim of designing clinical pathways to deliver safe and effective health and social care for those seeking gender affirming healthcare services. This work will also inform an implementation plan for its delivery.
Minister Butler and I are focused on progressing the Model of Care for gender healthcare and a key aspect of the development of the new model of care is stakeholder consultation. I am committed to ensuring that all stakeholders are heard and actively involved in this process. This inclusivity is vital for the success of the Model of Care that we aim to create.
Gaining an understanding of the experiences of those in the transgender community will be integral to the development of the model of care. That is why there has been and will continue to be a strong focus on the experience base which will bring in stakeholder perspectives and experience, as well as, the evidence base, which relates to the clinical research on the topic. This collaborative approach will ensure that the needs and perspectives of all stakeholders are considered, leading to a more inclusive and effective care model.
A number of lived experience engagement design sessions, attended by several advocacy groups, have already been held to inform the development of a plan to maximise stakeholder engagement. It is our sincere hope and expectation that this approach not only will strength the relevance and inclusivity of the final model but will also lead to better outcomes by the services truly reflect the experiences and populations they are meant to serve.
A cross-speciality Clinical Advisory Group has been established with the Royal College of Physicians of Ireland and convened in June 2025 to support the Model of Care design and development. In addition, a working group, which has a number of representatives with direct lived experience has also been established and the first meeting took place in late 2025.
In terms of progressing the model of care, 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 August of this year and the HSE are now reviewing the submissions and completing the evidence review. Further information on the evidence base review can be found the National Clinical Programme website.
Developing a model of care for Gender Healthcare Services is expected to be a complex process and the HSE and my department 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.
