I propose to take Questions Nos. 1031 and 1032 together.
The Cass Report has been reviewed by clinical experts within the HSE at the request of the Chief Clinical Officer and the review is currently under consideration by the HSE.
The provision of proper, appropriate, and integrated gender healthcare services is something that I want to ensure is in place for those who are questioning their gender identity or are experiencing gender incongruence or dysphoria.
As per the Programme for Government 2025, the Government is committed to ensuring a transgender healthcare service based on clinical evidence, respect, inclusiveness, and compassion.
A clinical programme for gender healthcare has been initiated by the HSE and an updated clinical model for gender healthcare services is being developed. The Clinical lead is in place and recruitment is ongoing for the rest of the multi-disciplinary team.
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 December 2025.
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 will now review submissions and complete the evidence review.
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 update their findings on the HSE website.
Lived experience engagement design sessions, attended by a number of advocacy groups, were held in July and September 2025. These sessions were held to inform the development of a plan to maximise stakeholder engagement.
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. It is not possible to pre-empt the outcome of this process by determining at this stage what this model of care will look like once developed.
Regarding the HSE review of the Cass report, 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.
