Minister to meet doctors over Tavistock clinic concerns

Doctors express concern over HSE’s decision to continue referrals to UK clinic despite criticisms in official report

Minister for Health Stephen Donnelly is to meet doctors from the National Gender Service (NGS) later this month over their concerns about the Health Service Executive’s decision to continue referring children to the Tavistock Clinic in the UK.

Four doctors at the NGS wrote to the Minister last week seeking an urgent meeting over the HSE’s decision to continue using Tavistock’s gender identity development service (GIDS), despite severe criticisms of the clinic in a recent report.

Last Thursday, psychiatrists Dr Paul Moran and Dr Ian Schneider, along with endocrinologists Dr Karl Neff and Prof Donal O’Shea, wrote a letter to Mr Donnelly on the issue.

They stated: “In light of the announcement by the HSE two days ago that it is to continue sending Irish children to the Tavistock GIDS for gender healthcare, despite the overwhelming evidence that this clinic is unsafe, and the decision of the NHS to close it, we request an urgent meeting with you to further discuss the risk this presents to Irish children”.

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Earlier this year, an interim report by Dr Hillary Cass found staff at Tavistock felt “under pressure” to adopt an “unquestioning affirmative approach” to gender that was at odds with standard clinical assessment processes.

Questioning the evidence based around “all aspects of gender care” in Britain, Dr Cass said there were “significant knowledge gaps” around the use of puberty blockers in children and called for more research in the area.

Puberty blockers can help delay potentially unwanted physical changes if a teenager is transgender. Tavistock advises that gender-affirming hormones, such as oestrogen or testosterone, can be prescribed to a trans teenager from the age of 16.

The national service provided by Tavistock is to be replaced by a number of regional centres.

Responding to the Cass report, the HSE said last week it would continue to refer children with gender dysphoria to Tavistock. Dr Siobhán Ní Bhriain, HSE national lead for integrated care, pointed out that the services offered by the clinic had not been deemed unsafe.

Dr Moran, who works in the NGS at St Columcille’s Hospital, Loughlinstown, had earlier criticised the Tavistock clinic in 2020. In internal emails, he said he felt the service was “not capable of adequate assessment of suitability and readiness for hormone treatments or surgery”.

On Sunday, Prof O’Shea confirmed the Minister’s officials had been in contact with a view to meeting as soon as next week.

The NGS accepts referrals from the age of 17, but waiting times of up to three years apply for some services.

LGBT+ organisations have long criticised the lack of an Irish-based gender identity healthcare service for children.

The HSE says it is working to identify alternative services to Tavistock and is keen to develop a specialist service in Ireland.

Some 238 young people in Ireland have been referred to Tavistock between 2011 and 2021, including 17 in the first five months of this year. The HSE says 11 children in Ireland are currently on puberty blocker and cross-sex hormones, prescribed by their clinicians in Ireland. It says it has never received any complaints about the services provided by Tavistock to Irish patients.

Children with gender dysphoria cannot have surgery until they reach adulthood and are referred to the adult service.

Paul Cullen

Paul Cullen

Paul Cullen is Health Editor of The Irish Times