The first case in the Irish courts seeking a change in the register of births to reflect a sex change (gender reassignment) opens in the High Court today.
Ms Lydia Foy is seeking a judicial review of the refusal of the Chief Registrar of Births, Marriages and Deaths to correct her birth certificate to reflect the fact that her identity is now, and she maintains always was, female, despite the fact that she looked like a boy at birth. The birth register records that she is male, with the name Donal Mark.
If a mistake is made in registering a birth, there is a relatively simple procedure for correcting it by drawing a line through the mistaken information and substituting the correct information.
This is what Ms Foy unsuccessfully sought following a gender reassignment operation in the UK. She is seeking a declaration that a mistake was made and that it should be rectified.
Alternatively, she is seeking a declaration that the refusal to rectify her birth certificate infringes her constitutional rights to privacy, dignity and identity.
While this is the first such case to be taken in this State, a number of similar cases have been taken in other jurisdictions, including the UK, the Netherlands and the European Court of Human Rights. They have had varying levels of success, and to date none has succeeded in the ECHR. However, the minority of judges in the ECHR favouring allowing a change of gender identity has been growing.
The only countries in the Council of Europe which do not permit a birth certificate to be changed are Ireland, the UK, Albania and Andorra.
The arguments made in such cases involve considerable amounts of medical and scientific evidence about human sexuality and identity. This includes a description of a disorder known as congenital gender disability, or gender dysphoria, where a person has the external genital characteristics of one sex but the brain of another. This is estimated to affect one in 12-15,000 males, and one in 50-60,000 females.
According to psychiatrists, this disorder leads to the sufferer living with the profound conviction that he or she is living in the wrong body, and identifying with the gender he or she feels part of. The person suffers considerable trauma, depression and isolation as a result.
The medical treatment, including surgery, which is undertaken to correct this state, called gender reassignment, is long, painful and costly. It is understood that in the case of this applicant, who underwent the procedure in the UK in 1992, the cost was underwritten by the Eastern Health Board.
The case is expected to take over a week. A number of international experts will be called, including Prof Louis Gooren, an endrocinologist who will give evidence of the importance of determining gender on the basis of the sex of the brain.
Ms Foy and the doctors who treated her are also expected to give evidence.