The current clinical lead for the HSE gender healthcare services, Karl Neff, is set to step down at the end of this year, after completing a draft for a new model of care.

The state of trans healthcare in Ireland is currently under intense scrutiny due to the decade-long waiting lists and barriers to accessing care. For years, activists have been calling for a reform of the current system, advocating for a model based on informed consent and bodily autonomy for trans and gender diverse people.

In this context, as reported by The Irish Times, an HSE spokesperson confirmed that the gender healthcare clinical lead will leave this year. Karl Neff, a consultant endocrinologist, assumed the role in 2024 and will step down by the end of 2026, after completing a draft model of care.

“Dr Neff had planned to leave upon completion of the draft model of care and [he] will be doing this,” the spokesperson said.

“The goal is to develop a person-centred model of care and when completed this will support the development of an integrated gender healthcare service that meets the needs of people in Ireland.”

According to The Irish Times, in correspondence dating back to January, released under Freedom of Information (FOI) law, Minister of Health Mary Butler communicated with then HSE chief executive Bernard Gloster about gender healthcare.

At the time, Butler said she had met with Neff to discuss the new model of care, and cited a trip to Iceland she made in order to review the country’s gender healthcare service. Iceland had an informed-consent model of care, where psychological assessments are included only with the patient’s consent.

Praising the Icelandic model in her correspondence, Butler stated: “It was clear from what we learned that in the majority of cases, most people benefited from counselling, psychological supports and in particular the support of social work.

“It was also clear from their model of care that all interventions were provided after appropriate assessment and at age-appropriate life stages.”

Minister Butler additionally mentioned a gender clinic run by Dr Tomás Ahern in Drogheda. Ahern also provides a private service through Gender Plus, offering gender-affirming healthcare in Ireland and the UK, alongside Irish psychologist Aidan Kelly.

Butler stated that she recently met Ahern and attached a business case for the HSE to finance a registered advanced nurse practitioner to work with the doctor at the clinic.

“I would ask the HSE consider this business case to ensure continuity of care for existing patients and to expand the capacity of Dr [Ahern]’s clinic to those waiting long periods for care,” Butler said.