On Thursday, September 4, Health Minister Mike Nesbitt announced that Dr Hilary Cass has been appointed to review Northern Ireland’s gender identity services. The news sparked concerns among the LGBTQ+ community, with The Rainbow Project issuing a statement in response.
The organisation noted that Dr Cass’ review in England, commissioned in 2020 and published in 2024, “has been criticised by peer reviewed studies in multiple countries, including Ireland, Canada, the US, Australia, New Zealand” and more. Additionally, the report led to puberty blockers being banned across the UK, “which has caused significant distress and harm within trans communities”.
CEO of The Rainbow Project, Scott Cuthbertson, shared, “Gender Identity Services in Northern Ireland have been almost completely non-functional for most of the past decade. The Health Minister must deliver what he has promised: fit-for-purpose, well-funded and staffed healthcare for trans communities in Northern Ireland.
“He cannot hide behind another review while transgender people and their families across the region are languishing on waiting lists, being failed by their healthcare services.”
Cuthbertson continued, “We wholeheartedly support the delivery of evidence-based, research-led trans healthcare. The Cass Review, however, led to the shuttering of services and the withdrawal of care for trans people across the UK, and supported a model which views transitioning as a negative outcome for patients.
“Patient-centred and user-led services are the foundation for improving health outcomes; we believe a Cass-led review in Northern Ireland will struggle monumentally to have the trust and confidence of trans communities, and will indeed worsen an already broken system.”
The Rainbow Project’s Policy Campaigns and Communications Manager, Alexa Moore, was also co-chair of the former Service User Input Panel to the Gender Identity Service Review in Northern Ireland, which concluded earlier this year. Commissioned by Robin Swann in his position as Minister for Health, the recommendations included supplying additional funding and staffing measures to restart the services, as well as moving to a new “lifespan” model, which removes barriers for young people moving from under-18s to adult care.
Moore stated, “Trans people and their families poured their heart and souls into the local review of Gender Identity Services… This announcement of yet another review, rather than getting on with the job of providing fit-for-purpose gender affirming care will be devastating to all those who gave so much of themselves over the past 6 years.
“Trans people here deserve better than a Minister who, once again, wants to kick the can down the road rather than delivering meaningful improvements to their lives.”
The Rainbow Project concluded its statement by calling for the immediate funding, staffing and commissioning of services, with no further delays to the provision of appropriate gender-affirming care to trans people in the North.
The Professional Association for Trans Health Ireland (PATHI) also expressed serious concern over the appointment of Dr Hilary Cass to conduct the two-day long review.
Within the statement PATHI warns that the process risks repeating work that has already been done and in doing so delaying urgently needed action.
“If Dr Cass leads this review in Northern Ireland, it’s hard to see how she could reach a different conclusion than in England without undermining her own work,” said Nicola Cantwell, PATHI Field Representative for Allied Health. “When is a review not a review? When the outcome is already decided. The trans community in Northern Ireland deserves better.”
Concluding their statement the organisation reaffirms that trans and gender diverse people in Northern Ireland deserve immediate action and implementation of an accessible, person-centred, user-led gender affirming care service. Without any further delays.
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