HSE criticised over failure to engage community in appointment of new transgender services Clinical Lead

Despite calls for the HSE to implement a model of trans healthcare in line with human rights standards, this latest decision was made without consulting transgender communities.

Photo of hand holding pink, white and blue trans Pride flag, article is about HSE trans healthcare.
Image: Instagram @transhealthie

Trans Healthcare Action has condemned the HSE’s decision to provisionally appoint a new Clinical Lead for Transgender Services without seeking any input or engagement from the trans and gender diverse (TGD) communities.

On October 11, 2023, Trans Healthcare Action wrote an open letter signed by 22 LGBTQ+ and civil society organisations demanding a model of trans healthcare that is in line with human rights standards. It called on the HSE to include trans voices in matters that directly impact their lives and requested that the HSE consult the trans community throughout the hiring process to create an inclusive model of care.

In November 2023, Trans Healthcare Action asked to meet with the Chief Clinical Officer of the HSE to discuss the expectations for this role, but they received no response. Despite this call of action, Dr Karl Neff, who currently leads Ireland’s National Gender Service (NGS), is said to be appointed for the position.

Trans Healthcare Action spokesperson Niamh Ní Féineadh said, “It is disappointing that, once again, a decision which will impact the treatment of every trans person in Ireland has been made without any consultation with the community.” She continued, “In all other sectors of medicine, patients have a say in critical decisions, yet the trans community has been denied their right to engage in this process.”

Ireland’s current system for trans healthcare is recognised as the worst among all EU member states, according to a report published in 2022 by Transgender Europe (TGEU).

Trans activists have repeatedly spoken out about the decade-long waiting list that patients face when attempting to access vital healthcare in Ireland and the invasive assessments that often result in trans people being denied necessary healthcare.

Dr Neff has stated that he believes these “comprehensive psychosocial assessments” are “vital…prior to medical transition,” but his stance goes against the World Health Organization’s ICD-11, which reclassifies gender-affirming care as sexual health, eliminating psychiatric screening. 

The HSE previously stated, “It is recognised best practice to develop a Model of Care in a consultative way, engaging with all relevant stakeholders,” but in direct contradiction to their statement, the HSE has repeatedly failed to engage with the community in decisions that impact healthcare outcomes.

Trans Healthcare Action is calling for the HSE to reassess the decision to hire a Clinical Lead for Transgender Services. Instead, they ask that the HSE engage the trans community in the decisions made around transgender care, upholding the human right to self-determination in healthcare. 

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