Ireland has been using the services of GIDS in England since 2012 for the treatment of Irish children with gender dysphoria. The numbers were as low as one referral in all of 2012 but rose to 46 in 2019; currently there are 101 children on the waiting list for gender services in the Tavistock GIDS, which is due to close.
In 2019 Dr Paul Moran, Consultant Psychiatrist in the NGS wrote to the Health Service Executive, (the national agency which runs the public health services in Ireland), to voice grave concerns regarding the presentations of the young people who were graduating into the service from GIDS England.
In the letter he requested that the HSE terminate the Tavistock service ‘as quickly as possible.’ He advocated for a planning process for paediatric gender services in Ireland and for a safe solution for patients from the Tavistock GIDS who had been placed on hormone treatment without proper assessment.
Since approximately 2016 both he and Professor Donal O’Shea, the latter a consultant endocrinologist, had begun to notice that many of the youth presenting from the GIDS had been commenced on physical treatments without adequate assessments. In fact in 2019 they conducted an audit on the treatment of 17 of those teenagers.
This data was shared with the HSE but in a letter in response to Dr Moran the clinical concerns raised were ignored entirely and the serious accusation of a data breach was levelled at the clinician. This claim was countered stating that not only was it not in fact a data breach but that it was his legal and ethical obligation to raise the points at hand.
The 2020 programme for government seeks to create and implement a general health policy for trans people in line with WPATH, a protocol which is not used in the NGS. Prof O’Shea discusses the fact that non clinicians with an activist agenda appear to have serious influence within the HSE while it ignores clinical advice from the NGS.
Since this time the relationship between the NGS and the HSE is said to be poor and recently Dr Moran and Prof O’Shea lodged a formal complaint against the HSE with the health standards watchdog in Ireland (HIQA) alleging that the HSE have directed children from Ireland to gender clinics abroad which adhere to a model of care which can harm children, an allegation which the HSE firmly denies.
In the documentary, Dr Aidan Kelly, a clinical psychologist who previously worked in the Tavistock GIDS and is now clinical director of Gender Plus gives his opinion regarding affirming care. Prof O’Shea outlines the different understanding some activists have with regard to the term ‘informed consent’ and the definition adhered to by doctors.
The programme explores the fact that the HSE has now written to the 101 families who have a child on the Tavistock waiting list and has signposted them to the Belgium public gender service under the Cross Border Scheme. Belgium’s service adheres to the WPATH affirmative model. Dr Madeleine Ní Dhálaigh a GP in Roscommon and a member of CAN-SG speaks of the increased numbers of adolescent girls presenting with gender distress in General Practices across the country and voices her concerns regarding the choice of the Belgium service. She notes that Finland, Sweden, Denmark and France could equally have been chosen, that these jurisdictions have stopped the affirming medical approach, have adopted an exploratory approach, and to varying degrees reserve medication for the smallest minority and under strict supervision. None of these countries could be noted to be socially conservative.
Niamh Ni Feineadh a trans woman who spoke for Trans Healthcare Action likened supporting gender care for children to supporting a hobby choice and compared gender affirming surgeries to an appendicetomy.
Vanessa Lacey, a trans woman who lobbied to have the European Professional Association for Transgender Health (EPATH) conference in Ireland earlier this year, described her disappointment at the refusal of the Trans Equality Network Ireland (TENI) to invite the NGS consultants to speak at the conference. As a result Lacey felt unable to attend the conference. TENI declined to take part in the documentary.
Ritchie Herron made a powerful contribution with his moving story of gender care regret and detransition.
‘Clodagh’ and ‘Sinead, a mother and daughter, provided heartfelt testimony about the gender confusion experienced by Sinead in her early teens and how she is now comfortable in her female body and grateful that she never proceeded with gender affirming care.
The producers and team should be commended for putting together such a balanced documentary.