Gender Care in Ireland

Adult gender care in Ireland runs through the National Gender Service at St Columcille's Hospital (Loughlinstown) (source).

National Gender Service

The National Gender Service is for people aged 18 and over; a referral is possible from age 17 and must come from a GP (source). In a 2023 report, the HSE wrote that young people who have already started hormones sometimes have to wait a long time for transfer to the adult service, because they join an existing long waiting list (source).

Youth care

For children and young people, the HSE is working on a new care model for gender care (source). Referrals to the Tavistock clinic in London, previously the usual route, lapsed with the closure of that clinic.

Legal framework

The Gender Recognition Act (2015) allows legal recognition of gender from the age of eighteen, on the basis of a statutory declaration; for sixteen- and seventeen-year-olds an additional procedure applies (source).

Youth care to date

Ireland had no specialist child and adolescent mental health service for gender care. Children and teenagers who needed a specialist psychological assessment were referred through the HSE Treatment Abroad Scheme to the Tavistock clinic in London; this happened 233 times between 2012 and 2022. Before the coronavirus pandemic, psychologists from the Tavistock travelled to Children's Health Ireland in Crumlin to carry out assessments. The paediatric endocrinologist there was not accepting new referrals when the HSE report of 2023 appeared (source). Doctors at the National Gender Service argue that Ireland should follow the recommendations of the Cass Review (source). With the closure of the Tavistock clinic, described in the article on the United Kingdom, that route lapsed.

New care model

After the interim report of the Cass Review, the HSE had its implications for Irish care pathways examined; the result appeared in 2023 (source). The HSE is now preparing a new Model of Care for gender healthcare, based in part on two systematic literature reviews (source). The endocrinologist Karl Neff became the HSE's clinical lead for gender healthcare in 2024; according to the HSE he will leave later in 2026, after completing a draft model of care (source).

The law in practice

An adult applies for a recognition certificate with a statutory declaration; the law requires no medical diagnosis or treatment for this. Sixteen- and seventeen-year-olds need an order from the Circuit Family Court, with the consent of the parents, a certificate from the treating doctor and a confirming certificate from an endocrinologist or psychiatrist (source). For young people under sixteen the law provides no procedure. A review of the law in 2018 recommended extending the arrangements for children; in late 2019 the government proposed simplifying the procedure for sixteen- and seventeen-year-olds, but changing nothing for children under sixteen (source). The consolidated text of the law still contains the court procedure for sixteen- and seventeen-year-olds (source). The role Ireland plays in the gender identity policy of the European institutions is described by genderbeleid.nl. Compare with other countries at policy by country.