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Health Services Provision

Dáil Éireann Debate, Tuesday - 20 March 2018

Tuesday, 20 March 2018

Ceisteanna (581)

Thomas P. Broughan

Ceist:

581. Deputy Thomas P. Broughan asked the Minister for Health the way in which his Department is monitoring adherence to the guidelines by an organisation (details supplied) for transgender healthcare; the reason psychiatric diagnosis is conducted as opposed to psychosocial assessment in accordance with the guidelines; and if he will make a statement on the matter. [12499/18]

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Freagraí scríofa

Transgender-specific guidelines have been developed by the World Professional Association for Transgender Health (WPATH) and the Endocrine Society.  These guidelines were devised by experts in transgender healthcare, along with members of the International Transgender, Transsexual and LGBT community.

International best practice for transgender children, adolescents and adults involves a comprehensive multi disciplinary psychosocial assessment by a multi disciplinary team and shared decision making in the best interests of the individual. Both WPATH and the Endocrine Society Guidelines 2017 specify the assessment must be carried out by a mental health professional (s) with experience in transgender health care and possess specific skills.

The emerging evidence on good outcomes following medical and/or surgical transitioning is based on use of multi-disciplinary psychosocial assessment, fulfillment of criteria for hormones and ongoing psychological support throughout the process. It is important that psychological support is available to individuals before, during and after transitioning. Informed consent is essential, whereby benefits and risks of hormone treatment and surgery are discussed with individuals seeking these interventions to try and prevent negative outcomes. Although regret rates are low, it can happen and can also lead to high levels of psychological distress.

The model of care provides the framework for the development of National Gender Clinics and MDTs for children and adults, funded by the Acute Hospitals and Mental Health Divisions of the HSE. Recruitment will commence to develop these national teams in 2018.  It is envisaged that these National Teams will be in place in 2018, pending successful recruitment campaigns.

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