High Court grants leave for doctors to bring action over State’s transgender care policy

Prof Donal O’Shea and Dr Paul Moran challenging HSE’s referral of young people for assessment abroad

Prof Donal O’Shea at the National Gender Service (NGS) and psychiatrist Dr Paul Moran, a consultant psychiatrist at the NGS, have brought the judicial review proceedings. Photograph: Chris Maddaloni/Collins
Prof Donal O’Shea at the National Gender Service (NGS) and psychiatrist Dr Paul Moran, a consultant psychiatrist at the NGS, have brought the judicial review proceedings. Photograph: Chris Maddaloni/Collins

The High Court has permitted two medical practitioners to bring a challenge against the Health and Information Quality Authority’s (Hiqa’s) alleged failure to review the HSE‘s care and management of services for gender “nonconforming” children.

Prof Donal O’Shea, a consultant endocrinologist at the National Gender Service (NGS), and psychiatrist Dr Paul Moran, a consultant psychiatrist at the NGS, have brought the judicial review proceedings.

On Monday, Ms Justice Mary Rose Gearty granted permission to Joe Jeffers SC and Brendan Hennessy BL, for the two doctors, to have a hearing of the case.

Prof O’Shea and Dr Moran have challenged the HSE’s referral of young people for assessment abroad, saying it poses a possible risk to children.

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Ms Justice Gearty said she acknowledged that the case could be seen as one having “divisive” elements.

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Prof O’Shea and Dr Moran have previously stated that they are not against a “gender-affirming” model of care.

The doctors have submitted that this model of care is typically found overseas, but that they have concerns over any inappropriate and irreversible medical treatment for patients presenting with gender identity issues.

A review of this model impacts Ireland with more than 230 children and young people from Ireland experiencing gender dysphoria – where a person feels a mismatch between their biological sex and their gender identity that may cause unease, dissatisfaction, anxiety or depression.

The applicants wrote to Hiqa, requesting it to undertake a statutory investigation, pursuant to section 9 of the Health Act, 2007 of the arrangements of the HSE for the management of gender nonconforming children’s healthcare.

Mr Jeffers has submitted: “Hiqa was required to consider whether there were reasonable grounds to believe that there may be a serious risk to the health or welfare of the children receiving the relevant services.

“There is no evidence, or no sufficient evidence, in the decision letter whether Hiqa did in fact consider whether there were reasonable grounds to believe that there may be a serious risk to the health or welfare of the children receiving the relevant services.”

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Mr Jeffers has also submitted that Hiqa had a care pathway established by the HSE, whereby Irish children are now being referred to a private clinic in Antwerp, Belgium, by a non-medically trained “trans-activist”.

“The clinic in question is located in ZNA Hospital, Antwerp and is operated by an endocrinologist by the name of Dr Klink. The complainants allege the clinic had no “model of care” or discernible operational guidelines, Mr Jeffers has submitted to the court.

Mr Jeffers told the court the applicants have concerns about “proper” care in Antwerp and over alleged lack of “regulatory oversight” by health authorities in Ireland.

Ms Justice Gearty granted permission for leave for review in the case on “arguable grounds” and adjourned the matter to July.

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