Fears gender law could allow teens access sex change surgery abroad
Professor reveals young people are buying dangerous drugs online
DOCTORS fear that under-18s will be able to access irreversible sex change operations abroad if Irish legislation is changed.
The Gender Recognition (Amendment) Bill seeks to allow 16 and 17year-olds to be able to declare their own gender – different from their assigned biological gender – without their parents’ consent and be granted a gender recognition certificate by the State.
Additional changes to the law, first introduced in 2015, would also allow under-16s to have legal gender recognition – but with parental consent. A review of the Gender Recognition Act is expected to recommend adopting the changes.
As revealed by the Irish Mail on Sunday last week, 45 Irish children questioning their gender identity are currently seeking services in the UK and a number of those have moved on to receive puberty blockers and hormone treatment, which would potentially prepare them for a sex-change operation.
The HSE has also warned there is some evidence of people directly seeking surgery in Thailand and the US without going through any of the prescribed pathways.
‘This practice may have serious implications for the immediate and long-term health of the person,’ a HSE spokesperson warned.
Professor Donal O’Shea, the country’s chief endocrinologist who helps transgender people access surgery, said there are legitimate concerns the certificate could be presented to medical practitioners outside the State who may accept its legal status as a pathway for treatment.
And the consultant endocrinologist at St Vincent’s and St Columcille’s Hospitals in Dublin warned teenagers are already accessing hormone therapy, such as puberty blockers, from online GPs outside Ireland, which he believes is ‘inappropriate and dangerous’.
Dr Paul Moran, a psychiatrist attached to the National Gender Service at St Colmcille’s Hospital, was among those who made a submission outlining his concerns to the gender review group, which is due to present its report and recommendations to Social Protection Minister Regina Doherty.
Dr Moran said he was strongly in favour of separation of legal gender recognition from a medical diagnosis when the Gender Recognition Bill was introduced but his views have since changed.
‘Unfortunately, there have been some unintended consequences which have arisen, and pose risks to transgendered patients,’ he added. ‘First, is the risk of inappropriate treatment, including irreversible surgery, due to the difference between Irish and European law.’ He said a change of state documentation can only be obtained after a clinical diagnosis of gender dysphoria in many EU countries.
‘This means that the documentation is accepted as a clinical record by some surgical centres and SRS (sex reassignment surgery) performed accordingly,’ he explained. ‘Under Irish law, the change of gender in state documentation is a self-declaration requiring no clinical diagnosis.
‘Unfortunately, this is not understood by surgical centres in Europe, who assume the Irish documentation is as clinically valid as their own national version.’ The Bishop of Limerick, Dr Brendan Leahy, has also advised caution.
‘The promotion of gender ideology is a totally new scenario and it would be imprudent to start making significant legislative enactments that are not well grounded in scientific research and reflection,’ he said. ‘A desire to do the good compassionate thing is not always the same as actually doing it.’
However, a number of transgender support groups, specifically the Transgender Equality Network of Ireland (TENI) and BeLongTo, which supports children and adolescents, are arguing for a separation between legal recognition and a medical diagnosis.
The review has been chaired by Moninne Griffith, executive director of BeLonGTo, a national organisation for LGBT young people.
Some 90 submissions have been made to the group, including from the Ombudsman for Children, Fine Gael LGBT, St Patrick’s Mental Health Services, the INTO, the Union of Students of Ireland, counsellors, medical professionals and human rights lobbyists.
Ms Griffith said she wants young people to be able to declare their own gender without a diagnosis but did not wish to comment further.
Under current law, children aged 16/17 years are required to have an application presented on their behalf through the Family Circuit Court. This requires two forms to be completed, one by the child or youth, the other by their guardian.
‘This may have serious implications for health’
PROPOSED changes under the Gender Recognition Bill allowing 16 and 17-yearolds to select their own gender without parental consent or medical diagnosis and be granted a gender recognition certificate from the State are causing concern in some medical circles.
Professor Donal O’Shea, the country’s leading endocrinologist who treats transgender young people, says the legal document might encourage troubled teenagers to seek surgery abroad rather than wait until they are older and have a diagnosis of gender dysphoria.
Another unintended consequence of the change could be that young people avail of an irreversible sex change only to change their mind later about their identity.
Teenagers are already accessing hormone therapy such as puberty blockers from online GPs abroad, a practice condemned as ‘dangerous’ by Prof O’Shea.
Opinion differs about whether legal recognition and medical diagnosis should be separate issues or aligned. Transgender support groups argue for the former but many EU countries insist on a diagnosis before state documents can be altered.
Gender dysphoria has only recently gained currency in this country and gives rise to much misunderstanding. It’s vital that in our eagerness to show compassion we don’t cause risk to those afflicted.