HSE’s new transgender committee a farce, says leading medical expert
Refuses to sit on panel that has ‘just advocates’ and ‘no experienced clinicians’
THE country’s leading doctor for transgender patients has refused to take a seat on the new gender identity panel set up by the Health Service Executive, calling it ‘as close to farce as you could get’.
Professor Donal O’Shea – consultant endocrinologist at St Vincent’s and St Columcille’s hospitals in Dublin – told the Irish Mail on Sunday he did not take up his position on the committee, which is examining the future provision of healthcare to transgender people in Ireland.
For the past two weeks, the HSE has refused to reveal the names of those appointed to the committee, apart from the chair and a transrights activist appointed directly by Health Minister Simon Harris.
But eventually, at the third time of asking, the HSE provided this newspaper with a list of names after we asked them to justify it being a ‘secret’ panel.
Prof. O’Shea, of the Gender Identity Service in Loughlinstown, Dublin, said it was ‘very worrying’ that no clinicians with direct experience of treating transgender patients have been appointed to this group.
‘That is going to have to change. You can’t have a committee deciding on delivery of care in that area with just advocates. It’s as close to farce in its current iteration as you could get,’ he said.
Mr Harris announced this summer that he was appointing Noah Halpin, a 28-year-old trans activist, to the panel.
Mr Halpin is a founder of the This Is Me campaign, which is seeking to abolish the current model of healthcare for trans patients as it involves a psychiatric assessment, which is a source of contention within the trans community.
There has been growing disagreement among the medical community and trans lobby groups over the best model of care.
Doctors believe that patients should be subject to a psychiatric evaluation as part of their care. But that has been objected to by some transgender patients and lobbyists. They are instead arguing for a model of informed consent where the model of care provided is largely led by the patient and not the clinician. Prof. O’Shea believes this is not appropriate in a transgender context, particularly for younger people. He told the MoS: ‘Noah Halpin has been very vocal in supporting all negativity about the service we provide. I didn’t feel it was appropriate to sit on a committee where there would be friction between advocacy groups and clinicians. ‘I gave them the option that Noah would be on it or me – with 25 years of experience in managing the condition in Ireland – being on it and they made their decision. It wasn’t so much an ultimatum as an offer that they had to make a decision on,’ he said. Prof. O’Shea said that not being on this committee has allowed him ‘to speak about it, as people who are on it are bound not to engage with media on the subject’.
‘This committee has been set up based on advocacy for informed consent, which I would say is dangerous for 50% of patients, particularly for children.’
In relation to Mr Halpin’s views, Prof. O’Shea said: ‘I understand the position he is coming from; that absolute binary, transgender people need very little input from a holistic model or a psycho-social model of care because they know who they are and have full support. But there are the other 50% who need a significant holistic assessment and support.’
Prof. O’Shea said that following a recent interview on the Seán O’Rourke programme on RTÉ Radio 1 he had a ‘very positive’ conversation with Mr Halpin, who also appeared on the show, regarding both of their perspectives and hoped a resolution could be found.
When contacted by the MoS and asked if he had changed his viewpoint on informed consent, Mr Halpin said ‘absolutely not’ and declined to comment further.
Prof. O’Shea has sought a meeting with Mr Harris to discuss his concerns, and said only an
‘This is going to have to change’ ‘I understand position he is coming from’
acknowledgment was received from the minister’s office.
In response to queries from the MoS, a department spokesman said: ‘The minister had no role in deciding the membership of the panel, other than requesting that Noah Halpin be appointed.
‘His [Minister Harris’s] overriding concern is to improve transgender healthcare in Ireland.
‘He is in regular contact with Prof. O’Shea and is always available to meet him, if requested.’
The HSE has repeatedly been asked by the MoS why the names of those appointed have been kept ‘secret’ and to comment on Prof O’Shea’s assertions.
It has failed to answer these queries on three occasions.
Requests for a response from Transgender Equality Network Ireland – a group which has two representatives on the committee – were not replied to.