Gender healthcare

We are producing a new model of care for gender healthcare.

A model of care is a framework for designing and delivering healthcare. Our model of care aims to provide safe and effective healthcare for anyone seeking gender healthcare services in Ireland.

It will not define what it means to be trans or gender diverse. We understand that gender diversity is a human experience. Each person may experience gender differently.

We respect gender-diverse people, their identities and their right to express themselves.

Gender diversity includes people who are:

trans
non binary
gender questioning

Transitioning and healthcare needs

Some gender-diverse people transition. This means they move from being seen or understood as their birth gender to being seen or understood as another gender.

People can transition socially and legally without needing healthcare services.

But some seek healthcare services, such as:

prescriptions for hormone therapy such as puberty blockers, testosterone or oestrogen
prescriptions for other medicines
psychological assessment and support
other clinical and social care interventions and transition supports, such as social work support or occupational therapy
gender-affirming surgery

Medical transition means using medicines or surgeries during a transition process.

There are benefits and risks linked to medical transition and other clinical interventions. Our model of care will outline how to deliver gender healthcare services safely and effectively.

What our model of care is built on

Our model of care is based on 2 main elements.

Evidence base

When developing a model of care, we evaluate the clinical and scientific research on the topic. This is called reviewing the evidence base.

We started our review of the evidence base for our gender healthcare model of care with 2 questions.

What are the clinical outcomes of medical transition?
What clinical needs are known to exist in the population that are attending, or may attend, gender healthcare services?

To answer these questions, we have developed 2 systematic review protocols.

Using these protocols, we can:

make the methodology available to the public during the research review process
maximise the transparency and reproducibility of the evidence base review process

Our work on answering the 2 questions is ongoing, with support from the HSE Library Service.

More questions may arise as the model of care develops.

Progress on reviewing the evidence base

Our progress is based on answering the 2 questions.

1. What are the clinical outcomes of medical transition?

We have finished the initial search and are screening the results for inclusion or exclusion. We use a pre-defined study protocol to do this.

Details of the protocol are available on PROSPERO. The registration number is CRD42024596567.

When we finish screening, we will make the provisional results available to the public.

If you feel that an important academic paper has been left out, you can submit it for consideration. This paper must have been published in a peer-reviewed journal.

We will review these papers in line with the inclusion and exclusion criteria.

Gender healthcare public consultation

2. What clinical needs are known to exist in the population that are attending, or may attend, gender healthcare services?

We completed the initial search and screening processes in July 2025.

In August 2025, we made the results available for public consultation. Members of the public submitted a range of papers for review.

Some were included and some were not. This was decided in line with the pre-defined screening protocol.

Details of the protocol are available on PROSPERO. The registration number is CRD42024596562.

In October 2025, we finished this review and began extracting data. We are now analysing the results.

The results of this analysis will be available to the public. We will use these to help develop the new model of care for gender healthcare.

We will update this page as work progresses.

Experience base

When developing a model of care, we need to understand people's lived experiences. This is called reviewing the experience base.

We are reviewing the experience base to understand the healthcare needs:

of people using gender healthcare services or who are seeking to use them
of families or caregivers of those seeking gender healthcare services - including children, young people and vulnerable or dependent adults
encountered by healthcare professionals who deliver gender healthcare services, including GPs

In developing our model of care, we plan to gather relevant experiences from each of these groups.

Progress in reviewing the experience base

Our first step in reviewing the experience base was to decide how best to contact people with lived experience.

We consulted a range of organisations, including Transgender Equality Network Ireland (TENI), BelongTo and LGBT Ireland.

We have a summary of the outcome of this work, and the related terms of reference.

Gender healthcare stakeholder experience terms of reference

We now plan to:

contact as many people with lived experience as we can
include a wide range of perspectives and experiences

We convened our National Clinical Programme Model of Care Working Group in November 2025. The group will direct this work.

Gender healthcare model of care working group terms of reference