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Gender healthcare

The HSE plans to update how gender healthcare services are delivered in Ireland, with an aim of providing safe and effective healthcare for those seeking gender healthcare services.

To do this, it is producing a new Model of Care for Gender Healthcare. When complete, the HSE Model of Care for Gender Healthcare will provide a clinical framework for safe and effective delivery of gender healthcare services in Ireland.

The Model of Care is not intended to define what it means to be trans or gender diverse. It is understood that gender diversity is a human experience, and that gender diversity can be experienced differently by different people.

Gender diverse people should be respected in their identities, and in their right to express themselves. Gender diverse people might include:

  • trans people
  • non-binary people
  • gender questioning people

Some gender diverse people transition, meaning that they move from being seen or understood as their birth gender, to being seen or understood as another gender. Gender diverse people who transition can explore their gender, socially transition, and legally transition, without needing healthcare services.

Some gender diverse people, as part of their transition process, may seek any or all of the following healthcare services:

  • Prescriptions for hormone therapy, such as puberty blockers, testosterone or oestrogen
  • Prescriptions for other medication
  • Gender affirming surgery
  • Psychological assessment and support for gender dysphoria or gender incongruence
  • Other clinical and social care interventions and transition supports

There are benefits and risks associated with these clinical interventions. The role of healthcare services is to make sure that healthcare interventions are delivered effectively and safely. The new Model of Care for gender healthcare in Ireland will outline how to safely and effectively deliver healthcare for those seeking gender healthcare services.

Two main elements will form the basis of the Model of Care:

  1. Evidence base - a review of the available scientific and clinical research in gender healthcare
  2. Experience base - an understanding of the experience of service users, their families, healthcare workers working in gender healthcare, and other stakeholders

For more information on these two elements, including updates on our work in these areas, please see below.

Evidence base

A key element of developing any Model of Care, is evaluation of the clinical and scientific research on the healthcare topic. This is termed a review of the Evidence Base.

As part of the development of the HSE Model of Care for Gender Healthcare, we are completing a review of the evidence base, with HSE Library Services, to answer two questions that are fundamental to inform the safe and effective delivery of a gender healthcare system:

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

To answer these questions, we developed two systematic review protocols.

Using systematic reviews allows the methodology to be publicly available during the research review process, maximising transparency and reproducibility of the evidence base review process.

The process for answering both questions was as follows:

  1. What clinical needs are known to exist in the population that are attending, or may attend, gender healthcare services?
    1. The initial search and screening processes were completed with HSE Library Services in July 2025.
    2. In August 2025, we made the initial results available for public consultation, and a number of additional papers were submitted by the public.
    3. These additional papers were reviewed for inclusion or exclusion in line with the pre-defined study protocol (available on PROSPERO under registration number CRD42024596562).
    4. In October 2025, review for inclusion and exclusion was complete, and data extraction began.
    5. Data extraction is now complete, and the results have been analysed.
    6. The results are being used to inform the development of the new HSE Model of Care for Gender Healthcare.
    7. A paper has been drafted with the results of this review, and is being submitted to peer reviewed clinical journals for publication.
    8. Once the results are published, they will be made publicly available.
  2. What are the clinical outcomes of medical transition?
    1. The initial search and screening processes were completed with HSE Library Services in March 2026.
    2. In April 2026, we made the initial results available for public consultation, and a number of additional papers were submitted by the public.
    3. These additional papers were reviewed for inclusion or exclusion in line with the pre-defined study protocol (available on PROSPERO under registration number CRD42024596567).
    4. In May 2026, this review was complete and data extraction began.
    5. The data has been extracted, and risk of bias assessments, and data analysis, are now being completed.
    6. Once this process is complete, the results will be used to inform the development of the new HSE Model of Care for Gender Healthcare.
    7. A paper will be drafted with the results of this review, and will be submitted to peer reviewed clinical journals for publication.
    8. Once the results are published, they will be made publicly available.

As this work progresses, we will be updating this page with our findings.

Experience base

A key element of developing any Model of Care is to gain an understanding of the experience of interest holders. This process is termed a review of the Experience Base.

The goals of reviewing the Experience Base are to understand:

  1. The clinical needs that are important to address from the perspective of service users and people seeking gender healthcare services from the HSE.
  2. The clinical needs that are important to address from the perspective of families and or caregivers of those seeking gender healthcare services: this is important in the cases of children, young people, and vulnerable and or dependent adults.
  3. The clinical needs encountered by healthcare professionals who deliver, or who may deliver, gender healthcare services in Ireland, including GPs.

For the new HSE Model of Care for Gender Healthcare, we will be seeking the perspectives of:

  • people using existing gender healthcare services
  • people seeking gender healthcare services from the HSE
  • healthcare professionals providing gender healthcare services, and or related clinical services (such as GPs)
  • other interest holders, such as the families of people using or seeking gender healthcare services

This work is now underway.

The first step was to determine how best to contact and include interest holders with lived experience. This was done via consultation with a range of interest holders, including TENI, BelongTo, and LGBT Ireland. A summary of the outcome of this work, and the related Terms of Reference, can be found below:

Report of the Stakeholder Experience Process Design Group (PDF, 262 KB, 5 pages)

Terms of Reference for Stakeholder Experience Process Design Group (PDF, 475 KB, 3 pages)

This step was only the first step of many in engaging interest holders. Our ambition is to contact as many interest holders as possible, and to include a wide range of perspectives and experiences via the HSE National Clinical Programme’s Model of Care Working Group, which was being convened in November 2025. Terms of reference for this Working Group can be found below:

Gender healthcare model of care working group terms of reference (PDF, 320 KB, 6 pages)

As this work progresses, we will be updating this page with our plans and next steps.

National Clinical Lead - Dr Karl Neff

The National Clinical Programme for Gender Healthcare is not directly involved in providing a clinical service to patients and their families. For all clinical matters contact your GP or healthcare provider.

If you have any queries about the work of the programme please contact us:
Email: ncp.genderprogramme@hse.ie.

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