Department of Health officials have been accused of altering records of a meeting between ministers and doctors to delete details of a junior minister promoting the use of an “unsafe” private transgender healthcare service.
Last August 30, the four lead doctors in Ireland’s National Gender Service (NGS) met with Health Minister Stephen Donnelly, his junior minister Mary Butler and five officials in the department’s headquarters in Miesian Plaza in Dublin to discuss concerns about Ireland’s transgender health services and the ongoing referral of children to the Tavistock clinic in England.
The doctors at the NGS, which treats adults who seek gender transition, outlined safety concerns over the use of the Tavistock clinic for children and advocated for an Irish-based service for children and adolescents.
The NGS has a waiting list of more than three years and 1,200 patients and the doctors said the NGS may have to close its waiting list due to a lack of support from senior HSE managers. The doctors said a business case submitted in 2020 to increase full-time staffing from six to 16.5 full-time equivalent clinicians had not been approved.
The official minutes of the meeting, released through Freedom of Information (FoI), recorded the doctors saying they had “no faith” in named senior clinicians in the HSE and disputed whether a model of care developed by the NGS or an alternative developed by HSE managers was the correct one for providing trans healthcare in Ireland.
This weekend the NGS doctors wrote to Mr Donnelly and Robert Watt, secretary-general of the Department, to complain about the deletion of a series of details from the minutes released by the department on “important matters of patient care, including the safety of children”.
The letter said: “The information deleted could be interpreted as an attempt to deflect attention from key decision-makers in the HSE, who have made decisions that have resulted in serious systemic dysfunction and resulted in an escalation of the waiting list crisis in the NGS.”
Among the details in the draft minutes proposed by the NGS that were not included by the department, it recorded Ms Butler advocating for the use of GenderGP, an online service, as an “alternative” to state-provided care for Irish patients.
“Alternatives to current service provision discussed at the meeting were unsafe,” the minutes proposed by the NGS state. “An online business called GenderGP was introduced by Minister Butler as an alternative. She stated that there are 900 Irish people currently registered with them.
“The NGS clinicians clarified that GenderGP is an unregulated and unsafe service whose founders had been suspended from the General Medical Council in the UK because of this company’s harmful and illegal activities, and that this company is in breach of Irish Medical Council guidelines.”
The department did not respond to questions about whether Ms Butler accepts she promoted GenderGP at the August meeting. The online service has also been promoted by some staff and directors of the Transgender Equality Network of Ireland (Teni), one of Ireland’s largest transgender support groups.
GenderGP has no age limits for providing care or minimum time periods before recommending prescriptions for puberty blockers. It does not always require parental consent to treat children.
Last year the UK’s General Medical Council sanctioned both its founders, Helen and Michael Webberley, for unsafe care of patients. Dr Michael Webberley was struck off after a tribunal found he failed several patients by not conducting proper assessments before and after recommending hormones or puberty blockers. He was found to be working outside his specialty as a gastroenterologist.
His wife Helen was suspended after she was found not to have properly explained fertility impacts to a patient seeking to transition.
On Friday, Ms Butler spoke on her local radio station in Waterford, WLR FM, about her “immense pride” about her transgender son who is in secondary school. Ms Butler, who is the junior minister responsible for mental health, said: “Supports for children who are trans are not where they should be. They are actually very, very poor here in Ireland. They are extremely poor.”
She said the provision of mental health services was not the main issue but “talk therapies” were important and praised resources provided by Teni and BeLonGTo.
In another document released under FOI, Noah Halpin, Teni’s healthcare officer, wrote an “urgent” email to Ms Butler last November when he heard that NGS doctors were scheduled to brief Oireachtas members on Irish gender healthcare.
Mr Halpin complained that the model of care used at the NGS did not follow standards set by the World Professional Association for Transgender Health (Wpath). He said the service continued to psychiatrically assess all patients and this was contributing to “the trauma of many of its service users”.
“As an ally to the transgender community, we would ask you, if possible, to please attend this event and to challenge the model of care currently being used by the National Gender Service.”
The department’s briefing for ministers ahead of the August meeting said there were “red-line issues”. There were “no governance reasons why the referral of children to the Tavistock Clinic should cease”.
It also said “there is no clinical basis for co-locating child and adult gender identity services in St Colmcille’s Hospital” where the NGS is based. The briefing said provision of a seamless transition between child and adult services “is the better approach”.