Transgress the NGS open letter

SIGN OUR OPEN LETTER DEMANDING THAT THE MINISTER OF HEALTH ORDER THE NATIONAL GENDER SERVICE TO STOP INTERFERING WITH TRANS PATIENTS ABILITY TO ACCESS BASIC HEALTHCARE THROUGH THEIR GP

Stephen Donnelly, Minister for Health

We are writing to highlight major challenges for trans people’s right to access basic healthcare through their GP due to interference from the National Gender Service (NGS) and demand action on this issue. This is the case for patients who are accessing hormone replacement therapy (HRT) by self medicating, referring to accessing HRT without oversight from a qualified medical professional, or through private healthcare providers. People’s choice to access HRT privately or by self medicating reflects the non-existence of an adequate public trans healthcare system, with current NGS waiting lists estimated at up to 10 years and rising.

Whether they are accessing HRT privately or by self medicating trans people still require basic medical care, including blood tests, to manage the risks associated with HRT. In certain cases they may also ask their GP to prescribe HRT directly, which some GPs are able and willing to do. These are basic forms of care which GPs regularly provide to other patients without question. For example GPs routinely carry out blood tests to monitor various aspects of their patients’ health and also frequently prescribe HRT to cis patients, such as women undergoing menopause.

However, the NGS has a policy of advising GPs not to provide blood tests or HRT prescriptions to patients accessing healthcare outside their control. This is an extremely harmful policy which puts trans patients at elevated risk of serious health issues. In their correspondence with GPs, and in response to parliamentary questions which have been posed about this issue, the NGS justify their position by claiming that such blood tests are not medically necessary. This is deeply misleading given there are serious health complications associated with either elevated or low blood hormone levels including osteoporosis, blood clots and liver complications. International best practice guidelines for trans healthcare recommend regular blood tests to monitor hormone levels. This is clearly stated in, for example, the “Royal College of Psychiatrists Good Practice Guidelines for the Assessment and Treatment of Adults with Gender Dysphoria” (2013, pg.36, 38, 41) and the “Endocrine Society Clinical Practice Guidelines” (2017, pgs. 17, 20, 21). The NGS also recommends that its own patients have their blood hormone concentrations monitored as a matter of course.

Given the fact that there is no medical basis to refuse blood tests, it is apparent that this policy is an attempt to prevent anyone accessing healthcare outside the NGS’ own deeply flawed system, involving unacceptable waiting lists and an outdated and invasive psychiatric assessment process. In reality, people will continue to access healthcare in various ways as they are legally and morally entitled to do, but will simply be put at increased risk.

The NGS has failed to respond to the concerns which have been raised about this policy on multiple occasions despite having an obligation to listen to the voices of the patients they are purportedly set up to serve. This situation clearly contradicts the HSE’s stated principle, as set out in the “Better Together: Patient Engagement Roadmap”, that patients should be engaged in decisions regarding their own care. 

Given this lack of response, it is now up to the Minister to intervene. We are asking the Minister to direct the NGS to cease advising GPs not to provide blood tests and HRT prescriptions to their trans patients and; secondly, to inform GPs that they can provide these services and provide guidance on how to do so. 

We note the Minister has previously committed on record in the Dáil to meeting with trans community organisations to discuss the problems with trans healthcare in Ireland but has failed to follow through on this promise despite multiple requests from the Transgress the NGS campaign. We are also concerned that our previous inquiries about this issue have been met with the response that the Government will implement the recommendations of the Cass Review, given the scientifically flawed and deeply ideological nature of the review which has also been opposed by international medical and human rights organisations as well as trans people themselves.

According to Transgender Europe Ireland is the worst country in Europe for trans healthcare. This is a national disgrace and must be rectified immediately through positive steps such as those we are demanding here. The government cannot continue to fail the trans community on this critical issue. 

Yours sincerely

--- 

Signed by: 

Transgender Equality Network of Ireland (TENI)
Union of Students of Ireland (USI)
Trinity College Dublin Students Union
University College Dublin Students Union
IADT Students Union
Intersex Ireland
LGBT Ireland
Leitrim Pride
Trans & Intersex Pride Dublin
Small Trans Library Dublin
Wexford Pride
Trans Healthcare Action
Community Action Tenants Union Dún Laoghaire
Trans Limerick Community
BI+ Ireland
Outhouse
The Trans* Research Association of Ireland
UL Student Life
Cork Alternative Pride
Transmuted CIC 
University of Limerick Student Life
Labour LGBTQ+
Queer Intifada

Individual signatories: 

G. a Chara, S. Maher, A. Marren, J. Hoodswain, E. Maloney, L. Gray, C. Creagh-Peschau, N. Hutchinson Edgar, H. Lane, M. frawley, E. Davis, E. Potter, D. Fitzpatrick, S. Vincent, D. Corish, A. Darby, I. Shabat, G. Murray, S. White, L. Armstrong, A. Guilfoyle, R. Mc Cormack S. Cussen, C. Davidson Monahan, C. Scully, D. Murphy, CJ Smith, E. Kiely Jordan, I. Griffin, M. O’Connell, P. DennanR. Connneely, T. Brophy, I. Woolfrey, E. Crawshaw, C. O'Leary, C. Boud Keegab, N Murphy, M. De Wilde, A. Hannigan, S. Murray, R. Barrett, O. Walsh, E. Hartford, A. Duff, E. Boylan, J. Gibbons, O. Mitchell, D. O'Sullivan, L. Callaghan, K. Morrow, V. Patel, M. McGhee, L. Casey, S. Ballesty, J. fitzpatrick, L. Flaherty, E. O'Kelly, S. Murphy, M. Convery, C. Spears Cahill, A. Cowan, B. Nardelli, T. Long, R. Cody, J. Shorten, G. Glynn, S. Dolan, B. Szczepan, S. Conneely, JD Chambers, R. Byrne, G Murphy, M Renehan, R. Barclay, N Nic Corcráin, K. Jackson, A. Rowe, S. Berry, N. Healy, h. cleary, Dr A. Berry, A. Byrne, P. O'Donnell, A. Blair, T. Sterne, E. Morris, R. Boyd, J. Maguire, M. O'Malley, V. Fullam-Smith, E. Hynes, C. Nolan, F. Pelicci Silveira, R. Byrne, S. Simpson, A. Cummins, F. Bowes-Fitzpatrick, A. Murphy, B. Kiberd, K. Lennon, E. O'Neill, A. Butler, A. Carr, H. Cantwell, S. James, C. Bustos, S. Eastwood, L. Scheffel, C. Dempsey, S. Kerr, J. O Grady, B. Ní Fhearraigh-Joyce, L. Cheasty, V. Heneghan-Stafford, C. Dalton, A. Clinton, E. Kiberd, S. Bradley, A. Lanckriet, A. Carney, A. Caulfield, M. Llewellyn, A. Mulvey, E. Mac Lennan, K. Flynn, A Jaffray, A. Sheridan, E. Caltagirone, L. collins, J. Carey, J. Allen, M. Myszor, L. Crowne, F Gogarty, J. Cruickshank, A. Griffin, E. Dunne, C. Burke, O. Shiels, S. Marrazzo, L. Corbett, R. Nic Ghearailt, L. Mae, A Shannon, G. Hicks, S.Cleary, K. Moran, L-R. Fennell, R. keane, E. Long, C. Kent, K. Atkinson, L. Fox-Whelan, K. Malek, G. Burke, L. Luddy, M. Usher, D. Penrose, C. SIMON, E. Mason, E. O'Connor, S. Fanagan, L. Molnárfi, B. Kelly, N. O’Byrne, Z. Dylan Brosnan, N.O’Leary, A. O'Hare, K. Malone, Dr R. Bohan, H. Moloney, Á. O’Hara, Q. de Barra, B. O'Driscoll, E. Ó Lorcáin, L. Bradley, M. Neilson, F. Pirbazari, F. Cleary, E. Lyons, Prof L. Cox, C. O'Farrell, M. Deegan, C. Galvin, J. Glennon, T. AguileraL. phillips, D. Frasiloaia, K. Nolan, J. Walsh, O. Zimmerman, B. Graham, C. Clare Behan, R. Ralph, A. De Buitlear, J. Brady, E. Kane, A. Ní Ceallaigh, S. Ramos, T. Kennedy, M. Ly Hagan, E. Crose, S. Murphy, C. O’Meara, M. McGowan, E. Dunlop, G. Whipple, R. Lawlor, K. Simplicio, A. O'Nolan, M. Kennedy, D. Wickman, C. Mc Daid, B. Pierotti, N. Fitzsimons, M. Wrenne, B. Flood, A. O’Connor, E. Quinn, M. Casey, C. Noone, L. Francois, C. O'Donnell, R. Walsh, E. Hanley, P. Duane, E. Ryan, N. Scully, H. Kent, A. Carruthers, C. Hebron, A. Davies, S. Moore, D. Dent, C. Murphy, O. Cotter, G. Kent, T. Roche, M-A Djeribi, M. Gannon, E. O’Callaghan, É. L. Verens, M. Finnegan, N. Ross, S Ní Bhaoighealláin, S. Boland, S. Byrne, P. Kavanagh, C. Byrne, C. Foody, Á. Fallon Verbruggen, D. Fitzpatrick, J. Renaghan, E. Warren, I. Zorroza, R. Doyle, C. Cullen, A. Owens, A. Hickey, S. Nako, J. Coffey, M. E. Timmins, O. Murphy, J. Doyle, H. Louise, R. Mullen, E. Murray, J. O'Meara, J. O’Sullivan, C. Walsh, C. Heussaff, G. Gately, K. Fitzgerald, A. Heussaff, C. O'Mahoney, K. Brayden, K. Deevy, J. Grier, G. Sweeney, H. Doherty-Greene, E. Mangan, R. Caffrey, D. Byrne, A. Keogh, N. Casserly, A. McDonald, L. Jones, J. Fogarty, Cllr K. May Daly, A. O’Neill, G. Hopkins, E. Weatherill, L. Hearne, L. Walsh, F. Herlihy, S. Hickey, F. French, Dr D. Lynch, D. Ward, É. Pluymers, M. Ferrari, A. McKay, A. O'Connor, S. Daly, K. McAndrew, T. Forde, L. Ferreyra-Carroll, S. Byrne, I. Dudf, S. Cooney, Dr C. Dislis, J. Coyle, A. Knight, G. Kavanagh, F. Lynch, O. Bell, A. Murphy, Á. Moran, R. O'Sullivan, M. Slevin, K. Hysi, M. Slevin, A. Thorn, A. Ó Murchadha, D. Daly-Ronayne, E. Fitzpatrick, R. Glynn, E. Guidera, A. Campbell, J. Hoszowsk, T. Kavanagh, J. Bradish, C. Skelton, S. Barrett, K. Fogarty, S. Condron, H. Dillon, L. Luna Smee - UCC Student’s Union Welfare Officer 24/25, J. murphy, J. Hernon, E. Corcoran Hughes, A. Blandin, L. Toal, L. Gilligan, E. Byrne, M. Ryan, B. O’Reilly, C. McKenna, C. Ní Loínsigh, C. Collins, G. White, G. Ng, L. Carrick, N. Lemfadal, M. Rooney, É. Nic Coitir, D. Figueiredo Costa Viegas, C. Ballantine, A. Murray, R. Howard, A. Miller, K. Martin, D. Walsh, C. Ryan, L. Peloille, R. Mulveen, P. Tawyodh, H. Morris, A. Hayes, H. Gardner, J. Gilbert, C. McGovern, H. Gardner, C. Henry, C. Mc Donagh, S. JayteeÉ. Ó hAnluain, M. Fritsche, P. nulty, J. D’Arcy, O. Tormey, J. McMurray, R. Dardis, A. Day, R Conneely, C. Orange, R. Harron, J. Waugh, N. Byrne, J. Ellul, S. Connolly, E. Shaughnessy, L. Griffin, R. Kennelly, F. Kadim, W. Richardson, K. Borrmann, E. keogh, E. Curiel, A. Di Nardo, E. O'Sullivan, D. Johnstone, R. Horgan, J. Moya Roset, L. Kirwan-Ashman, A. Curran, S. Wiley, Dr. S. Karmakar, C Corley, R. Duncliffe, A. Flynn, D. Monaghan, L. Cronin, K. Devi, T. Malenko, L Nagle, E. McHugh, K. Gahan, E. Gough, R. Holland, J. Craig, J. Doyle, I. Carolan, A. McMahon, A. Martínez, J. Nevalainen, M. Bent, M. Hickey, J. Vergara, K Fletcher, E. Cunningham, A. Doyle, J. Wilkinson, L. McLoughlin, E. Hand, V. Steele, R. Ó Riain, D. Zyana, N. Ferreyra-Carroll, A. Slattery, C. Moeller, M. Heffernan, C. Maguire, R. Ní Chirnáin, W. Buczek, T. E Court, K. Egritepe, D. Fleming, M. ryan, S. Staunton, P. Corrway, J. McCabe, D. Lyons, E. Corcoran, M, Downey, N. McManus, L. N. Marmion, P. E McCartney, A. Skilton, C. Moran, S. Brazil, D. Farrell, K. Jamson, Dr T. O'Keefe, Senior Lecturer and expert in Gender Studies, J. Helly, C. Kenny, J. D, V. Seco, S. McKeague, S. Carney, T. Ennis, A. Walter, J. Dempsey, C. McGonigle, R. Kelly, D. mac conville, S. Warren, M Doolin-Murphy, E. Murphy, N. Gailite Pelaka, J. Ochnicki, R.Bright, D. Galvin, C. McGlynn, D. Ó Cruadhlaoich, J-L Cullen, F. Donghi, F. Scott, F-O Antar, C Redmond, W. Lawal, F. Antaine O'Hanlon, S. Duffy, C. Greene, P. Danko, A. Newton-May, L. O'Shea, Á White, L. Blake, E. Crawford, A. Walsh, R. Campbell, D. Behan, S. Maher, O. Breen, Ó. Monahan, M. Sweeney, M. Lovett, F. Cooke, C. Keane, T Burke, L. Hourihane, B. Bonham, M. Ahmed, M. Foley, N. Murphy, Á. Fortune, J. Black, L. Price, M. Doyle, S. Fox, Small Trans Library Dublin, J. Bernard, S. Reina, M. Lucey, R. Doyle, M. Feeney, E. O’Riordan, N. Domoney, D. O Suilleabhain, F. Rust, A. Cullen, D. Heffernan, B. Carpenter, E. Challacombe, S. Seymour, A. Flood, B Scott Faunch, M. Malone, N. Agrios, R. Goode, L. Smith, B. O'Hair, D. Barry, E. Kearns, E. Watters, O. Scholze, E. Fox, B. Boyle, A. Deinum, J. Cleary, A. Comerford, C. Johnston, M. Carneiro, A. Stroughair, R. Walsb, S. Campbell, E. Markelova, A. Phelan, E. Cullen, V. Thomson, B. Johnson, P. Costello, J. Hand, R. Delahoyde, C. Thomson, B. O'Sullivan, O. Frawley, A. Howells, S. Mcdonald, D. Quinn, C. McGreevyE. Connolly, C. Quigley, S. Cullen, J. Lucia Agnoli, M. Ó Súird, S. Fitzgerald, Dr R. Usherwood, A. Ní Cholgáin, K. Stoker-Phelan, M. J. Mcluskie, C. Ferriter, M. Carey, G. Montgomery, S. Benson, J-J McGregor-Coope, F. Killilea, L. Murphy, O. Egan, S. Ward, F. Birmingham, R. Coulter, A. Hogan, K. Turley, C-A Kelly, S. Hickey-O'Mara, R. Loughran, L. Walsh, B. Tryhuk, N. curran, F. Detrez, K. Stafford, E. Zakharuk, A. Barrett, F. Ní Chonchúir, L. Daly, L. Dowling, A. Casey, S. Exton, S. O Connor, C. O Mahony, K. Purcell, Z. Laplaud, C. Ogbevoen, E. Delany, K. Voltz, J. Melia, E. O’Dowd, D. Coughlan, É. Quinn, B. O’Gorman, M. Thomson, S. Curran, E. Noonan, P. Cullen, A. Nugent, A. ODoherty, J. O'Rourke, I. McHale, S. Míl, M. Jones, P. Cully, A. Donegan, R. Fay, A. Marrinan, H. Casburn-Collins, D. Mc Ardle, A. Finnegan Craven, M. O'Carroll, G. dorrigan, K. Xuereb, S. Sherwin, C. McCarthy, D. Crowley, S. Kane, E. Ó Ceannabháin, F. Sheridan, S. O’Brien, I. Whelan, D. Cullen, J. Roche-Fortune, S. McHugh, S. Burgess, J. Whipple, D.Molyneux, J. Brough, L. O’Brien, M. Pachowicz, B. Horgan, M. Ní Rathaille, A. McDonald, P. Mac Brádaigh, A Hassall, L O'Donovan, S. Lynch, K. Waters, K. Ciprikis, S. Walsh, E. Conner, E. Ursula Gleave, E. O’Reardon, A. Craciun, J. Smee, H. smee, S. Mooney Smee, D. O'Farrell, K. Halpin-Hill, L. Connolly, H. O’ Connell, A. Wolfe, C. Nolan, A. Ward, K. Higgins, M. Kerins, B. Purcell, R. Pezzi, J. Spear, C. McCormack, D. Rooke, C. Kelly, B. Edwards, K. Keane, M. Butcher, C. Roper, L. Farrell, T. O'Connor, A. Johnston, R. Fahy, S. Amat, P. Ryder, M. Hughes, D. Thistlethwaite, A. Gilbert, M. Finnegan, J. Daly, D. O Suilleabhain, A. Caulfield, A. Mothersoul, N. K, D. Rodgers-Lee, K. Stokes, J. Sassi, P. Brodie, A. Mun, Á. Tubridy, C. Barry, T. Gavin, M. Tubridy, S. O'Reilly, I. Bevan, K. McConnell, P. Delany, P. Murfitt, A. Quinn, L. Tymowski, E. Holmes, A. Cunningham, C. Fazio, O. Mac Giolla Dhaltúin, M. Coady, V. Kelly, Wexford Pride Committee, M. Doyle, L. Fitzgerald, G. O'Connor, A. Coady, L. D'Arcy, J. McNicholl, A. Billingsley, R. Goulding, C. Leigh, G. C. Toomey, R. Keane Kelly, L. Flaherty, A. Lamb, D. Berkes, G. Nolan, C. Witts, W. Benayada, R. Craven, H. R, L. Taylor, B. O’SullivanS. Cowman, T. Burke, R. Wiles, M. Crowe, J. Victory, K. privett, M. Mag Riada, M. Byrne, B. Downs, L. McComish Day, R. Keane, F. Eloghosa, C. Lee Chubb, A. Hughes, E. Levickas, C. Ní Chaoimh, J. Barrett, R. Rathbone, S. Quinn, T lynch, D. Joffe, A. OSullivan, M. Nowotny, A. Staudt, S. Falvey, E. O' Connor, E. Deegan, M. Bourke, S. Healy, C. McKeon, A. Butler, K. Shore, J. McBoyle, M. Collison, L. Daly, M. Loftus, M. Fleming, A. Hutanu, C. Kinsella, K. Aniszewski, R. Rooney, L. Carroll, T. Croke, M. Kinsley, A. Zakharchenko, L. Scanlon, L. Clery, P. Finn, S. Morgan, E. Healy, L. Pollock, M. Romanov, T. Carey, S. Chapman Kent, J. Rose Smith, J. Bishop, A. Diskin, S. Dire, P Delany, H.E. Rooney, H. Downey, R. Lyons, J. hutchinson, J. hutchinson, C. Dooley, S. Cullen, J. Norrington, K. Cremin, J. O'Connor, E. O'Connell, S. Quinn, A. Dujardin, S. Laird, J. Warren, H. Holmes, N. Murphy, A. Nolan, O. O'Reilly R. Rowan, A. O'Donnell, R. Byrne, Dr M. Tubridy, S. Walsh, C. Laherty, S. Fox, L. O'Brien, L. Torode, S. McCarthy, b. Mulvihill, L. Byrne, O. Danikiewicz, D. Breen, E. Whyte, E. Whyte, C. O'Neill, C. Woods, B. Keena-Ures, Z. O' Toole, A. Baker, A. Molloy, L. O’Dowd, A. McConnell, V. Maria Passaghe, A. Casey, A. Campion-Ryan, P. garvey, R. Cotter, K. Geoghegan, T. Nutterfield, C. Garvey, E. Healy, V. Lyons, C. Mullowney, N. Brosnan, A. Owen, C. Dalton, E. O Beirne Cleary, R. Cleary, R. Dunne, L. O'BEIRNE-CLISSON, M. Carey, M. Wallace, R. Lawlor, E. Jordan, T. viana castro, M. frawley, A. Frawley, A. McKenna, J. Mooney, Dr E. Gusciute, P. Brodie, P. Brodie, G. Kennedy, S. Connolly, J. Somers Donnelly, A. Farrell, S. Flynn, F. Sweeney, C. Dunphy, T. Dunphy, J. Ryan, L. Woodall, M. Breathnach, E. Doyle, M. Narnhammer, N. Finn, Z. E.Justice, M. Doolin-Murphy, C. Martin, G. Mulligan, J. O'Caoimh, D. O'Caoimh, D. McGann, A. Rooney, O. Moore, S. Linnie, B. Finn, L. Stringer, B. Guiney, R. Rooney, A. Long, T. Deane Okeeffe, F. Lyons, Cork Alternative Pride, S. Howard, N. Scott, S. Ryan, P Ui Conaill Pender, J. McKeever, K. Phelan, K. Boylan, C. Browne, J. McKell, J. p. payne, C. Moley, A. Mun, E. Star, J. Kearney Dr M. RyanA. Mulvey, K. Ormonde, A. Pratas Oliveira, A. Chowdhury, J. Gorman, L. Guilfoyle, A. Ashe-Kilroy, K. Lennon, A. Griffin, W. Reynolds, E. Hynes, A. Finn, J. Hoodswain, G. Burke, JD Chambers, A. Sheridan, CJ A. K. Smith, J. Moya Roset, A. Edmondson, J. Finnerty, S. Fuery, E. López Cuesta, S. Gomez coya, S. Morin, D. Tchang, H. Ryan, W. Henning, I. de Cubas, R. Mc Cormack, L. MacBride, C. Doherty, M. Copland, C. Moore, V. Kelly, A. Garvey, J. Vaarsi, Bi+ Ireland, H. McNamara, A. Silvestri, A. Voyard-Venant, A. Quinn, A. Baiza, T. Ryan, S. Conneely, L. Renehan, D. Irving, G. lambe, K. Henry, N. Murphy, T. Duff, G. Marques de Almeida, J. Long, C. Reboreda, M. O'Ceallaigh, L. Nolan, P. Flynn, L. Callaghan, A. Craughan, W. Kinsella, R. Young, S. Thomas, B. O Gorman, S. Ní Fhaoláin, S. Dunphy, A. Reenan, M. Matys, C. Kenny, C. Rafferty, A. Callaly, A. Flood, K. Walker, P. Sevilla, L. Kennedy, A. Murray, E. Watters, J. Herlihy, J. Sheridan, J. Tobin, T. Weldob, B. O'Sullivan, J. Black, K. Flynn, L. Armstrong, F. Smith, Wexford Pride, L. Dunne, H. Condren, w. hickey, A. Hennessy-Behan, F. Donohue, S. Burke, K. McCabe, L. MCN, R. Travers, K. Boyle, J. Brennan, E. Allen, V. Russell, E. Forkan, J. Davis, S. Curran, L. Victor Shanley, L. Carroll, E. Fitzgerald, L. McGrath, N. Finn, A. Murphy, M. Doolin-Murphy, J. O'Caoimh, V. Makkena, G. Cody, J. McKeever, D. Prause, K. Nolan, A. McManus, L. Dunne, L. McGrath, N. Ennis, S. Daly, S. Mullen, A. Jolyet-Cunningham, B. Woods, D. Kelly, A. McGauran, M. McDonald, E. Allen, J. O'Neill, S. Birmingham, G. Clancy, R. Higgins, L. Kennedy, A. Robinson, E. Crowley, E. Anderson, A. O'Brien, R. McGrane, K. Earley, C. Colgan, A. Buckley, Y. Branagan, T. Tseng, S. Zaw Oo, B. Horgan

Sign in to Google to save your progress. Learn more
Enter your name below to add your signature to the letter *
Do you want to be added to the Transgress the NGS contact list in order to be kept up to date about news from the campaign? *
If you would like to be added, please enter an email address and/or phone number below.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report