Trans healthcare in Ireland is at a critical point, with community organisations challenging a proposed HSE model they say falls short of what was negotiated. TENI has taken its concerns to government ministers, calling for a fresh approach centred on informed consent, primary care and accessible support. The outcome matters to trans people seeking care across the country.

A draft has left the community concerned

The central dispute is over a draft model for how the HSE should provide healthcare to trans people in Ireland. TENI says the proposal does not reflect the community organisations' negotiations and risks carrying problems from the existing system into a new one. The organisation has called for the draft to be replaced. (TENI; PATHI resignation letter)

TENI says it has stayed involved in the process so trans people continue to be heard by decision-makers. Other groups, including PATHI, have withdrawn in protest, highlighting a sharp divide over whether the current process can deliver the care people need. (TENI; PATHI resignation letter)

Ministers hear calls for a different approach

TENI says it met Health Minister Jennifer Carroll MacNeill and Minister for Mental Health Mary Butler, alongside LGBT Ireland and Belong To. The organisations raised community anger and asked for a new proposal that is depathologised, based on informed consent and led by primary care. (TENI)

The group says Butler agreed that a revised model should be self-affirmative, inclusive and accessible. The Programme for Government also includes commitments relevant to improving trans healthcare, though turning policy aims into a working service will require decisions about how care is organised and delivered. (TENI; Programme for Government 2025)

Why primary care and informed consent matter

A primary-care-led model would put more emphasis on accessible healthcare services, rather than making specialist provision the sole route into support. The HSE's guidance for healthcare workers provides information on gender healthcare, but the wider question is how a national model will connect people with timely, appropriate care. (HSE)

Informed consent is another key principle in the debate. For trans people, a system built around clear information and respectful, individual decision-making can make the experience feel less like a hurdle and more like healthcare. Community leaders have also argued for a system designed around people's needs and lived experience. (TENI; GCN)

What happens next for trans healthcare in Ireland?

The immediate question is whether the disputed draft will be revised. TENI says it will continue pressing for change, while the withdrawal of other organisations signals that agreement on the process itself remains a challenge. (TENI; PATHI resignation letter)

For anyone following the issue, it helps to distinguish between a policy commitment and a service people can actually access. The model's eventual wording will matter, but so will its practical details: how people are referred, where care is available and whether support is accessible across Ireland. (Programme for Government 2025; HSE)

A better model won't be measured by its promises alone, but by whether people can get the care they need.

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