SIGN OUR OPEN LETTER DEMANDING DEMANDING THAT THE VOICES OF TRANS PEOPLE AND REPRESENTATIVE COMMUNITY ORGANISATIONS ARE HEARD IN THE DEVELOPMENT OF THE NEW MODEL OF TRANS HEALTHCARE For the attention of: Jennifer Carroll McNeill, Minister of Health, Mary Butler, Minister of State at the Department of Health, Bernard Gloster, HSE CEO, Colm Henry, HSE Chief Clinical Officer We are writing on behalf of Transgress the NGS, a grassroots trans community campaign, and on behalf of our supporters and affiliated groups. We wish to highlight our continued concerns with the situation regarding trans healthcare in Ireland, including with the development of the National Clinical Programme for Gender Healthcare being overseen by the HSE and the Department of Health. Over the past year the problems with the current public system for the provision of trans healthcare have only become more apparent and widely understood. Waiting lists have continued to grow and the recording of a psychiatric evaluation being carried out at the NGS which we released online (https://www.instagram.com/p/DRxbq8cjKLs/) in December 2025 clearly demonstrated what the trans community has been saying for many years about the invasive, unnecessary and harmful nature of these assessments. The announcement later in December that the NGS would be closing its waiting list, whether or not this actually occurs, is symptomatic of a failed public trans healthcare system and the abandonment of trans people by the political establishment. Last, we are deeply opposed to the fact that the NGS is overseen by St John of God’s Community Services, both because this is a religious institution that has historically been opposed to transgender healthcare and because this connection involves classifying trans people as mental health service patients. The Labour Party private members’ motion recently passed by the Dáil, the ongoing advocacy by trans community groups and allies, and the thousands of people who turned out for Trans Pride in June 2025, clearly demonstrate the widespread public support for fundamental changes in the trans healthcare system. We are of course aware that there is work underway to develop a new model of trans healthcare overseen by the HSE. However we have serious concerns about this process and the likelihood that it will deliver a model of care that will meet the needs of our community. Our concerns with this process include firstly, the lack of a commitment to a model of care based on the principle of informed consent in line with international best practice as set out in WPATH guidelines, as has been advocated by the trans community and representative organisations for many years and, importantly, was explicitly endorsed in the private members motion passed by the Dáil in December last year. Second, we are deeply concerned about the involvement of senior NGS clinicians in the development of the new model of care. This is due to the complete lack of trust between the NGS and the trans community, including because NGS clinicians have a policy of advising GPs against providing blood tests to trans patients, thus putting their health at significant risk, and because the NGS has a record of denying care to patients who publicly criticise their approach. Their involvement will thus have a chilling effect on trans people and limit our ability to engage in any future consultation processes. For this reason we (Transgress the NGS) have decided not to engage in the consultation process associated with the development of the new model of care. Third, we are concerned with the lack of opportunities for trans people to meaningfully participate in the development of the new model, which will seemingly be limited to a narrow range of groups and individuals deemed representative of the community and involve requests for feedback without any guarantee our perspectives will be taken into account. We demand that trans people be seen as equal partners and collaborators in the new development of the new model (following the definition of collaboration in the HSE’s Better Together Patient Engagement Roadmap). Linked to these issues we have several key demands relating to the development of the new model of care. These are: 1) A commitment to a GP-led model based on the principle of informed consent corresponding to the longstanding demands of the trans community. 2) That there should be no involvement of current NGS clinicians in the process. 3) That there be no involvement of religious institutions in any new trans healthcare model. 4) That interim guidance be issued to GPs as a matter of urgency regarding how they can provide care to trans people who have been abandoned by the failure of the public healthcare system, including by working with private trans healthcare providers in Ireland and elsewhere in Europe, providing access to blood tests including for estradiol and testosterone (particularly for trans people who are self medicating) and prescribing HRT directly. We look forward to your response to these demands. If they are not addressed satisfactorily we will have no choice but to escalate our campaign and ensure our voices cannot be ignored as has historically been the case. Regards, Transgress the NGS Community and political organisations who have endorsed the letter (as of 13th February 2026): Gay Health Network, UCDSU, The Trans* Research Association of Ireland, ROSA Socialist Feminist Movement, The Chaska Project, Trans Pride Limerick, Trans Limerick Community, Dublin University Gender Equality Society, Trans Healthcare Access Glasgow, Trans & Non Binary Society ATU, Trans Pride Northern Ireland, Navan Pride, Nenagh LGBT, Wexford Pride, Maynooth Pride Society, Intersex Ireland, TUS Midlands, Midlands LGBT+ Project

SIGN OUR OPEN LETTER DEMANDING DEMANDING THAT THE VOICES OF TRANS PEOPLE AND REPRESENTATIVE COMMUNITY ORGANISATIONS ARE HEARD IN THE DEVELOPMENT OF THE NEW MODEL OF TRANS HEALTHCARE For the attention of: Jennifer Carroll McNeill, Minister of Health, Mary Butler, Minister of State at the Department of Health, Bernard Gloster, HSE CEO, Colm Henry, HSE Chief Clinical Officer We are writing on behalf of Transgress the NGS, a grassroots trans community campaign, and on behalf of our supporters and affiliated groups. We wish to highlight our continued concerns with the situation regarding trans healthcare in Ireland, including with the development of the National Clinical Programme for Gender Healthcare being overseen by the HSE and the Department of Health. Over the past year the problems with the current public system for the provision of trans healthcare have only become more apparent and widely understood. Waiting lists have continued to grow and the recording of a psychiatric evaluation being carried out at the NGS which we released online (https://www.instagram.com/p/DRxbq8cjKLs/) in December 2025 clearly demonstrated what the trans community has been saying for many years about the invasive, unnecessary and harmful nature of these assessments. The announcement later in December that the NGS would be closing its waiting list, whether or not this actually occurs, is symptomatic of a failed public trans healthcare system and the abandonment of trans people by the political establishment. Last, we are deeply opposed to the fact that the NGS is overseen by St John of God’s Community Services, both because this is a religious institution that has historically been opposed to transgender healthcare and because this connection involves classifying trans people as mental health service patients. The Labour Party private members’ motion recently passed by the Dáil, the ongoing advocacy by trans community groups and allies, and the thousands of people who turned out for Trans Pride in June 2025, clearly demonstrate the widespread public support for fundamental changes in the trans healthcare system. We are of course aware that there is work underway to develop a new model of trans healthcare overseen by the HSE. However we have serious concerns about this process and the likelihood that it will deliver a model of care that will meet the needs of our community. Our concerns with this process include firstly, the lack of a commitment to a model of care based on the principle of informed consent in line with international best practice as set out in WPATH guidelines, as has been advocated by the trans community and representative organisations for many years and, importantly, was explicitly endorsed in the private members motion passed by the Dáil in December last year. Second, we are deeply concerned about the involvement of senior NGS clinicians in the development of the new model of care. This is due to the complete lack of trust between the NGS and the trans community, including because NGS clinicians have a policy of advising GPs against providing blood tests to trans patients, thus putting their health at significant risk, and because the NGS has a record of denying care to patients who publicly criticise their approach. Their involvement will thus have a chilling effect on trans people and limit our ability to engage in any future consultation processes. For this reason we (Transgress the NGS) have decided not to engage in the consultation process associated with the development of the new model of care. Third, we are concerned with the lack of opportunities for trans people to meaningfully participate in the development of the new model, which will seemingly be limited to a narrow range of groups and individuals deemed representative of the community and involve requests for feedback without any guarantee our perspectives will be taken into account. We demand that trans people be seen as equal partners and collaborators in the new development of the new model (following the definition of collaboration in the HSE’s Better Together Patient Engagement Roadmap). Linked to these issues we have several key demands relating to the development of the new model of care. These are: 1) A commitment to a GP-led model based on the principle of informed consent corresponding to the longstanding demands of the trans community. 2) That there should be no involvement of current NGS clinicians in the process. 3) That there be no involvement of religious institutions in any new trans healthcare model. 4) That interim guidance be issued to GPs as a matter of urgency regarding how they can provide care to trans people who have been abandoned by the failure of the public healthcare system, including by working with private trans healthcare providers in Ireland and elsewhere in Europe, providing access to blood tests including for estradiol and testosterone (particularly for trans people who are self medicating) and prescribing HRT directly. We look forward to your response to these demands. If they are not addressed satisfactorily we will have no choice but to escalate our campaign and ensure our voices cannot be ignored as has historically been the case. Regards, Transgress the NGS Community and political organisations who have endorsed the letter (as of 13th February 2026): Gay Health Network, UCDSU, The Trans* Research Association of Ireland, ROSA Socialist Feminist Movement, The Chaska Project, Trans Pride Limerick, Trans Limerick Community, Dublin University Gender Equality Society, Trans Healthcare Access Glasgow, Trans & Non Binary Society ATU, Trans Pride Northern Ireland, Navan Pride, Nenagh LGBT, Wexford Pride, Maynooth Pride Society, Intersex Ireland, TUS Midlands, Midlands LGBT+ Project