DUP minister expresses 'serious concerns' over Mike Nesbitt's expansion of controversial gender service
Stormont’s communities minister has written to Mike Nesbitt over his gender identity clinic plans, raising “serious concerns” over the move – and questioning whether the service will be in line with recommendations from a scathing review of similar services in England.
Gordon Lyons wrote to the health minister on Tuesday after the News Letter reported that £806,000 had been allocated to a “lifespan” gender clinic with no lower age limit on referrals.
UUP leader Mr Nesbitt has been under growing pressure from within his own party over the decision, with two former leaders publicly criticising the policy this week.
The DUP has also said that the issue was not brought before the Executive and therefore was not signed off by other ministers.
The Department of Health argues that the “expanded” service is not new – and that “nothing has changed in terms of criteria from the model of care that has been in place for many years and spanning several Ministers of Health”.
However, that raises questions about why the service has not changed, given the recommendations of a review into gender services commissioned by the last UK government.
That 2024 report by Dr Hilary Cass in 2024 effectively brought an end to the practice of medical interventions in children – and resulted in a ban on the prescription of puberty blocker drugs.
It was critical of the gender-affirming approach in general, and a lack of appropriate care provided by gender clinics. The UK hub at the Tavistock hospital was subsequently closed.
Communities minister Gordon Lyons has pushed Mr Nesbitt on whether the report’s recommendations have had an impact on the minister’s plans.
In the correspondence, seen by the News Letter, Mr Lyons says: “I note that your decision follows the closure of the heavily criticised Tavistock Clinic in London, as highlighted by the Cass Review. The review raised alarms about the lack of robust evidence supporting medical interventions for young people experiencing gender distress and the potential for harm from treatments such as puberty blockers.
“Given this context, can you outline why you feel this service in Northern Ireland is required and have you considered the findings of the Cass Review in taking this decision?”
The DUP minister said he was “deeply concerned about the impacts this service will have on the safeguarding of children; there is a duty on all of us to protect our young people from irreversible decisions that lack a robust evidence base”.
Children attending the clinic are unlikely to be offered medical interventions such as puberty blockers, unless as part of UK-wide trials which are yet to be approved by the health secretary Wes Streeting.
However, critics have warned that referring children presenting with gender distress to a specialised gender clinic will reinforce the idea that gender identity is at the root of the problems they are facing.
At the weekend, a respected psychiatrist who blew the whistle on practices at the (now closed) Tavistock children’s gender identity service in London, criticised the approach taken by Mr Nesbitt.
Dr David Bell said children experiencing gender distress should be handled by existing mental health services, and that the concept of a specialist gender clinic for young people is outdated and potentially “damaging” to children.
Gordon Lyons has also asked for “details on the consultation and decision-making process prior to this funding allocation” and asked why the health minister “felt this service took priority over the many other funding pressures in your department, which you regularly remind us of, such as mental health provision and hospital waiting lists”.
Asked about who was consulted on the minister’s plans for the Lifespan gender service, a Department of Health spokesperson said it has been “working closely with the Belfast Health and Social Care Trust to address waiting times, resources, and to develop a model of care for Gender Identity services that meets the needs of transgender people living in Northern Ireland.
“As part of this process, a Gender Identity Service Pathway Review Group and a Gender Identity Liaison Panel, which sits under the main Pathway Review Group, were established to provide clinical and service expertise and encourage those with lived experience to provide input.
“The Department has been working with both groups to develop a solution which meets the immediate needs of service users and enables the service to expand services and build capacity over a period of time. The expanded service has been developed after close collaborative working with members of the Review Group and Liaison Panel”.