Former Stormont health minister says controversial gender clinic did not have ministerial approval
The Stormont minister in charge when a controversial gender identity clinic was launched in 2014 says he did not approve the service – and was never briefed on its commissioning.
Edwin Poots has now called on the Department of Health to make that clear – after it said that the service was commissioned when he was minister.
It comes amid mounting pressure on current health minister Mike Nesbitt over his decision to fund an expanded gender identity service in Northern Ireland – with no lower age limit on referrals.
Two of the UUP leader’s senior colleagues have been publicly critical of the policy, with Doug Beattie calling it “madness” and Steve Aiken saying it should be revoked. There is also growing opposition to the plans – which include £806,000 in funding – from grassroots Ulster Unionist members and local councillors.
The DUP has said the recent proposals were not brought back to the Executive, as had been requested. Communities minister Gordon Lyons has written to Mr Nesbitt raising “serious concerns” about the service, and queried whether it has been changed in light of the Cass Review – which was scathing about the services provided by the NHS on children questioning their gender.
The Department of Health (DoH) has said the service is not new, and merges existing transgender provision for children and adults – with the “model of care that has been in place for many years” continuing.
The News Letter had asked DoH when the existing gender service for children was started, and which minister signed the policy off.
A spokesperson said: “A Regional Gender Identity Service (KOI) was commissioned from Belfast Trust by the then Health and Social Care Board (now the Strategic Planning and Performance Group, SPPG) in August 2014 when Edwin Poots was Minister of Health”.
Responding to a News Letter story the DoH comments, Mr Poots said he did not give approval for the service.
“As the former Health Minister, I can confirm that I was never briefed, had sight of, or give [sic] approval for the Gender Identity Service. I call on the Department of Health to clarify that the Gender Identity Service was established without Ministerial approval”, he said.
The News Letter has asked DoH whether the former HSC Board - or Belfast Trust - raised the commissioning of the gender service with the department and/or the minister at the time. We are currently awaiting a response.
The KOI service continued under successive health ministers after Mr Poots left office in 2014. These included the DUP’s Jim Wells and Simon Hamilton, Sinn Fein’s Michelle O’Neill and the Ulster Unionist Party’s Robin Swann and Mike Nesbitt – as well as two periods of suspension where no ministers were in place.
Serious questions about the care given to children who believe they are the opposite sex have been raised over the past few years, receiving increased media coverage and facing growing political opposition.
A 2024 report by Dr Hilary Cass 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 – but the report called for an expansion of services.
DoH has said the merged and “expanded” Lifespan service, approved by Mike Nesbitt last month, is continuing with the “model of care” that has been in place under previous ministers.
As a consequence of the Cass report, the prescription of puberty blockers was banned by the health minister – with the backing of Executive colleagues. However, the ‘affirmative model’ is still understood to be the basis of the service.
That means that children saying that they are transgender are affirmed as such. Critics warn that this means other issues which may be at the root of their distress over their gender can be overlooked.
Dr David Bell – a distinguished psychiatrist who wrote a critical report about the activities of the (now closed) gender identity service at the Tavistock clinic in London – says that model should be scrapped.
He told the News Letter that 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.