Northern Ireland getting its own Cass Review as Mike Nesbitt plans shake-up of transgender services

The announcement came from Health Minister Mike Nesbitt after a wave of critical stories during the summer about the province's current trans services.

It included the revelation (by the News Letter) that children as young as five had been accepted as patients of the specialist trans services, which are run by the Belfast health trust.

What followed were questions about how much understanding and input different health ministers have had into trans services for children.

UUP MLA Mr Nesbitt had also announced during the summer that he has allocated an extra £806,000 to help reorganise the province's trans NHS services.

Effectively, this will merge the currently separate services for adults and for children into a single service.

Against this backdrop, Mr Nesbitt has now said cross-bench peer Baroness Hilary Cass will “conduct an assessment of the gender identity services provision in Northern Ireland”.

Baroness Cass conducted a similar review, known widely as the Cass Review, into how NHS England handles children and youths who say they are transgender.

Her report, which was four years in the making, was published last year.

Among its many findings was that trans health services for children and young people were based on “remarkably weak evidence”, adding: “The reality is that we have no good evidence on the long-term outcomes of interventions to manage gender-related distress.”

Following her report, the practice of giving puberty-blocking drugs to children was stopped – including in Northern Ireland – much to the anger of trans activists.

Announcing the new review, Mr Nesbitt said: “I am delighted that the eminently qualified Dr Hilary Cass has agreed to my request to provide an assessment of the actions being taken in Northern Ireland. Last year she published her wide-ranging review into gender identity services for children and young people in the UK.

“Whilst understandably much of the focus of her report centred on the recommendation on puberty blockers – which Northern Ireland rightly adopted – she also came to other important conclusions.

“In finding that most young people experiencing gender-related distress would not benefit from a medical pathway she instead called for a much stronger focus across the UK on psychological support, as well as a more holistic approach to care.

“That is exactly what I want Northern Ireland to be delivering. Much of the previously approved £806,000 business case for the new Lifespan Gender Service is to invest in new and additional psychological and psychiatric support, as well as a greater multi-disciplinary approach.

“From my reading of the Cass Review that is exactly the direction of travel she has recommended.

“While I am content with the process undertaken to develop the revised service, in response to a number of questions being raised, I believe an independent expert assessment of the service may go some way to address these issues.

“I am delighted that Baroness Cass has agreed to complete that assessment which will commence in November 2025.”