Northern Ireland's health minister Robin Swann says: I'd like to spend more money on NHS transgender services

Robin Swann said that he would like to "expand services and build capacity", but this would cost an extra £660,000 per year and he faces "very significant funding challenges".

Mr Swann made the comments in response to a written question in the NI Assembly, posed by People Before Profit MLA Gerry Carroll, asking "what plans he has to provide inclusive and safe healthcare for transgender people".

Mr Swann responded on April 8 (his response was uncovered by the News Letter while sifting through written questions this week).

All this comes amid a surge of criticism of "gender affirming care" on the NHS following the publication on April 10 of the Cass Report.

It was an investigation into the explosion over the past decade in the numbers of children and youths claiming to be either the opposite gender or "non-binary" (those who place themselves in a new gender category like "genderqueer" or "genderfluid").

"Gender affirming care" refers to the practice of taking somebody at their word when they declare they are transgender/non-binary, instead of regarding it as a possible sign of mental ill-health or a phase.

Dr Cass said of the field in general: "This is an area of remarkably weak evidence... The reality is that we have no good evidence on the long-term outcomes of interventions to manage gender-related distress."

Medics across the UK – including in Northern Ireland – have been giving drugs to children for years (puberty blockers and cross-sex hormones), with some of those patients going on to have their sex organs surgically removed/redesigned once they are 18-plus.

Responding to Mr Carroll, Mr Swann said: "My officials have been working closely with the Belfast HSC Trust to address waiting times, resources, and to develop a model of care for gender identity services that meets... the immediate needs of service users and enables the service to expand services and build capacity over a period of time.

"However, given the very significant funding challenges faced by my department and the lack of an agreed budget it has not been possible to progress this work as we would have liked."

He said staff are trying to "develop a business case to enhance existing service provision", adding: “Funding of around £660k in 2024/25 will be required recurrently to fund the service development.”

The Belfast Trust runs two services for patients who say they are transgender/non-binary: an adult one (the Regional Gender Identity Service, AKA The Brackenburn Clinic), and a children's one (Knowing Our Identity, or KOI for short).

Both have been in existence since 2014, and are currently overwhelmed by the number of people presenting as transgender/non-binary.

The adult Brackenburn Clinic is for people aged 17 years and six months upwards. It can put people on drugs and refer them for surgery in England (no "sex change" surgery is done in NI on the NHS).

The children's KOI one was providing drugs but ceased offering them to new patients from 2020. It cannot offer surgeries because in the UK people have to be 18 first.

However, it still provides “assessment and specialist psychological support”, and the Belfast Trust confirmed to the News Letter that this will continue uninterrupted following the Cass report.