Trans lobby's ‘co-design’ role in Nesbitt-backed gender identity clinic branded 'reckless' by Christian Institute
The influence given to LGBTQ+ lobby groups by the health minister Mike Nesbitt in the design of a controversial gender identity service has been branded “reckless, dangerous” and contradictory to the expert warnings of the Cass Review.
The Christian Institute says that Northern Ireland is “running towards the same disaster” that happened in England around gender services for children by allowing groups such as the Rainbow Project a role in the design of a gender identity clinic.
The Department of Health (DoH) says “service users” were just one element of the “co-design” of the new service – but the review was “steered by expert clinicians”.
Health officials also say they are confident the service is in line with recommendations from Dr Hilary Cass – but the clinician has been invited to review it “just to be sure”.
This week, Mr Nesbitt revealed that Baroness Cass – whose review of gender services in England resulted in the closure of the UK’s main gender clinic for children – would conduct a review of the new service.
The UUP minister said that Baroness Cass had 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”, he said.
The announcement comes after two Ulster Unionist MLAs criticised their leader’s plans for the gender service, amid widespread concern within the party about the policy. The News Letter previously revealed that children as young as five years old have been referred to the children’s service – with the current service having no lower age limit.
A Freedom of Information (FOI) request submitted by the Christian Institute, seen by the News Letter, shows that the LGBTQ+ lobby were involved in a Gender Identity Review Group and Liaison Group set up by the Department of Health (DoH) to shape the service. The Gender Identity Service will receive £800,000 of recurrent funding from Stormont, and brings together existing child and adult services into one.
The documents show criticism of the Cass Review by LGBTQ+ representatives. Minutes of the Gender Identity Review Group from September 2024 show an activist from an unnamed organisation telling health officials “there has been a lot of lobbying to get where we are now in terms of the proposed service development but not much engagement on the temporary ban” on puberty blockers.
The documents also show uncertainty from Belfast Trust staff – who would be delivering the service – about whether Northern Ireland would follow the Cass recommendations in England, and if so, requesting a protocol to follow. Despite uncertainty about the policy direction of gender services, the Trust advised that it would present a business case for the new service “possibly within a couple of weeks”.
The documents have been heavily redacted, so it is not possible to see which groups were speaking at specific points, but the meeting was attended by health service officials, clinical staff from Belfast Trust and “service user representatives” from the Rainbow Project and Focus: The Identity Trust.
Both groups are advocates of what is euphemistically called “gender affirming care”. This involves support for affirming the identity of patients, and medical interventions such as puberty blockers for children, and procedures such as mastectomies for adults.
James Kennedy, NI Policy Officer at the Christian Institute welcomed the review by Baroness Cass, but told the News Letter: “It is outrageous that controversial lobby groups have been embedded in designing a new gender identity clinic for adults and children. This is not just inappropriate — it’s reckless, dangerous, and directly contradicts the expert warnings of the Cass Review.
“Cass made it clear that ideology had infected gender services in England so thoroughly that basic medical protocols and safeguarding were overlooked. The Tavistock clinic had to be shut down to stop the harm being done. And yet here in Northern Ireland, we are running towards the same disaster, with transgender activists seemingly handed a seat at the table from day one.
“The minutes of the Review Group are very alarming. In one meeting, it's openly stated that ‘a lot of lobbying’ was behind the current direction of the service. Lobbyists were tipped off about the Health Minister’s plans, including the ban on puberty blockers, before the matter was even brought to the Executive”
A DoH spokesperson said lobby groups “were not provided with specific details of the service development, however members of the review group and liaison panel, who actively contributed to the co-design and provided input into this service development, may have also been members of various organisations”.
They added: “The Lifespan Gender Service is not a new service, rather it is the merging of two existing services created under previous Ministers. The Minister’s approval for funding the business case for the Regional Lifespan Gender Service was not unusual as this is simply a re-design of existing service provision”.
The department said the review of the service began in 2019 – long before the Cass Review – and that the revised model is “the direction of travel advocated by Dr Cass in her review”.