People seeking help from the National Gender Service will end up “harmed” by longer wait times, the NGS clinical lead has warned.  

Doctor Karl Naff has warned that the wait times for people seeking treatment will likely become longer.  

Dr Naff told Moncrieff current waiting times are between three and three and a half years, and it will “unfortunately get worse soon”.

“We have been asking for the last three years now for additional resources,” he said. “This was foreseen to get worse when I started in 2019.” 

“If we don't get additional resources by the end of this year, then it gets to a point of safety,” he said. 

“We would have people waiting for, at that stage, could be even more than four years.” 

“There's a lot of things going on, a lot of people who are deferring important medical interventions, a lot of people who could end up harmed by long waits,” Dr Naff said. 

“And so, we will maybe have to come to a decision to close the waiting list to that point, purely as a matter of safety but also as a matter of providing a service for the people who are already attending.” 

Dr Naff said there are currently 1,400 people on the waiting list and between 600 and 700 people attending the NGS.  

He said they are currently working with patients who entered the waiting list in the first quarter of 2020. 

“It'll get to a crunch point where if the pressure gets too high, wait times get too long and there is no sign that the agency will grant our request for additional resources then the service may come apart,” he said.  

GPs 

In the face of longer waiting lists, activists Trans Harm Reduction and Dublin Trans Pride have accused the NGS of advising GPs against providing blood tests and prescribing hormone therapy.  

They have launched a campaign, calling on people to contact the NGS to demand their commitment to stop advising GPs against providing blood tests and prescribing HRT to trans patients.

“The NGS must stop interfering with people’s ability to access care through their GP”, Trans Harm Reduction said in a template email to the NGS.  

Dr Naff said they would "never ever recommend prescription of hormones or referring for gender affirming surgery in the absence of a comprehensive assessments”.  

He said the NGS does not try to decide if people are transgender or not, but rather assessing the “benefits and risks” of intervention.  

Advice to GPs

“It’s like any medical or surgical intervention, we do this in obesity as well,” he said. “We have a multidisciplinary assessment at the start of that pathway, including a mandatory psychological assessment.” 

“The purpose of that is not to say do you have obesity or not - It's to say on the balance of benefit and risk. Is this procedure likely to result in benefit or harm.” 

“If we think it will result in benefits, we recommend that - if we think it will result in harm, we do not. It’s exactly the same with gender.”

He said if they assess that a person would benefit from treatment, they recommend prescriptions that are then provided by their GP.  

Dr Naff said providing prescription is “a matter for the GP” - but if the NGS is asked, they will advise not to offer prescriptions without an assessment.  

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