Senior figures in the HSE decided to continue allowing controversial puberty blocking treatment at Crumlin Children’s Hospital in the wake of a High Court ruling in London in December, according to internal communications seen by The Irish Times. They also reassured the hospital that it would continue to be indemnified by the State Claims Agency.

The HSE were of the view that the “risk of withdrawing treatment on foot of ruling in another jurisdiction represents far higher risk to patients than continuing treatment and we support clinicians in same”, according to an email circulated a week after the judgment.

The High Court in London ruled on December 1st that puberty blockers were an “experimental treatment” and it was not possible for patients aged under 16 to give the required legal consent.

Relatedly, an October 2020 briefing paper prepared for the HSE noted that the endocrinologist at Crumlin who had a special interest in transgender services had resigned in September 2020 and that a “significant reason” for the resignation was the failure to establish a multidisciplinary team and agree a model of care. “The decision to embark on a medical transition journey for young people without comprehensive specialist multidisciplinary psychosocial team assessment and support can lead to catastrophic outcomes,” the report noted.

The documents released under Freedom of Information also included emails from consultant psychiatrist Paul Moran. Referring to the Keira Bell case against Tavistock he said: “It is only a matter of time before we will have cases taken against the HSE by some of the children currently attending Crumlin. The same gender service (Tavistock GIDS) implicated in the case above continue to recommend hormone treatments for children without adequate assessment.”