We are currently seeing people who were referred between between three and three and a half years ago. We are working to reduce this time but wait times can go up or down. This does not mean you have to wait to start exploring and expressing your gender. For more information on social and legal transition see the “While You Wait” and “Supports” section.

You will receive a letter once you are placed on the waitlist. Please note if you were under 18 at the time of referral, then the letter confirming your place on the waitlist will be sent directly to your referrer. If you or your referrer did not receive the letter confirming your place on the waitlist then please contact us at [email protected] or 01 211 5045 and we can check to see if you are on the waitlist. 

There is no checklist of things that you “have to do” before attending. However, in our experience, the two most common issues that are identified during initial assessments are challenges with social transition or occupational functioning (getting out of the house, engaging in education or the world of work).  

Therefore, seeking help in progressing your social transition could be of benefit. For guidance on important steps you can take while you wait, please refer to the “While You Wait” section. 

If you are having difficulty leaving the house (or any serious problems in occupational functioning) then talk to your GP about getting a referral to an Occupational Therapist or appropriate local service. We can speak to your GP about this if they need advice.

Mental health can suffer and if you have any mental health symptoms you should speak to your GP. Hormones may not improve mental health symptoms, and in some cases may make mental health symptoms worse. Therefore, it is important to address any mental health difficulties and ensure that mental health is stable before starting hormones.

Additionally, we have created a list of local resources for a range of challenges that people may face. Examples include: psychotherapy listings, addiction supports, stress programs, grief services, and many more.  For access to our resource pack Click here

Lastly, it can be helpful to bring the names and addresses of any mental health services or professionals that you attended in the past to your first assessment. This is not essential as we can seek the information from your GP and/or referrer if needed but waiting for this information may delay follow-up appointments with us. 

No you do not:- this is not a requirement for our service. If you have seen or are seeing a mental health professional, we may ask them to forward any reports to us directly with your permission. This may be needed to complete the clinical assessment and ensure that we are appropriately addressing any ongoing mental health needs. 

The initial assessment is the first step of a full multidisciplinary consultation.

Many people expect this assessment to be focused solely on gender and gender dysphoria. However, we take a holistic view of a person and their experience, and so complete an assessment that tries to understand you as a whole person, in the context of your life and circumstances.

While dysphoria can be important, it is not the sole focus of our service. Our intention is to make a holistic assessment of social health, mental health, relationships and sexual health, occupational function, and general well-being. We do talk about gender too, including any plans for further gender affirming interventions. However, we do need to ensure that we identify and address any and all health needs as we move forward.

If the focus of healthcare is solely on hormones and surgery,  then other elements of a person’s health and well-being may be neglected, leading to worse outcomes, both for transitioning and poorer quality of life. This is why our approach is to be holistic and very detailed in both our clinical assessment and our interventions.

Our standard multidisciplinary initial assessment occurs over a minimum of two visits. The first visit is about three hours long (it can be shorter or longer). There is a break in the middle, we also recommend if possible you plan to have some free time afterwards as it can be a tiring day.  In this visit we talk about your general health and well-being.  

This will include the following:

Early life

• Your mother’s pregnancy, your birth and early development

Your personal story

• Growing up, school, family life, social development

General well-being 

• How you are doing: what’s going well, what’s not going so well.

Gender 

• Gender exploration: we will talk about how you have explored your gender so far, and what supports you have
• Transition to date: we will talk about your personal transition(what gender means to you) and social transition to date (how you present your gender to the world). We might also talk about any legal transition you may have gone through (it is ok if you have not started any legal transition or if you never want to legally transition). we will also talk about any medical transition you have gone through before attending us: it is ok if you have already had surgery, if you are on hormones (even if these are unprescribed), or if you have been on hormones in the past (even if these were unprescribed)
• Any challenges that have been encountered in your transition to date.
• Plans for any further gender affirming medical or surgical interventions.

Social health 

• Home life: we will ask about how things are going in terms of home life including about where you live and who you live with (if housing is insecure or unsafe then we need to know this so that we can help you to address this as you move forward).
• Financial or legal challenges: if you need financial or legal support then we will talk about this and offer advice and guidance in how to access any necessary support.
• Social relationships: we will talk about your social environment (who you live with and/or spend time with) and about how transition has affected or may effect your personal relationships

Mental health

• Current mental health challenges: we will talk to you about any current mental health problems or symptoms that you might be having.
• A history of mental health problems: if you have had mental health problems in the past that have now gotten better, then we will talk about this – sometimes medical transition can result in recurrence of previously experienced mental health symptoms.
• We may need to get records of previous treatment, with your permission.

Relationships and sexual health

• Hormones and surgery change your body and how your body functions in many ways, including major changes in your ability to have sex and your ability to have children.
• We will talk about current and previous relationships, both sexual and romantic and how changes in sexual and reproductive function might affect you and your relationships.
• We will also talk about your thoughts about fertility and having children.
• Hormones change how your genitals work, how they feel, and how they look: we will talk to you about your relationship with your body and how you expect this might change post transition

Occupational function 

• Work or study: we will ask about how you have got on or are getting on in the world of education and/or work.
• Many people find it difficult to get into education, or to get into the world of work: we will talk about any challenges you may have had in these parts of your life and try to offer advice and support to address these challenges.
• Some people will have serious problems with occupational function that makes it difficult to leave the house or to do simple day to day tasks: we will talk about any difficulties you may have in leaving the house or in getting day to day things done.

Sometimes, meeting your partner or someone from your family can be an important part of completing the initial assessment. This is something we can discuss when you attend your first meeting.

You might meet any member of the multidisciplinary team for your first appointment. Sometimes you will only meet one person, but sometimes you will meet two of the team on the same day. The members of the multidisciplinary team you might meet at your visit includes:

• Social Worker
• Consultant Psychiatrist
• Consultant Endocrinologist
• Speech and Language Therapist
• Clinical Psychologist
• Clinical Nurse Specialist in Gender
• Liaison Psychiatry Nurse Specialist
• Occupational Therapist

Sometimes the team members you see have been selected for you based on specific needs identified in your referral letter, but most often you will just see the next available team member (on a random allocation). We do not accept requests to see specific members of the team for your initial assessment.

No:- you don’t need to bring anything with you. Although, it can be helpful to write down any questions you may have and bring them with you. 

It is also a good idea to bring the names and addresses of any previous services or professionals that you have seen before for support with mental health, autism, or any significant health or social care issue. This is important as we may need to liaise with them about your healthcare needs. 

You can have a friend, relative or partner accompany you to the hospital but the assessment will only be between you and the healthcare professional. 

If during the assessment, both you and the healthcare professional think it would be beneficial to have them sit in, then this can be arranged. 

The National Gender Service is based in St Columcille’s Hospital Outpatients Department. When you arrive at the hospital please check in at the main entrance and you will be guided to the outpatient waiting area. 

How to get here:

• The hospital is served by bus and has parking available at a cost. 
• The Luas Green Line is within 20 minutes walk of the hospital
• If using the car park then there will be a charge: please bring change for the Pay Stations or have a smartphone that you can use to download the payment app. 

Dublin Bus:

• Please check www.dublinbus.ie for up-to-date travel information.
• The hospital bus stop is called “Loughlinstown Hospital”
• If coming from Dublin City Centre then the bus stop you get off at is number 3135
• From Dublin City Centre you can take the 155 (Starts from Ikea Ballymun and ends at Bray) or the 145 (starts from Heuston Station and ends at Ballywaltrim)

Luas:

• Please check www.luas.ie for up-to-date travel information
• Take the Green Line towards Brides Glen and get off at Brides Glen stop.
• From there you can walk to the hospital along the N11: this takes approximately 20 minutes. 
• Alternatively, the number 84 bus runs from Brides Glen Luas stop to the hospital however please note that it is infrequent.
• Please check www.dublinbus.ie for up-to-date travel information.
• The hospital bus stop is called “Loughlinstown Hospital”
• If taking the 84 bus from Brides Glen Luas stop to the hospital, make sure that the direction of the bus is towards Newcastle
• When taking the 84 bus towards Newcastle, get off at bus stop number 3135 called “Loughlinstown Hospital” 

You can contact the team at 01 2090009 or email us at [email protected]. While our office hours are 9am-5pm Monday to Friday, there might not be someone available to take your call. However, if you leave a message, we will get back to you. 

Once initial assessments are completed, we discuss as a whole team and a number of things can happen next:

Most often, you are referred for your endocrine clinic appointment to commence hormones.

or

You are not referred for your endocrine appointments at this time. A member of the team will talk to you about why this is. You may be linked in with specialist supports to assist with specific areas of your life. This support may be provided by our team or elsewhere.

or

In a small number of cases, endocrine intervention will not be recommended and a member of the team will talk to you about this.