Northern Ireland’s Health Minister has published a new report assessing how the region’s Gender Identity Service aligns with the findings and recommendations of the 2024 Cass Review.
Commissioned in September 2025, Dr Hilary Cass’s assessment examined whether services for children and young people experiencing gender incongruence and gender dysphoria in Northern Ireland comply with her recommendations for services in England.
The report, Cass Assessment Report for Gender Identity Services, concludes that the Department of Health is now in a “crucial position” to move forward with plans for a Regional Lifespan Gender Service, bringing children’s and adult services together under one unified model.
Dr Cass praised the integration of Child and Adolescent Mental Health Services with clinical and social services in Northern Ireland’s current approach. She highlighted the joined‑up structure as a strength that can be built upon as services transition into a new lifespan model. Her assessment also sets out several recommendations for Northern Ireland, including:
- Strengthening workforce development
- Supporting NI to join the UK National Provider Network
- Participating in the PATHWAYS research programme
Commitments to progress several of these recommendations are already underway.
Department of Health officials will now consider Dr Cass’s recommendations and work with counterparts in England, and health and social care service providers in Northern Ireland.
This work will support the implementation of a redesigned, evidence‑based model of care.
Northern Ireland’s Health Minister Mike Nesbitt said:
“In 2024 Dr Cass published her wide-ranging and landmark review into gender identity services for children and young people in the UK. There is simply no one better placed to provide an assessment of the gender identity service provision in Northern Ireland.
“Given the significant political and media commentary around the decision to proceed forward with a Regional Lifespan Gender Identity Service, I commissioned Dr Cass to conduct this assessment.
“It is vital that we get these services right, to ensure children and young people in Northern Ireland receive a high standard of care that meets their needs and is safe, holistic and effective.”
The Lifespan Gender Service, a major redesign of existing provision, will bring together the CAMHS Knowing Our Identity Team, and the Adult Gender Service.
Both will operate within one model of care, under a single management structure, ensuring age‑appropriate support for individuals exploring their gender identity or experiencing gender dysphoria.
The report emphasises that:
- Referral to the service is not gender‑affirming.
- Referral is an administrative step enabling access to a full, multidisciplinary assessment.
- A referral or assessment does not guarantee access to affirming treatments or determine clinical outcomes.
The redesigned service will ensure individuals receive comprehensive evaluation and support, grounded in clinical evidence and best practice.
The Cass Assessment identifies an opportunity for Northern Ireland to develop a collaborative relationship with England’s under‑18s services, ensuring consistency, shared learning, and improved standards across the UK.
Image credit: iStock
