Intersex Ireland stands in solidarity with PATHI and Trans Healthcare Action in their decision to withdraw from the working group developing Ireland’s new model of gender healthcare. Their statements raise concerns about whose knowledge and experiences are heard, and whether this process is prepared to relinquish the medical gatekeeping that has caused so much harm.
Intersex Ireland was not involved in this working group from the outset. We were never invited to that table. Our absence should concern anyone who believes that a healthcare model must be shaped by the people whose lives it will affect.
Intersex people are not a footnote to this discussion. Some of us are also trans. Some of us are non-binary. Some of us need gender-affirming healthcare, and some approach those services carrying medical histories that are already complicated by interventions, secrecy and trauma.
The European Union Agency for Fundamental Rights’ 2025 report, drawing on its 2023 survey, found that 22% of intersex respondents were trans women or men, while a further 41% were non-binary or gender-diverse. These are findings from a European LGBTIQ survey, rather than a worldwide population estimate, but they make the substantial overlap between our communities impossible to dismiss.
Being intersex is not the same as being trans. Neither identity cancels out the other. An intersex person should never have to leave part of themselves outside the consultation room to receive appropriate care. Our contribution also extends far beyond those of us who identify as trans. Intersex communities have extensive experience of what happens when medical institutions decide that bodily difference gives them permission to take control. We know the consequences of interventions performed without consent, information withheld about our own bodies, and decisions made around us rather than with us. Medical trauma affects trust, examinations, disclosure and the ability to feel safe in a consultation. A service that ignores that history risks reproducing the very conditions that caused it.
PATHI describes a draft circulated before the evidence gathering and experiential work were complete, with important perspectives missing. It raises concerns about opaque evidence, excessive assessment, centralised control and the absence of community involvement in governance. Trans Healthcare Action states that the process failed to uphold its own stated values of experience, clinical evidence, respect, inclusiveness and compassion.
These are serious criticisms from organisations that entered the process to help improve care. They require answers. Their withdrawal cannot simply be absorbed into another round of meetings while the same approach continues.
For intersex people medical systems have too often imposed changes to our bodies without our consent, while people seeking changes they actively want encounter barriers to obtaining them. Both reveal a system in which professional authority can override the person whose body and future are at stake.
People must be supported to make informed decisions about their own bodies, including the decision to refuse treatment. Bodily autonomy belongs to the person receiving care.
We support free, timely, accessible gender healthcare, available locally through properly resourced primary and community care services, with access to specialist expertise where needed. We support informed consent, continuity of care, transparent evidence and meaningful accountability. We expect healthcare professionals to understand intersex variations, respect gender diversity and recognise the effects of medical trauma.
We also expect community participation to carry actual power. People directly affected must help shape the model, oversee its delivery and hold services accountable when they fail. Intersex people must be included in that work in our own right. An acronym on a policy document does not represent us. Other organisations cannot substitute for our voices.
PATHI and Trans Healthcare Action have made clear that they remain committed to building better healthcare. We stand with that commitment, and with their decision that participation cannot come at the expense of their principles. Our bodies are not institutional property.
Any model of care that cannot begin there has no business calling itself reform.
Further Reading:
- Ireland May Finally Recognise Non-Binary and Intersex People
- Ten Years On – Ireland’s Gender Recognition Act Still Leaves Us Behind
- We Have Never Been Silent: Speaking on Intersex Healthcare and Human Rights at RCSI
- When Ireland Spoke to the World: Meeting U.S. LGBTQI+ Envoy Jessica Stern
- We Were Never Meant to Be Invisible: Reflections from Bread and Roses 2026
- Why Should Non-Binary Cyclists Have to Lie to Participate?
- Anti-Fascism Must Include Bodily Autonomy
- Open letter from Arcane Cycling Team regarding gender options on the Cycling Ireland membership portal
- Rights Without Routes
- Athens, Boobs, and the Future of Intersex Rights
- Ireland Under Scrutiny: ECRI and the Fight for Trans & Intersex Rights
- Ireland’s First Intersex Cycling Champion
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