A key element of developing any Model of Care, is evaluation of the clinical and scientific research on the healthcare topic. This is termed a review of the Evidence Base.

As part of the development of the HSE Model of Care for Gender Healthcare, we have begun our review of the evidence base with two initial questions (additional clinical questions may arise as the Working Groups begin to develop the Model of Care):

1. What are the clinical outcomes of medical transition?
2. What clinical needs are known to exist in the population that are attending, or may attend, gender healthcare services?

To answer these questions, we have developed two systematic review protocols.

Using systematic reviews allows the methodology to be publically available during the research review process, maximising transparency and reproducibility of the evidence base review process,

Work on answering both of the above questions is ongoing, with support from the HSE Library Service. Progress on answering both questions is as follows:

What are the clinical outcomes of medical transition?

1. The initial search is complete and now we are screening the results for inclusion or exclusion, as per the pre-defined study protocol.
2. Details on the protocol for this systematic review, including inclusion and exclusion criteria, are available on PROSPERO (www.crd.york.ac.uk/prospero) under registration number CRD42024596567
3. Once screening is complete, the provisional results of this systematic review will be made available for public review.
4. At that point, if any member of the public feels that an important academic paper, that has been published in a peer reviewed journal, has been omitted, there will be an opportunity to submit it for consideration.
5. Any papers submitted by the public will be reviewed in line with the inclusion and exclusion criteria in the PROSPERO registered protocol: (please see www.crd.york.ac.uk/prospero under registration number CRD42024596567)

What clinical needs are known to exist in the population that are attending, or may attend, gender healthcare services?

1. The initial search and screening processes were completed in July 2025.
2. In August 2025, we made the initial results available for public consultation, and a number of additional papers were submitted by the public.
3. These additional papers have now being reviewed for inclusion or exclusion in line with the pre-defined study protocol.
4. Details on the protocol for this systematic review are available on PROSPERO (www.crd.york.ac.uk/prospero) under registration number CRD42024596562.
5. Data extraction is now underway, and the required clinical information is being collated.
6. Once the data extraction is complete, then we will analyse the results.
7. The results of this analysis will be made publically available, and will be used to inform the development of the new HSE Model of Care for Gender Healthcare.

As this work progresses, we will be updating this page with our findings.