Health Minister publishes Cass Assessment report for Gender Identity Services
Date published:
The Health Minister has published a report which assessed Northern Ireland’s Gender Identity Service’s compliance against the 2024 Cass Review.
Minister Nesbitt commissioned Dr Hilary Cass in September 2025 to assess whether changes to services for children and young people with gender incongruence and gender dysphoria in Northern Ireland are compliant with her recommendations in the review of services in England.
The report Cass Assessment report for Gender Identity Services | Department of Health concluded that the Department’s position now presents a crucial opportunity to develop a Regional Lifespan Gender Service, and to build the foundations for a collaborative relationship with the English under-18’s services.
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.”
Dr Cass’ assessment of services in Northern Ireland commends the integration of Child and Adolescent Mental Health Service, clinical and social services within its current model of care.
Dr Hilary Cass said:
"I commend Minister Nesbitt for the investment he has committed to the Lifespan Service, and in particular, for the benefits it will bring for children and young people with gender incongruence and gender dysphoria.
“These young people often have very complex needs and require holistic services that do not just focus on their gender, but on their broader well-being. The changes will support joint working and learning with teams in England, with a focus on helping young people thrive and achieve the best possible outcomes in adult life."
Dr Cass and her team have made key recommendations, focusing on workforce development, supporting NI joining the UK National Provider Network and participating in the PATHWAYS research programme, with commitments already underway.
Department officials will now consider the recommendations and work alongside counterparts in England, and Health and Social Care (HSC) service providers in Northern Ireland to implement them.
Minister Nesbitt thanked Dr Cass and her team:
“I want to acknowledge and thank Dr Cass and her team, for taking the time to conduct this assessment during their visit to Northern Ireland in November.
“I hope this report gives assurances that the new Lifespan Gender Service is compliant with Dr Cass’ 2024 review, and that the decision to invest in new and additional psychological and psychiatric support is the right approach.”
Notes to editors:
- The Cass report can be found here Cass Assessment report for Gender Identity Services | Department of Health
- The Lifespan Gender Service, a redesign of existing service provision, brings together the existing Children and Adolescent Mental Health Services (CAMHS) Knowing Our Identity Team and the Adult Gender Service into one model of care, under a single management structure.
- The Regional Lifespan Gender Service in Northern Ireland will provide age-appropriate support and treatment for individuals experiencing gender dysphoria or who are exploring their gender identity. It is important to note that referral to the service is not gender affirming. It is an administrative step that initiates access to comprehensive evaluation by specialist multi-disciplinary teams. A referral or assessment does not imply automatic access to affirming treatments or pre-empt clinical outcomes.
- The Independent Review of Gender Identity Services for Children and Young People, commonly referred to as the Cass Review, was commissioned by NHS England and NHS Improvement in 2020. It led to the publication of a final report in 2024.
- Baroness Cass is a retired Consultant Paediatrician and a former president of the Royal College of Paediatrics and Child Health.
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