Professor Donal O’Shea is a consultant endocrinologist at St Vincent’s and St Columcille’s Hospitals in Dublin, and, as such, has seen an explosion in the number of people, young people in particular, who are presenting with gender dysphoria.

As an expert in hormone therapy, O’Shea has been privy to some of the most heart-wrenching cases of post-operation regret among transgender patients, with some dying by suicide and others undergoing difficult reversal surgery, hormonal treatment and prolonged counselling.

He has incurred the ire of transgender activists for expressing concern about the speed with which children are often being prescribed puberty-blocking drugs in Ireland, claiming, with the backing of other consultants, that underlying mental health issues are sometimes not being addressed beforehand.

He was one of a group of senior medical professionals who recently called for the suspension of puberty-blocking services for children with alleged gender dysphoria at Crumlin Children’s Hospital. O’Shea and consultant psychiatrists Paul Moran and Ian Schneider said practices there were “unsafe”.

It appears their warnings fell on deaf ears in the HSE. Their advice that the service should be “terminated with immediate effect” was not even recorded in the minutes of the meeting with hospital management, despite the consultants’ concern at their experience of having children referred to them from Crumlin whose mental health issues, they say, had not been properly identified and addressed.

The HSE however claims most clinicians are happy with the Crumlin service, which is provided by two staff from the Tavistock and Portman NHS Foundation Trust in London.

The Tavistock Trust itself has suffered a number of resignations by psychologists who allege an “over-diagnosis” of gender dysphoria, and the Trust is also being sued by a parent of a former patient with the support of a nurse who worked at the clinic. They clam the clinic is carrying out “experimental” treatments, and that hormone-blockers are being administered to children who cannot properly consent.

Dr O’Shea last October was strongly critical of a HSE panel on gender identity, saying it was “as close to a farce as you can get”, because the panel did not include clinicians with experience of treating transgender patients. His comments were met with anger by many transgender activists, among them a Social Democrat councillor who called the comments “unscientific nonsense” for spurning the “self-decide” model of transgender services.

“He is the barrier for trans people seeking the healthcare they need to improve their lives,” Councillor Owen Hanley claimed. “[Prof. O’Shea is] ignoring international best practice, clearly acting as a gatekeeper against people’s best wishes, mistrusting and misunderstanding trans people. Prof. O’Shea should not be in charge of whether or not people can access trans healthcare,” he said.

The Ministerial nominee to the HSE panel, who had regularly criticised O’Shea’s work, also promotes the “self-decide” model among clinicians according to Prof. O’Shea, something he said might work out for 50% of patients, but the other 50% “are highly vulnerable” because of mental health issues that need to first be addressed, he says, despite their preference for hormone treatment or sex-change surgery.

The doctor insists his profession is trying to create the right supports before and after surgery so as to diminish harm to the patient, but adds “we cannot mitigate against all harm unfortunately.” It seems astonishing to me that the HSE, even under Simon Harris, would establish a panel without any experienced clinicians on this important and sensitive issue.

With 291 children using the Crumlin service since 2015, and many more adults attending the Loughlinstown facility for transgender patients, the issue of transgenderism appears to be snowballing for clinicians, schools, and many parents.

In the rush to treat gender dysphoria however, the widespread acceptance in principle of sex-change surgery and puberty blockers, even among cautious doctors like O’Shea, as a solution to this problem is still disquieting for not a few people.

The traditional view that gender dysphoria often presents in conjunction with mental health issues requiring psychological and, sometimes, psychiatric help appears a much more rational approach than allowing vulnerable people to undergo invasive, life-changing procedures and have their natural processes interrupted with chemicals in their search for happiness.

One also must wonder whether the power of suggestion has had a contributory effect in the rapidly increasing cases of gender dysphoria, given the issue was almost unheard of thirty years ago.

The cultural power of the LGBT movement has certainly seeped into most institutions, whether it be educational, media or political, and their insistence that a dichotomy now exists between one’s sex and gender has become mainstream, despite the very flawed reasoning of this worldview.

After all, how could a boy with XY chromosomes be sure they’re a girl if they could never possibly have felt what it is to be a girl? And how could anything other than a mental health issue explain “gender fluidity”, where one’s gender supposedly changes regularly?

But it seems that the current clinical approach of ultimately trusting the instincts and feelings of transgender patients has won out for now over the traditional regard we used to have for first conforming our minds to material reality.

The clinical reliance on hormones and surgery ultimately indicates at least one of three things:

(a) most clinicians have succumbed to transgender theory and believe some boys/men could be girls/women and vice versa

(b) whilst not necessarily believing (a), they nonetheless believe some patients will be happier after a sex-change or hormones

(c) they lack confidence in the potential for successful psychological or psychiatric solutions to most cases of gender dysphoria

In all this, one of the greatest victims has been the truth of our existence, rejected as burdensome, often in favour of escapism from our hurts and insecurities. The irony is that healing can only really begin when the truth is unearthed, warts and all.

Many transgender patients may regret the course they have taken, as Professor O’Shea readily admits, but will the history books look back kindly on this experiment?

I’m not so sure.