Senator Sarah O’Reilly has hit out a “push” from the Chair of the Oireachtas Health Committee, Pádraig Rice of the Social Democrats, to expand Hormone Replacement Therapy (HRT) to those who identify as transgender.
Speaking on Tuesday in the Seanad, the Aontú Senator described it as a “concerning development,” and one which “totally ignores the difficulties and struggles of biological women who are going through the menopause.” Mr Rice made the remarks earlier this month.
The HSE scheme is offered to women experiencing symptoms of menopause and perimenopause, with a GP deciding whether HRT should be recommended, with the treatment including tablets, skin patches and gels.
Since 1 June 2025, women who qualify can get free HRT from a pharmacy participating in the free HRT scheme if you have a prescription from a GP, registered nurse or midwife and you are registered for the Drugs Payment Scheme, or have a medical card.
In March, Social Democrats TD Paul Murphy asked the Minister for Health whether the free HRT scheme would apply to trans women; and the criteria that will be used to make the assessment. In early October, his colleague in the Social Democrats and chair of the Health Committee Deputy Rice told a Dáil debate on community pharmacy that it was “completely unacceptable that trans women are being excluded from the scheme.”
“There can be no excuse or justification for this decision,” Mr Rice told the Minister for Health, Jennifer Carroll MacNeill.
“I and others have been raising this with the Minister for a couple of weeks now and I am disappointed with the response. Instead of accepting that the exclusion of trans women is wrong and changing course, the Minister has dug in, further disadvantaging one of the most marginalised groups in society. It really is simple.
“Trans women should be included in the scheme. To employ one interpretation of the scheme for trans women and another for cis women is wrong. It is particularly galling this week when we had representatives of the transcommunity in the Oireachtas to celebrate the tenth anniversary of Gender Recognition Act. Free HRT should mean free HRT and I urge the Minister to do the right thing and reverse that decision.”
‘CONSTANT PUSHING OF IDEOLOGY’
Senator O’Reilly criticised the remarks, saying it is “deeply misleading to suggest that excluding trans women is discrimination.”
“The medical purpose for this scheme is to support menopausal women,” she said. “Our healthcare resources should be directed where there is a need, not where ideology demands them. There is a question of when and where will this constant pushing of ideology end? What’s next? Are we going to fight for biological men to have access to a free smear test?” she asked the Seanad.
The senator said that the “whole purpose” of the free scheme was the recognition of the difficulties women face as they go through menopause, referring also to the 740 women who are currently on waiting lists for endometriosis surgery.
“We have women across the country on waiting lists, desperate to see a gynaecologist,” she added.
Referring to further difficulties related to women’s health, she added: “ Worryingly, there is a 12% negative difference in the five years survival chances for women diagnosed with breast cancer in public hospitals versus those diagnosed in private hospitals.
“This is life threatening to people around the country, and it is disappointing that the focus by other parties is not on these issues.”
“They’d prefer to campaign to abolish the Dáil prayer or for HRT to be prioritised for trans women, or for non-binary legislation. This push goes hand in hand with the replacement of breastfeeding with chest feeding, and mothers with pregnant people,” the Cavan senator added.
“We are told again and again that this is inclusion, but in truth, it’s a total erasure of women, who we are and what we are as women. This is not about excluding anyone from compassion and care.
“It is about ensuring that our policies protect the most vulnerable, and that decisions are guided by facts, not by pressure from activist organisations. Women deserve dignity, respect, and healthcare that acknowledges who we are, not language and legislation that seeks to erase us.”