The treatments cost the HSE a total of €31,580, including expenses incurred by patients travelling to the UK for surgery and associated therapies.
Transgender reassignment or ‘sex-change’ procedures are not performed in Irish hospitals, but can be arranged in another country and funded by the taxpayer under the Treatment Abroad Scheme.
Some 93 people have been approved for sex-change procedures under the scheme since 1999.
A total of 28 of these received treatment in the UK in 2016, but the number fell to just six last year. The treatment is a multi-stage process that involves hormone-replacement therapy, surgical reconstruction of genitalia, and other procedures to alter a patient’s physical appearance.
The six patients who underwent sex-change operations under the scheme last year visited Britain a total of 14 times for various stages of the treatment.
“Clinical decision making determines whether or not someone is put forward for this procedure under the Treatment Abroad Scheme (TAS),” a spokesperson for the HSE said.
“Therefore, each of the patients who availed of the treatment did so by way of clinical referral from their treating physician in Ireland, as per the guidelines.”
The scheme allows patients in EU member states to access treatments abroad, where those treatments are not available in their own country.
“The cost of treatment is borne by the health service in the referring member state.
“The TAS provides for the cost of approved treatments in another EU/EEA member state or Switzerland through the issue of form E112,” the spokesperson said.
“[It] allows for an Irish-based consultant to refer a patient that is normally resident in Ireland for treatment, unavailable in Ireland, in another EU/EEA state or Switzerland, where the treatment in question meets [certain] criteria.”
These criteria include that the treatment is considered medically necessary and will have the effect of meeting the patient’s needs.
It must also be a proven form of treatment, rather than an experimental therapy, and be provided in a recognised facility by a registered medical practitioner.
Figures previously obtained under the Freedom of Information Act show that the HSE paid for 22 patients to have sex-change surgery between 1999 and 2010.
A further 37 were funded to undergo the procedure between 2010 and 2015.