The Health Service Executive has paid for at least 49 patients to undergo sex-change operations abroad at a cost to the taxpayer of about €1.5 million.

The procedure is not performed in Irish hospitals but it can be arranged in another country and funded by the HSE under the treatment abroad scheme. Gender reassignment or “sex-change” surgery is a treatment for gender identity disorder and involves the reconstruction of genitalia to resemble that of the opposite sex.

According to the HSE, the average cost of an assessment and the associated surgery is about €30,200; although the cost of female-to-male operations is considerably higher than male-to-female procedures.

The cost to the HSE of funding 49 patients would amount to almost €1.5 million, excluding travel and post-operative therapy costs.

Figures obtained under the Freedom of Information Act reveal the HSE paid for 22 public patients to have the surgery between 1999 and 2010