Ireland lags far behind in Transgender healthcare

By Jane Byrne

Image: Creative Commons license

As November 20 marked Transgender Day of Remembrance, we take a look at the services or lack thereof available to transgender people in Ireland.  

Saturday, November 20, marked Transgender Day of Remembrance 2021. The day, which was first recognised in 1999 by transgender women Gwendolyn Ann Smith aims to bring awareness to transphobia and mourns people who have died as a result of transphobic violence.

According to a worldwide research project started by Transgender Europe, there were 375 registered murders of trans and gender diverse people between October 1 2020 and September 30b 2021. These figures represent a 7% increase from 2020. 

With violence on the rise, it begs the question – what is it like to be transgender in Ireland today? 

Currently under the HSE, there is one National Gender Service (NGS) clinic located in St. Columcille’s Hospital, Loughlinstown, County Dublin. This service provides specialist support to people seeking medical and surgical interventions to help affirm their gender. 

According to the National Gender Service website, the current wait times in their clinic is 2.5 years. However, according to magazine Gay Community News (GCN) a freedom of information (FOI) request facilitated by Transgender Equality Network Ireland, (TENI) showed the waiting list for the NGS has increased this year by 126 patients to 790 people by August. This increase coupled with limited resources and staff means people could be waiting up to five years to be given an initial appointment. 

This comes after the HSE revealed in 2019 that 109 people waiting on trangender healthcare were placed on wrong waiting lists. The patients had been on the wrong waiting lists for up to three years without any communication from the NGS. To the patients left waiting and to the transgender community this was a hard blow to their efforts. 

The Transgender Equality Network of Ireland (TENI) are Ireland’s premier dedicated trans rights organisation run by and for the trans community. 

They expressed their disappointment at the HSE, saying: “Trans people experience a higher incidence of negative mental health outcomes than the general population. Poor mental health in our community is often exacerbated by the lack of appropriate gender-affirming health services.”

TENI has consistently fought for shorter waiting lists and better healthcare for transgender people. 

Speaking to Lilith Ferreyra-Carroll TENI’s National Community Development Officer, she discusses the main issues affecting transgender people in Ireland today: “Healthcare is a massive struggle for the trans community….trans people are amongst the most marginalised community in Ireland and therefore have higher instances of poverty, homelessness, unemployment, discrimination and mental health issues compared to the general population.”

One person who has dealt with transgender healthcare in Ireland is Jack.* (he/them).

Jack talks about the moment he knew he didn’t identify with his cisgender.* 

I was in 4th year of secondary school. I felt wrong in my body and didn’t know why for a long time. I started watching Youtube videos of people who had transitioned and I knew then it was what I wanted – watching other people made me feel good, it was a comfort thing.” 

Jack, like many other transgender people in Ireland, felt let down by the healthsystem. 

“I went to the NGS clinic in Loughlinstown hospital after waiting months and months. I met with a therapist and discussed my options re name changing, testosterone and documentation. I wanted top surgery* first before going on testeronterne but under the HSE programme you have to go on hormones first..”

For many transgender people who have waited their whole life to feel like themselves, going on hormones for years isn’t an option. Currently in Ireland there is no public surgery options for transgender patients, meaning a lot of people have to travel to different countries for the procedure. Although private surgery is available in Ireland, it is triple the price of surgery abroad.

This ordeal is all too familiar for Jack. In 2019, Jack booked a flight alone to Poland for top surgery. At that point, he just wanted top surgery and not testosterone and this was not an option in Ireland.

“The fact I had to book a flight and procedure by myself to a transphobic country to get surgery that I can’t get at home is a disgrace. Due to social stigma I was too afraid to tell anyone I was doing it. In the end I didn’t go through with it because I didn’t really trust the clinic and I was worried about aftercare – I had heard horror stories. The thoughts of sitting in a foreign country alone after such a huge surgery frightened me,” he said.

At the moment Jack does not have much faith in the HSE to get him where he wants to be in his journey. 

TENI is one of a few organisations in Ireland that support the transgender community by providing guidance, education and help  Their website, offers a variety of information for those identifying as transgender, support for families and an array of workshops.

They also have a Transgender Family Support Line which is run by non-judgemental volunteers who themselves are transgender or have a gender non-confirming family member, and is open to provide support and information. You can  call them on 01 907 3707 available every Tuesday (10am-12pm) and Sunday’s (6pm-9pm). 

*Names have been changed to protect identities. 

*Cisgender: denoting or relating to a person whose sense of personal identity and gender corresponds with their birth sex. 

*Top surgery: is a reconstructive surgery performed on the chest for those who wish to alter their chest size, shape, and overall appearance. This surgery is typically performed by a plastic surgeon that has specific training in transgender or gender-affirming surgeries.

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