The current state of trans healthcare in Ireland
Dr Aidan Kelly
When people feel compelled to covertly record their own medical appointments out of desperation, something has gone profoundly wrong with the healthcare system - yet this is where the trans community in Ireland currently finds itself.
Just before everything shut down for Christmas the media spotlight was firmly trained on trans healthcare in Ireland.
We saw a Labour motion to mark the tenth anniversary of Gender Recognition receive broadly positive input from cross-bench speakers - as clear an indication as we are likely to get that the toxic polarisation so evident in UK politics has so far, thankfully, failed to take hold in Ireland.
Sadly, however, politics (small p) is still playing a major role when it comes to trans healthcare in other ways. The figures at the head of the failing National Gender Service (NGS) have rolled out their usual playbook, uncritically platformed by the same journalists who facilitate their attempts to apply pressure on the government to give them what they want.
Two years ago, I wrote in GCN about how Prime Time journalists were being used in exactly this way - and here we are again, watching the same pattern repeat.
Blaming patients for systemic failures
These clinicians seem impervious to years of protests and first hand accounts from community members about the trauma they have experienced at their hands.
They appear more focused on positioning the trans community as the aggressors, without any capacity to reflect on why people may feel so desperate and persecuted that they see the only way to instigate change is to organise mass protests and publish covert recordings of alleged abusive practices (see the social media accounts of Transgress.ie for more context). These are not the actions of individuals who feel heard and understood by those tasked with caring for them.
Instead, the NGS leadership - ably supported by the aforementioned complicit media - seems committed to positioning the trans community at best as ideological activists who can't be trusted, and at worst as individuals who pose a genuine threat. In reality it appears to me as though it is they who are ideologically rigid and wed to an outdated version of appropriate assessment practices and a narrative that seeks to position trans people as mentally ill.
Whatever model of care the HSE adopts from the current Gender Programme that is underway, the trans community deserve healthcare providers who see them as partners in their own care, not as problems to be managed or threats to be contained. Real accountability must include meaningful consultation with service users and a commitment to evidence-based, affirming care.
