Thursday 20 September 2018

'It's another case of Ireland exporting healthcare' - Transgender community call out for better health system

Hundreds of people gathered outside Leinster House last week to call on the government to provide improved healthcare for the transgender community. Photo: Noah Halpin
Hundreds of people gathered outside Leinster House last week to call on the government to provide improved healthcare for the transgender community. Photo: Noah Halpin

Rachel Farrell

Members of the transgender and nonbinary community are calling on the government to "update" their current options for healthcare, as many people face a trip abroad or waiting lists for treatment.

This Is Me, a campaign group set up last December, took to the streets outside Leinster House on Saturday in hope of garnering attention in their call for "safe and adequate healthcare" for people in the community. Sinn Féin leader Mary Lou McDonald and Solidarity TD Ruth Coppinger were among some of the political figures in attendance.

The group was founded by 27-year-old Noah Halpin, who has been waiting for treatment for over two years.

"The majority of the developed western world would use WPATH (World Professional Association for Transgender Health). However, we in Ireland use an outdated psychiatric model of care- meaning some people have to be assessed by two different psychiatrists," Noah told Independent.ie.

"There are only two endocrinologists in Ireland that can provide hormone replacement therapy (HRT), but in order to see them you must have that psychiatric diagnosis first. The waiting list is up to two years long.

"In terms of gender reaffirmation surgery, we do not have any surgeons in Ireland that provide this." 

Noah says that many members of the community are left with no option but to travel abroad for treatment or surgery. For Noah himself, waiting over two years for the initial psychiatrist appointment has been "exhausting". 

"The process has been long and exhausting. I first went to a GP almost three years ago and told them that I was trans and needed to transition," he said.

"The GP hadn't a clue what to do with the information, so sent me home to do my own research and come back with the names and places I needed to be referred to. Once I was referred, I waited two years on a waiting list for the psychiatrist."

Last week, Noah finally met with his psychiatrist, but anticipates another long road ahead.

"From when I stepped in the door of his office, to when I stepped out, the appointment had taken three whole hours. Three hours of relentless questioning. Invasive and intrusive questions which bore no relevance to gender.

"It was exhausting. I was informed on what I already knew, I was trans and I would be referred onto the endocrinologist for HRT. But they refused to give me a date."

According to Noah, it's the long waiting time that causes "anxiety" in people in similar situations.

"I don't know if it will be months or years, and it's the wait that causes so much anxiety in so many people. There is only one surgeon that will perform top surgery on trans men in Ireland, however, her waiting list is years and years long, so I am forced to travel abroad. 

"When I manage to raise enough, I'm hoping to go to a surgeon in Poland, where many Irish trans masculine people go. Their techniques are superior to ours, their experience is higher and their prices although still high, aren't extortionate like in Ireland. 

"It's another case of Ireland exporting healthcare."

The group says that Minister for Health Simon Harris agreed to meet with the campaign but up until this month, they had yet to receive a response. However, they believe Mr Harris has taken notice of the protest that recently took place.

"We don’t expect to hear a response immediately. To get such a positive response is overwhelming, a lot of people have thanked us for creating an event where they can meet these wonderful people and feel accepted," said Noah.

"We were informed by two people whom attended a meeting with him about LGBT healthcare, that he recognised Saturday's protest and agreed that trans healthcare needs to be looked at." 

It is understood that the Department of Health and HSE are expected to recruit new staff to work on transgender healthcare this year to address the current waiting times.

"A proposed model of care for transgender children, adolescents and adults was developed last year by the HSE Quality Improvement Division, and submitted to the HSE Divisions of Primary Care, Mental Health and Acute Hospital programme. The model was developed in consultation with key treating clinicians, planners, policy makers, advocates and service users," a spokesperson for the Department of Health told Independent.ie.

"This model is providing the framework for the development of National Gender Clinics and MDTs for children and adults, funded by the HSE, which will involve investment in new posts in 2018.  

"This is a concerted measure by the HSE to address the waiting times and immediate service needs of children, adolescents and adults in transition. It is envisaged that these National Teams will be in place in 2018, pending successful recruitment campaigns."

"The HSE, across a number of programmes including mental health, acute hospitals, primary care and social inclusion, is committed to building services for this community in accordance with international best practice." 

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