Transgender Healthcare“We are sending trans people abroad for highly invasive and major surgeries, with little after care when we get home.”

As heard on Today with Sean O'Rourke

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Noah Halpin is the founder of This is Me Ireland, an organisation working to improve access and standards in healthcare provided to transgender and non-binary people in Ireland. He told Seán O’Rourke on Wednesday that he decided to start the campaign after he was put on a three and a half year waiting list to access hormone replacement therapy.

“I saw an opportunity for the trans community to come together and say this isn’t good enough and this needs to change.”

Noah began trying to access hormone replacement therapy (HRT) five and a half years ago and only got it last October. He thought he could be referred by his GP to an endocrinologist, but the GP told him he’d need a psychiatric evaluation first. The wait to see a psychiatrist was made longer by the fact that only certain specialists could make the evaluation. Noah thinks it’s not necessary in the first place:

“I do not think there should be a psychiatric diagnosis required. The trans community repeatedly say that we are not mentally ill. The World Health Organisation says that we are not mentally ill. The World Health Organisation de-classified trans identities as mental health or behavioural disorders last year, however in Ireland we are still treating them as such.”

Noah thinks mental health support should be available to people during transition. He says that this kind of psychological support is very different from a requirement to get a psychiatric diagnosis of gender dysphoria in order to access hormone treatment, as is the case in Ireland.

“That is a diagnostic assessment as opposed to a psycho-social evaluation.”

Noah Halpin also raised the issue of difficulties experienced by trans people in accessing surgery in Ireland. He says not all trans people want surgery, but for those who do opt for procedures like ‘top surgery’ (the removal of both breasts and all breast tissue) the prospects don’t look good. He says the only surgeon in Ireland currently providing this treatment to trans people has just announced her retirement.

“This now means that we have nobody performing what we would call top surgery in Ireland. We also don’t have any gender affirmation surgeries in Ireland and we never have. This means that we are sending trans people abroad for highly invasive and major surgeries, with little after care when we get home.”

The discussion then moved on to younger people in the trans community. Noah took the opportunity to dispel some myths prevalent among people who he says are not very aware of the treatments for trans young people:

 “A lot of people believe that children are being put on hormones before the age of 18.  A lot of people believe that children are being given irreversible treatments before the age of 18, however that’s not the case.”

Noah explained that the only treatment given to children are hormone blockers which can temporarily pause adolescence until the age of 18 at which time the person can make an informed decision how they want to proceed with their health care. The effect of these blockers, Noah says are “completely reversible”.

To hear Seán’s full interview with Noah, as well as the contribution of endocrinologist Donal O’Shea, click here.

© The Listener 2019

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