After the free Hormone Replacement Therapy (HRT) scheme was introduced in Ireland earlier this year, trans women are facing confusion on whether they are eligible, a recent article by The Journal highlights.

HRT is a treatment used to balance and replace hormones that the body does not produce. It is also used to relieve symptoms of perimenopause and menopause. The same medications can also be prescribed to trans people as gender-affirming healthcare. For people who have undergone an orchiectomy, such medication would be the only source of hormones, making it crucial to the body’s ability to function normally.

Under the scheme introduced by the Irish government in June, the costs of HRT medications that had been prescribed to women experiencing symptoms of menopause will be met by the State. While the HRT scheme doesn’t explicitly exclude trans women, there is a lack of clarity on the issue, with individuals facing different situations.

In March this year, Minister for Health Jennifer Carroll MacNeill was asked to clarify the issue by People Before Profit TD Paul Murphy; however, no clear answer was provided. Instead, the Minister stated that the scheme covers HRT products “which have been prescribed for the purposes of alleviating the symptoms of menopause”.

Trans individuals who stop taking HRT can experience the same menopausal symptoms as other women, and many of them have prescriptions for the same medicines as those included in the free HRT scheme.

The Journal correspondent Conor O’Carroll spoke to several trans women who have tried to access the HRT scheme, with different results and inconsistencies in the pharmacies’ approach. A trans woman who has had an orchiectomy shared that when she tried to access free HRT under the scheme in June and July through a pharmacy in Dublin, she was refused. However, another trans woman said that she was able to access her prescription for free in the very same pharmacy.

Similarly, a trans woman from Cork told The Journal that she had been forced to pay for her medications, even though this HRT was “medically necessary” in her case. When she enquired if she’d be covered under the scheme, the pharmacy did not seem to have a clear answer.

The woman shared how having to ask to even be considered under the scheme is “utterly exhausting”.

“We are used to fighting for everything”, she said. “This is what we’re used to, and it’s disappointing.”

In a statement to The Journal, the Professional Association for Trans Health Ireland said, “Unclear guidance from the Department of Health is creating unnecessary confusion and placing barriers in the way of equitable care.”

They continued saying that, while pharmacists are “ready and willing” to provide free HRT to trans women under the scheme, “they need confirmation from the Department of Health that trans people are included in the scheme.”

Calling on the Department to address the confusion, they added: “Trans people should be included without ambiguity”.

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