Opinion: Why compassion is key to solving Ireland's transgender healthcare crisis

Clinical psychologist and Director of Gender Plus, Dr Aidan Kelly, shares his views on improving trans healthcare in Ireland.

This article is about solving the transgender healthcare crisis in Ireland. The image shows a medical professional consulting with a patient. The back of the patient's head is shown in the left foreground of the photo, with an out of focus doctor facing her.
Image: Shutterstock: SeventyFour

Dr Aidan Kelly, Director of Gender Plus and a clinical psychologist specialising in the area of gender identity, shares why compassion is the key to solving Ireland’s transgender healthcare crisis.

There is a lot of misinformation and confusion when it comes to healthcare for transgender and gender-diverse individuals. 

Although Ireland has taken some socially progressive steps in LGBTQ+ rights, becoming the first country to approve same-sex marriage by public vote in 2015, the truth is that its transgender healthcare system is currently in crisis, being one of the worst in Europe. 

In fact, Ireland was ranked in last place on the European Union’s Trans Health Map 2022, which shows the overall status of trans-specific healthcare in each EU member state. 

While there are often strong views expressed in the media about what access to healthcare should look like for this patient cohort, many of those who work in the field internationally are aligned in their approach in terms of how best to treat and care for one of the most marginalised groups in our society. 

First and foremost, transgender and gender-diverse (TGD) people need care and compassion to be respected and to feel heard. There are sadly a higher number of psychological and social difficulties faced by these individuals, and these need to be supported, but this should not be at the expense of being able to access appropriate gender healthcare. 

Stakeholder engagement is key to understanding the needs of any patient group, and transgender healthcare is no different. People are complex, and when it comes to healthcare, the answers to the challenges they face are rarely black or white. 

We must involve TGD people at every stage of the process so that they are active participants in shaping the provision of their care; this is vital if we are to achieve better engagement and outcomes for all. 

Currently, in Ireland, there is an inaccessible adult gender service with waiting lists of up to three and a half years. For those under the age of 18, there is no Irish service at all. This lack of care provision has resulted in thousands of TGD people in Ireland accessing care online, many without being able to access essential medical oversight. 

This is a failure of our healthcare system and, if we are honest, a poor reflection on our society more broadly. 

Instead of arguing over who uses what bathroom, we need to remind ourselves that trans and non-binary people are our family members, friends and neighbours. They deserve to have a voice in the healthcare that will directly impact them. 

While it is easy to be drawn in by the divisive narratives published and promoted by certain sections of society whose motives are unclear, this does little more than cause further harm to this marginalised group. 

Although medical interventions can be an important part of a trans or non-binary person’s journey, the social factors of acceptance, inclusion, and feeling listened to can be just as important in helping people find comfort and acceptance of the parts of themselves which cause the most distress. 

Dr Aidan Kelly is a clinical psychologist specialising in the area of gender identity. He is also the director of Gender Plus, a service which provides holistic healthcare for gender-diverse people.

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