Gender is a complicated topic – or is it just complicated because we aren’t being educated on it? Only in the last 10-20 years have LGBT+ issues truly been given the worldwide exposure they deserve, and amongst these issues includes the topic of our gender identities. It’s a fairly simple concept: at birth, we are either female or male, but sometimes people grow up not feeling comfortable with that assigned gender. This can be an incredibly anxiety-inducing and intimidating realisation for people, especially in Ireland, where the transgender populace are still highly neglected and shunned by society.
People can discover that they are transgender in a variety of ways. For some, they tend to identify more with female characters in media and television, and this can be the first sign. They may be inherently more interested in ‘traditionally-female’ things, like dolls and dressing up in female clothing. This was the case for Alissa*, 20, a trans female who has been on estrogen hormone treatment for 8 months. “When I was 3, I used to want to steal my mother’s clothes like bright scarves and wrap them around myself and play ‘dress up’. I always stole my sister’s dolls away from her and her nail polishes,” she describes. Adam*, 21, who identifies as genderfluid, recalls vivid feelings of discomfort with their gender in their youth. “I always felt like the odd one out, I could never mesh well with the other girls, I was very much the ‘tomboy’. As I got older, those pressures to conform kicked in and I tried to dress and act the way I was expected to but it always felt off,” they explain. “I liked my feminine side but I didn’t want to embrace it in the way others wanted me to.” While some argue that this behavior is just “kids being kids”, it needs to be understood that this can equally be a sign of a child identifying closer to a gender that is not their own.
This manifestation of extreme anxiety and emotional distress surrounding one’s assigned gender at birth is a psychiatric disorder called gender dysphoria. While it is typical for transgender individuals to experience this disorder, many also do not. The American Psychiatric Association summarise it as “the presence of clinically significant distress”, clarifying that it doesn’t imply being transgender is a mental illness – but rather, the extreme mental turmoil being transgender can sometimes bring can develop into a severe disorder, not unlike depression. Gender dysphoria can be debilitating and life-threatening, affecting the person’s relationships and day-to-day life. Thankfully, gender dysphoria is almost never permanent. Counseling – and eventually hormone treatment – can help ease the condition and allow the individual to better align with their true gender. However, this is where Ireland as a country fails to deliver.
It’s no secret to most people that certain rights have had a tumultuous history in Ireland. Being a country with such an intimate relationship with religion, Ireland has been slow to accommodate to minorities, and the LGBT+ community has faced the worst of it. In the early 90s, it was still illegal to be openly gay until its decriminalisation in 1993, and gay marriage was still not officially recognised until 2015. For transgender individuals, it has been an even more rocky road. In 2015, it was made legal to change one’s gender on their birth certificate, and while Ireland’s gender rights are some of the most accessible in the world, the good ends there. Only a handful of Irish GPs around the country will assess transgender patients, and those who do will then refer the individual onto St. Colmcille’s Hospital in Loughlinstown, Dublin. To date, this is the only hospital in Ireland that medically assists transgender individuals and supplies HRT, or Hormone Replacement Therapy. For anyone outside of Dublin, this means regular trips for their treatment and check-ups, making it a costly affair. This also means being on a waiting list that can last years before actually being provided treatment. “I was placed on a waiting list at 17, and I obtained my healthcare for transition at 20,” describes Alissa, “so the waiting list is beyond shocking. It’s upsetting we live in a century where knowledge and information is as easily accessible as its ever been, and yet only one hospital in all of Ireland knows how to help people like me.”
And while hormone treatment can be a physically-demanding ordeal for transgender individuals, it is the key to allowing many people to truly be happy with themselves, especially after suffering from gender dysphoria. Hormone Replacement Therapy has two variants: feminising or masculinising therapy, the former primarily relying on the female hormone estrogen, and the latter the male hormone testosterone. Due to the hormones involved, the changes one goes through while on HRT vary wildly. For male-to-female transitions, breasts will slowly (and somewhat painfully) begin to develop, skin begins to soften, body hair becomes less apparent, and head hair will grow at a faster rate. Some transitioning females slowly begin to feel mood swings more frequently as well. For transitioning males, their body becomes more muscular and their skin more coarse. Facial and body hair will grow at a faster and more abundant rate, and the voice will deepen, though sometimes the voice will not reach the same tone as a cisgender male would. Compared to transgender females, transgender males don’t report as many mood changes while undergoing treatment. It can take almost a year before any noticeable physical changes can occur, and years before the body will fully transition. The recipient must continue taking hormone treatment for the rest of their life, or else some of the changes could reverse or cause medical issues. In terms of reconstructive surgery to alter their body, many Irish transgender individuals must travel to the UK, as Ireland currently has no facilities to accommodate for this.
Alongside a lacking healthcare system and exorbitant costs, young transgender individuals can’t help but feel incredibly isolated in their formative and fragile teenage years, as Irish education is entirely devoid of any transgender discussion – but this issue unfortunately applies to all of LGBT+ culture. Sex education in secondary schools is still incredibly antiquated and lacking, so it’s no surprise that the discussion of gender identity and sexual orientation is treated as almost non-existent as well. It cannot be emphasised enough how damaging this is for young LGBT+ youth; especially transgender individuals, who will feel incredibly isolated and invalidated when their school is essentially denying their existence and identity. Rachel*, 20, who is a trans female, recalls the “hit and miss” support for transgender individuals in her secondary school. “Towards the end of 6th Year, the school did begin having a focus on acceptance of the LGBT+ community, but other than that there was no official support structure.” Instead, Rachel found the staff to be of mixed opinions on the topic. “My 5th Year Religion teacher advocated greatly for us, whereas my 6th Year teacher took less of a supportive stance. She never outright classified it as a sin, but you could easily get the feeling she was pushing some sort of agenda.” The lack of an unbiased and factual regime for LGBT+ or trans-identifying youth is notably outdated for our modern society.
This is clearly having serious repercussions on the Irish people. Decades-old stigmas about the transgender minority are still prevalent, and it seems no steps are being taken to change this. The problems don’t end there – Adam strongly believes that non-binary individuals are highly neglected as well, “Ireland has made great strides since the implementation and consequential review of the Gender Recognition Act in 2015. But a lot needs to be done in regards to the recognition of non-binary people, how we deal with young trans people and their legal recognition”. While young adults and teenagers have luckily grown up in the Computer Age with the ability to self-educate themselves on these matters, Ireland can no longer continue to pull the wool over their eyes and act like LGBT+ rights aren’t basic human rights. “I have experienced a lot of the stigma and social issues because of people’s perceptions on what it means to be transgender,” Alissa explains. “When I came out, I lost friends of all ages. Teachers started talking to me like I wasn’t a student, but something strange. I got glances and whispers from peers that escalated into some really awful bullying, and I have been kicked out of bathrooms in derogatory ways by faculty in shopping centres.” Rachel similarly experienced a total lack of acceptance from one of their close friends. “When I came out to one of my friends in secondary school, he simply repeated “you’re not trans. Just because you experience characteristics of one illness doesn’t mean you’re suffering from it.”” While he eventually came to terms with Rachel being transgender, this immediate hostility is a product of stigmas surrounding being transgender, and the long-lasting effects this oppression could have on one’s mental health is unacceptable.
It is human nature for us to be afraid of what we don’t understand, but Ireland faces a crisis where it is not remedying this fear in any shape or form, and continues to neglect an already-lacking area of LGBT+ culture. Thankfully, the rise of the This Is Me transgender rights campaign is quickly growing traction in Ireland with an incredibly successful protest in Dublin in July 2018, garnering hundreds to support the cause. This Is Me is looking to improve the psychiatric care for patients with gender dysphoria, decrease waiting times for hormone treatment, better mental health support and demands the government recruit more professionals in transgender healthcare. Hopefully, with the same perseverance and determination that the LGBT+ community showed in 2015 to achieve the rights for gay marriage, so too will they achieve better rights for transgender individuals – hopefully sooner rather than later.
* = Names have been changed for the sake of anonymity.