Business & Politics

Is the Failure of Trans-Healthcare in Ireland a Consequence of our Genuflection-Obsessed Past?

trans pride flag

20th July 2020


In a 2016 census, 78.3% of the Irish population identified as Roman Catholic, a significant decline from the 2011 statistic of 84.2% in 2011. Numerically, this accounts for nearly 3.7 million people in our Republic, a domineering demographic. We have seen the social and political remnants of our historic love of the body of Christ, from Magdalene laundries to the fights for  equal marriage and abortion rights. When Sinead O’Connor said “fight the real enemy” in 1992, Ireland gagged and has gradually done so. Sadly in 2020, we’re still dealing with the repressive social constraints of our past, continuing to affect some of our most vulnerable.

In the ILGA-Europe annual review, statistics on a variety of LGBTQ+ issues ranked Ireland; 14th for the threat of hate crime and hate speech, 5th for accessibility to legal gender recognition and bodily autonomy and 21st for social attitudes toward equality and non-discrimination. This annual review gathers a plethora of factors including legislative recognition and social attitudes in order to rank states accordingly. The group warns that while progress for LGBTQ+ people in Europe “paints an image of the region as a leading light” for human rights and equality, these developments are “a surface impression that does not tell a complete or accurate story”. One such story which is not being told accurately is that of transgender healthcare.

Transgender healthcare in Ireland is failing those who need it. One way of explaining why is our obsession with anything Catholic, from Communions to Lourdes, we can’t get enough of it. In this article, I’m going to explain why this obsession is hindering access to healthcare for some of our most marginalized groups.

What are the issues exactly? 

Stigma, discrimination and isolation are some words commonly thrown around when we discuss trans healthcare in Ireland. To understand why we first need to look at the system itself. Firstly, the Irish healthcare system is unusual within the European context, since it is not designed with the objective of offering universal, equitable access to either primary or acute hospital care, meaning, our healthcare system is unfortunately founded with certain institutionalised bias. Secondly, the system is predominantly tax-financed, 69% to be exact, this means that resource allocation is controlled by the governing parties and their objectives, so it’s run by the Irish elite. Thirdly, throughout the period 1911 to 2011 a fundamentally libertarian perception of healthcare was common, healthcare was viewed as a marketable commodity rather than a personal right. And, finally, Irish healthcare was facilitated by everyone’s favourite morality brigade, the Catholic church.

Ok, I hear you ask, what does this have to do with trans healthcare? Well to summarize the above; our healthcare system is classist, biased, institutionally capitalist and deeply religious, all of which do not mix well with LGBTQ+ issues.

What this results in is the following; currently, there are only two endocrinologists in Ireland who will prescribe hormone replacement therapy (HRT), despite every doctor and GP being qualified to do. 28-33 months is the average wait time to access HRT, an unnecessary obstacle considering per capita Ireland is one of the richest countries in Europe so it is clear we can do better. Countless studies have shown such waiting times increasingly exacerbate individual suffering, in addition to creating tensions between doctors and patients that can lead to an erosion of trust in the healthcare system among the transgender community. Psychologically speaking, the lack of support available during such a tumultuous time may cause individuals to travel abroad or seek solutions in the black market. These decisions, devised out of desperation, can cause both physical and emotional damage to the individual.


“Stigma, discrimination and isolation are some words commonly thrown around when we discuss trans healthcare in Ireland.”

Okay, I get that, but why are you blaming Catholicism? 

Well, trace anything back and you will find roots in ideology. In this case, health bias is the result of years of social stigma, instilled from our old friend the Catholic church. Remember when I said our island has nearly 3.7 million Catholics? Well, its important to understand how this faith views transgender individuals in order to understand the knock-on effects on transgender healthcare. In 2019 the Congregation for Catholic Education released  “Male and Female, He Created Them”, outlined as a ‘path’ of dialogue on the question of gender theory in education from a cathloic based ethos.

The paper was the first extensive statement on transgender identity by the Vatican and was in direct response to the contemporary shift toward a more gender expressive society. Opening with a quote by Pope Benedict XVI and addressing members of the Diplomatic Corps, Benedict depicts a modern educational crisis. The increased openness to sexuality and gender curricula around the globe has “allegedly conveyed a neutral conception of the person and life, yet in fact reflects an anthropology opposed to faith and right reason” according to the publication. For 31 pages it continues to outline the church’s stance on sexuality and gender, which I don’t think will make a best-seller anytime soon.

The publication, written by religious elites  who for decades have benefitted and capitalised from a status quo society, states that a transgender identity seeks to “annihilate the concept of nature”. I can’t possibly comprehend the logic behind such a statement, but given 31 pages of covert gendered discrimination and institutionalised bigotry, I’m unfortunately not surprised.

Given that those who founded our healthcare system did so on a moral obligation which involved discrimination of anyone who wasn’t white and male, it is no surprise that marginalised groups are still suffering in our contemporary healthcare system. Looking to the future, we need to drop the shackles of our past, and progress with a secularised system of health, and remember that healthcare shouldn’t be a privilege. Transphobia is institutionalised within Irish health and society. If we have the tools to recognise it, we have the tools to change it.






Featured photo Sharon McCutcheon



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