FROM BAD TO WORSE

The past year has seen sharpening conflict and contradictions over trans healthcare in Ireland, with the government dropping any commitment to improve the healthcare situation, alongside growing protest and mobilisation over the issue. Fiadh Tubridy shares an urgent call to arms.

A year ago, the situation was already dire. Trans people in Ireland were faced with interminable waiting lists to access the National Gender Service (NGS). Grotesque, outdated forms of psychiatric evaluation were being used to determine people’s worthiness to be granted basic healthcare. No service whatsoever for anyone under 18. All this had led to the Irish trans healthcare system being ranked the worst in Europe, according to Transgender Europe – a network of over 200 trans rights organisations.

At the same time, there was at least a nominal commitment to reform trans healthcare in Ireland, with the programme for government including a promise to move towards an informed consent system informed by international best practice.

However, over the past year the situation has very rapidly gone from bad to worse, with the government ditching any pretence of caring about the provision of basic healthcare to trans people. Some of the key developments include the appointment of Karl Neff as the HSE’s new Clinical Lead for Transgender Services in Ireland. Neff is currently a senior figure in the NGS. His appointment in a key position of power, in the face of protests from trans community groups, highly suggests that the NGS’ model will almost certainly be maintained as part of any revised healthcare system.

This was followed by the news that any changes to the trans healthcare system would no longer follow international best practice guidelines as set out by the World Professional Association for Transgender Health (WPATH). Soon after came the announcement of clinical trials for puberty blockers. This is despite the fact that blockers have been used without issues for decades, and the removal callously condemns a generation of young people to growing up without any form of healthcare.

More recently, the government has indicated that it will consider, and likely take on board, the recommendations of the Cass Reviewthe discredited report on trans healthcare in the UK commissioned by the Tories.

Lastly, we have seen the effective collapse of Gender GP, a private trans healthcare service that was relied upon by many people in Ireland. This was a for-profit system with significant cost barriers and issues with quality of service, but it still filled a gap left by the dysfunctional public system. In the past few months, the increasingly unreliable service left large numbers of trans people in Ireland with no access to healthcare whatsoever.

All of these changes have clear causes. They include the spillover of the war on trans life being waged by the Tories and, increasingly, the Labour Party in the UK. The highly likely adoption of the Cass Review by the Irish government epitomises this situation. Another key factor is the growing far-right threat in Ireland, and some in government shifting hard right in response, which has legitimised far-right talking points and further energised the movement.

The current attacks on trans people in Ireland, alongside those on migrants, can be constituted as an early sign of the end of the liberal veneer and celebration of diversity that characterised the Varadkar era, however shallow and meaningless it may have been.

However grim the outlook, all these changes have been met with determined resistance by trans community groups, organisers and activists. The past year has seen a marked growth in the movement for trans healthcare, bodily autonomy and liberation. We have witnessed the development and consolidation of new campaigns and organisations which are all performing important functions within a social-movement ecology.

Trans Healthcare Action has done excellent work engaging with policy-makers and politicians. The group provides a critical perspective and voice for trans people in the media. Visit www.transhealthcare.ie to sign up for their monthly newsletter and see their clear vision for the reform of healthcare in Ireland.

Transgress the NGS is a coalition of grassroots trans community organisations waging a specific campaign for an end to interference by the NGS. Trans people’s ability to access healthcare through their GPs is an initial step towards achieving an informed consent system where people could access healthcare through primary care providers. Organised actions have included several digital pickets, a protest at Loughlinstown Hospital (where the NGS is based), a sit-in at the Department of Health, and a recent street theatre action at the HSE headquarters. They have recently started gathering signatures for an open letter to the Minister of Health. Find them on Instagram: @transgress.ie.

Meanwhile Trans and Intersex Pride has continued to mobilise people for mass demonstrations and in response to specific attacks, including visits by the influential transphobic organiser Posie Parker. They highlight the intersections between struggles for trans liberation and those of other oppressed groups. Healthcare is also one of several themes for this year’s Trans Pride on July 15.

In the year ahead, it is critical to continue to organise and build these campaigns. Anyone reading this should get in touch with the groups listed above and get involved. It is also critical to take account of the changing political context and the government’s shift to the right, which mean campaigns and strategies that seek to work with rather than directly confront politicians and policy are less and less likely to succeed.

Instead, we must align ourselves as part of a broader working class movement alongside other oppressed groups and anyone else threatened by the current collapse of public services and growing far-right threat. This is a movement which has common interests in fighting for better services, such as housing, healthcare and education, and ultimately against capitalism and imperialism, within which we must all unite.