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TAKING ACTION

With decade-long waiting lists, invasive assessments and refusals of treatment, trans healthcare in Ireland is broken, and these issues are symptoms of an outdated, centralised, pathologising system. To fill the void in providing life-changing care, the trans community and healthcare professionals joined forces to create Kindred Clinic Cork, Ireland’s first peer-led trans health service pilot. Beatrice Fanucci spoke to the team to find out more.

For years, activists have been calling for systemic change in Ireland’s trans healthcare, advocating for a model that is based on informed consent and centres trans experiences. It is in this context that Trans Healthcare Action and the Sexual Health Centre in Cork came together to launch a pilot peer-led trans health service. Funded by the International Trans Fund, Kindred Clinic Cork was created to bridge the gap by providing care for trans people that is free, safe, local and gender-affirming.

The idea for the project emerged in 2024, during a public meeting that brought together civil society organisations and members of the trans community in Outhouse LGBTQ+ Centre, in Dublin. “We asked the community what they thought we should be doing to progress trans healthcare, and ‘peer-led clinics’ popped up on the screen. And I think, at that moment, all of us thought, ‘Why not?’,” Ky Walker Redmond, Resourcing Coordinator for Trans Healthcare Action, shared.

“We’ve seen it done around the world, why not in Ireland? We could create our own clinic. For generations, queer people and our allies have created the care we need, in spite of roadblocks. We could do it again.”

Following this meeting, Trans Healthcare Action began researching other peer-led clinics around the world that successfully provide gender-affirming healthcare, such as Equinox Gender Diverse Health Centre at Thorne Harbour Health in Victoria, Australia, and Callen-Lorde Community Health in New York, United States.

Talking about this part of the process, Morr O’Malley, Coalition Coordinator for Trans Healthcare Action, explained how the clinic “would not be possible without the collaboration and support of our friends around the globe”.

“While exploring how a peer-led clinic would look in Ireland, the experience and knowledge of those who had gone before us was invaluable in ensuring that we would have the best possible service.”

Ky further explained: “We had been meeting with activists and clinicians around the world for years, but now we had a distinct mission in front of us. We got on a call with the folks who started Equinox to learn about its beginnings as an evening trans health clinic out of Thorne Harbour Health, a sexual health service then called Victorian AIDS Council.

“We knew this approach aligned with the World Health Organization’s ICD-11, which shifted gender identity-related health to fall under ‘Conditions related to sexual health’. That’s when the idea really began to take shape. So we needed to find a space within Ireland that provided community-centred sexual health services, and we found it in the Sexual Health Centre.”

Taking the blueprint of Equinox, Australia’s first and only peer-led trans health service, Trans Healthcare Action designed a model of their own, assembling a team made up of a GP, nurse, and peer navigator, and informed by a trans co-production group. They proposed their clinic to the Sexual Health Centre team, who came aboard with enthusiasm.

On the project, CEO at the Sexual Health Centre, Fiona Finn, said: ”Supporting people to access safe, accurate and evidence-based sexual health information and services is central to the Sexual Health Centre’s work. In line with the World Health Organization’s recognition of trans health as part of sexual health, we see this as an important and appropriate area of our work.

“We are delighted to support Kindred Clinic Cork as an initiative that strengthens access to gender-affirming care, peer support and community-based services for trans people in Cork.”

The clinic’s services, which are delivered by licensed clinicians, include the provision of maintenance prescriptions for hormone therapy, blood tests and monitoring, supplies, advice, and referrals to the Sexual Health Centre’s services. The pilot aims to safely support people who are already undergoing hormone therapy, including those who are self-medicating.

Kindred Clinic Cork’s peer navigator, a member of the trans community, manages the clinic and provides support, guidance, resource sharing and sign-posting to service users. The clinic also offers a series of social and community services, including workshops, a care fund, self-injection supplies, safe binding and tucking guidance, and gender-affirming kits featuring accessories and trans survival guide zines. Moreover, it provides a community space where trans people can find books related to their experiences to read or borrow, and merchandise from partner organisations, including ShoutOut and GCN.

“We realised that what trans people need most is clinicians who respect their bodily autonomy and work with them to achieve their goals,” said Ciara Witts, Communications Coordinator for Trans Healthcare Action. “That’s why we created a service that allows trans people to have control over their own bodies, and their own lives.”

Kindred Clinic Cork is founded on the conviction that there is capacity within Ireland’s existing network of sexual health clinics to provide gender-affirming care. A decentralised approach that enables these services to provide care for trans people could significantly improve access and reduce wait times, while also reducing stigma.

The approach adopted at Kindred Clinic Cork focuses on four core tenets:

Community-based care

Delivering healthcare in community and primary care settings ensures that treatments are easily accessible locally, an approach that especially benefits trans people who live in rural or underserved areas. Such a system could drastically reduce waiting lists and guarantee that people are able to get the care they need close to home.

Harm reduction

Kindred Clinic Cork adopts a harm-reduction lens for gender-affirming care, meaning that they implement practical approaches to reduce the risks and negative impacts associated with self-medication, including access to blood tests. This approach centres a trans person’s bodily autonomy and is facilitative rather than coercive, ensuring that people can make informed decisions about their own health.

Depathologisation and informed consent

The informed consent model of care enables a person to make free, informed decisions about their own health and treatment, based on accurate education from their clinician regarding the risks, benefits, and limitations of interventions. This approach has the capacity to depathologise access to care, remove barriers and improve trans people’s experiences in healthcare settings.

Co-production and peer-led care

A model based on co-production recognises that trans people are best positioned to advise on decisions that directly impact their healthcare. By centring their lived experiences and perspectives, the trans community is actively involved in planning, designing, delivering and evaluating gender-affirming healthcare services. Kindred Clinic Cork has been conceptualised, designed, developed, and implemented through co-production between the trans community and clinicians.

“That we were able to do this – create our own clinic – shows just how amazing our community and allies are,” Ky said. “We are not powerless. We have it within us to imagine and build the future we want for trans people in Ireland. And Kindred Clinic Cork is just the beginning. We want to see clinics like this all throughout the country, clinics that centre trans people’s self-determination.”

Kindred Clinic Cork is a prime example of what a successful system for gender-affirming care should and could look like: local, depathologised, and produced in collaboration with the community it serves. The peer-led project is based on the principles of self-determination and bodily autonomy. It highlights the potential of care grounded in the local community, developing a model that could be scaled and replicated across the island. With the right support, Kindred Clinic Cork and the model of care it offers have the potential to transform access to healthcare across Ireland.

For more information on Kindred Clinic Cork, contact kindred@sexualhealthcentre.com. Please note that Kindred Clinic Cork is no longer accepting applications for its pilot phase. To donate to the clinic and support its work, visit sexualhealthcentre.com/donate and select Kindred Clinic from the dropdown.

Trans Healthcare Action is a grassroots trans-led organisation, building an Ireland where all people have autonomy over their own bodies, lives, and futures within communities of care. To find out more and get involved, visit transhealthcare.ie.

The Sexual Health Centre provides a space for individuals in Cork to get non-biased answers and the most up-to-date and comprehensive information about sexual health, wellbeing and sexuality. To find out more about the centre, visit sexualhealthcentre.com.

This article is part of GCN’s new Amach le Bród (Out with Pride) series, to combat anti-LGBTQ+ misinformation and platform underrepresented voices. The project was funded by the Coimisiún na Meán News Reporting Scheme.

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