“The first step on my medical transition was visiting my GP. When I went to him he had no idea where to send me. When I told him I was trans and that I needed to transition he didn’t know what to do with the information. He just said, ‘go home, do the research, find out who I need to refer you to and come back’.” Noah Halpin founded and runs This Is Me, a grassroots campaign for improved healthcare for transgender and non-binary people in Ireland. Here, he shares his experience of the Irish health service and calls for greater support from within the community.
Following doctor’s orders, Noah’s research led him to discover the extent of inaccessibility to what is life-changing – and often life-saving – healthcare: “I found out that there are only two endocrinologists in the country who will prescribe hormone replacement therapy [HRT] to trans people.” This is a situation exacerbated by Ireland’s reliance on the outdated psychiatric model of care provision: “You need to be diagnosed with a psychiatric condition before you can see an endocrinologist. [Of the two endocrinologists], one will only take a diagnosis from his own liaison psychiatrist and no other.” The other [based in Galway] requires two separate psychiatric assessments. Nonetheless, Noah persevered.
Two years of waiting brought three hours of questioning, “invasive and irrelevant questioning about my sexuality, sex life, my parents’ relationship. As if any of these things have anything to do with gender. It was utterly exhausting and really, really intrusive.” As it currently stands, the system is one defined by inaction; ignorant of the toll its inertia takes on users. Noah explains: “The wait for medical transition is the most traumatising part of transitioning. Being told you have a date, not knowing dates, being let down – again.” The behaviour of his psychiatrist, who told Noah he would recommend him for HRT, throws this into sharp relief. When pressed for even a vague indication of a treatment date, he replied: “I’m not telling you because I know if it doesn’t go that way you’ll come back to me.” Noah's is not an isolated case.
A moment last winter transformed anger in activism. “Back in December, my referral letter had gone to that [endocrinologist] around a year and a half beforehand. When I phoned, I was told my letter had been lost and that I was never on their list. I sat at home and had a cry and got really, really angry. I went online to some private trans spaces in Ireland and when I put a post up explaining what happened, a huge amount of people responded saying it happened to them too. I set up a little event page on Facebook and thought ten or fifteen of my friends were going to show up and shout at Leinster House with me.” On that day in January, the first organised protest for better trans healthcare in Ireland drew four-hundred people.
While Noah acknowledges the huge amount of support received at that time, he stresses the need for more to build on the initial momentum: “We are a very small community, we make up one to two per cent of the population. We can’t do it alone, we need help.” He is frank on where support has come from [“the trans community itself and different LGBT+ organisations”] and where it has not [“the rest of the [LGBT] community”]. To elaborate: “What we say is, trans people turned up for Marriage Equality marches. Trans people turned up for Repeal marches. But when the Gender Recognition Act march happened during the same year as Marriage Equality, less than 100 people turned up for it. And most of those were trans people.”
Cisgender members of the community ought to know their history and the central place of trans people within it. “You have to remember that Stonewall began when a trans woman of colour threw a shot glass at a mirror in the club. That’s where gay liberation started,” Noah explains. Cisgender gay and bisexual men and women must remain aware of the historical pathologisation of their bodies and identities. This remains a grim feature of contemporary trans experience and the wider LGBT+ community must come together in calling time. Trans people are people and know what is best for them.
Noah considers Marriage Equality to have contributed in some way to a sense of apathy around activism: "Obviously it’s the best because we all have equal rights to marry, but it’s also the worst because people have said, ‘we’ve done all we need to do now’ for the LGBT+ community – that there’s nothing else left." He urges the community and wider society to educate itself on the extent of the struggles left to fight and win, be that inclusive sex education, robust hate crime legislation, legal recognition for non-binary people and younger trans people or equitable access to PrEP.
In spite of challenges inside and outside the community, Noah remains cautiously optimistic. He is tentative in even admitting this and rightly so, given his experience: “I think it’s dangerous to become hopeful. There are so many times where we’ve been promised meetings that haven’t come to fruition. From our experience in Leinster House, [what’s said] isn’t always true, [what’s said] doesn’t always happen.” He acknowledges the support of politicians like Mary Lou McDonald, Ruth Coppinger [who both appeared and spoke at This Is Me’s second public demonstration], David Norris, Fintan Warfield, Helen McEntee and Finian McGrath. However, those who hold the power to really improve the situation have been less forthcoming.
That said, the mobilisation of young people since 2015 ensures Noah’s confidence in the movement for more inclusive, robust and compassionate healthcare for the trans community remains stoked. “People are more educated on issues and we’ve got the highest proportion of young people registered to vote ever. People [now] notice when things aren’t right and they’re prepared to stand up and say it. I think of all the people who came out on the streets last Saturday and last January, the people who have been writing to TDs and Ministers." Change is coming. [Legislators] have heard us. The pressure is on – they realise we’re not going to stop until change is made.”