Lack of services puts transsexuals at risk

A LACK of services for transsexuals has led to botched sex-change operations and the use of backstreet clinics, according to a transgender expert.

Dr James Kelly, a Dublin-based psychologist who runs a transgender clinic, said the overwhelming desire to live their lives as members of the opposite sex meant some people took drastic action.

“I have patients who never actually got access to services and so there have been cases of self-mutilation, to the extent of some people putting their lives in danger. People also go to various sorts of unqualified practitioners for surgery. I have even heard a rumour of some-one setting up a testicle removal clinic.”

A report published in 2004 by the Equality Authority (EA) found the Health Service Executive tended to focus on providing funding for people to travel abroad for sex change operations rather than providing services on the ground. Since 2000, the HSE has handed out €70,000 to fund genital reassignment surgery abroad for seven people.

Chief executive of the EA Niall Crowley said since the report, Access to Health Services for Transsexual People, was published there has been “the beginning of dialogue between us, the HSE and two transgender groups which we hope will lead to positive change”. The EA currently has a number of case files involving allegations of discrimination by transsexuals.

Dr Kelly, who works at the Oscailt Centre in Dublin’s Pembroke St, has up to 70 transgender patients on his books, the majority of whom are male-to-female cases.

The condition, also known as Gender Identity Disorder (GID), is “definitely not a lifestyle choice”, Dr Kelly said. He said there is increasing evidence the areas in the brain implicated in the determination of gender may be responsible.

Dr Kelly said the lack of health services available to those with GID had a significant impact on their lives. This included depression, suicidal feelings and alcohol and drug abuse. It has also led, in some cases, to people accessing hormones on the black market without medical supervision.

Since 2000, the Department of Diabetes and Endocrinology in St Columcille’s Hospital and St Vincent’s University Hospital has provided an endocrine service for transsexual patients. A review of the first 52 found 18 were either currently or previously married and 14 had children. Over half had experienced difficulties accessing any health services.

A statement from the HSE said it was “carrying out a mapping exercise of services provided by the HSE to people with gender identity issues”.