Service must be made available
Since 2000, the HSE paid nearly €70,000 to enable seven people with the condition known as ‘gender identity disorder’ or GID to have sex change operations outside the State.
However, there is mounting evidence to suggest that the number of cases going untreated at home is causing some GID-affected persons to resort to highly dangerous operations performed by back-street practitioners.
No less alarming are reports that some people with gender identity disorder, also known as ‘transsexuals’, have engaged in self-mutilation, often during DIY-style operations, because they were unable to access services.
Such drastic action highlights the need for a more coordinated, and, it has to be said, a more sympathetic approach in dealing with these problems.
In a nation where sexual matters have tended to be swept under the carpet, it would be hard to exaggerate the personal, family and social difficulties confronting those who decide to take the traumatic step of undergoing a sex change. Invariably, they tend to become the subject of whispering campaigns, a target of sensationalism, or the butt of nod-and-wink jokes.
The simplest way to think of transgender identity is that a person may psychologically be one sex, but physically another.
Major gaps were identified by the Equality Authority in 2004 in the provision of services for those with gender identity disorder. The authority criticised the HSE for its focus on sending people abroad for surgery, rather than providing it in Ireland.
In response to this criticism, the HSE is currently carrying out a countrywide ‘mapping’ exercise to identify the need for such a service here.
According to Dr James Kelly, a Dublin-based psychologist who runs a transgender clinic, the overwhelming desire of some people to live their lives as members of the opposite sex can lead them to take drastic action in order to achieve this end. In certain cases, patients who had failed to gain access to the necessary services went on to engage in self-mutilation to the extent that their lives were put in danger.
Given the veil of secrecy shrouding such matters, people have also, on occasion, resorted to quacks and unqualified practitioners for surgery. According to Dr Kelly, one rumour in circulation had it that a testicle removal clinic had been set up in Dublin.
As Irish society becomes more pluralist, it is apparently becoming more inclusive and more tolerant of difference. As a result, the number of people seeking a sex change is on the increase, a trend evidenced by the fact that there up to 70 transgender patients on Dr Kelly’s books, the majority of whom are male-to-female cases.
New light has also been thrown on the vexed question of gender identity disorder by recent medical research, which points to the possibility that gender is determined by specific areas of the brain. This view runs counter to the popular belief that those seeking gender change are motivated by lifestyle choice.
There is ample evidence so suggest that the lack of dedicated health services can have serious repercussions for those experiencing GID, including depression, suicidal tendencies, alcohol and drug abuse.
Unless proper services are provided countrywide, meanwhile, backstreet operations will increase and lives will inevitably be lost.
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