Barriers to trans care: Not being believed was tough part of journey for Saoirse

A transgender woman from Cork opened up about how she was forced to resort to private healthcare due to barriers that almost prevented her transition.

Now 24, chair of the Cork East branch of the Social Democrats, Saoirse Mackin said she was unable to get approval from a psychologist in CAMHS to access a place on the waiting list for hormone replacement therapy. The activist was subsequently referred to an endocrinologist through a private psychologist. Ms Mackin from Blackpool said she has no regrets after two years of hormone replacement therapy. However, she expressed concern about the mental health impacts on those unable to afford private healthcare.

She acknowledged that delays in accessing trans healthcare had led to her previous mental health issues. Nonetheless, the most difficult part for her — she admits — was not being believed. She also called for a reduction in waiting times relating to trans healthcare amid fears that people will die before accessing treatment they urgently require.

“When it came to getting on hormones it was a six-and-a-half-year process for me,” Saoirse said. “That was from the first time I saw someone to the time I started hormones. 

"I was unable to get a referral through the public system because they didn’t believe I had gender dysphoria. I was told that if I did start hormones there was a chance I would regret it. 

"The whole process is so difficult that if you didn’t have mental health issues going in there you would definitely have them coming out.”

Treatment in private healthcare 

She recalled her experience in the private healthcare system.

“It was at a huge cost because these appointments are not cheap. 

"I was told that I had a classic case of gender dysphoria despite being told a few weeks before this that I wasn’t trans. 

"After a few months I was finally given a referral. I had been on the waiting list for two and a half years. When I finally got to see the endocrinologist, the appointment took little more than two minutes.“

Her fear is that others may consequently see their mental health suffer.

“The issue is that you know what you need but everyone around you is going to believe the professional. People are always going to look to the experts. I have been on hormones for two years now and do not regret it despite being told that I would. 

"My life is changed but it is worrying to think of other people unable to go ahead with treatment simply because they are not being believed. 

"This means that people are going to be left in a much worse position than they were before, particularly in terms of their mental health.”

Saoirse’s battle to see trans health services improved in Ireland continues. 

“My endocrinologist believed me. However, that’s not the same for everyone. Every aspect of transgender healthcare comes down to whether you are believed. If your leg is broken they can do an x-ray to confirm what is wrong. In this situation, you have to convince the other person that what you are telling them is the truth. If I have to go for surgery in the future, I will have to find two psychologists to confirm that I can go ahead with this despite living as a woman and knowing I am trans for so many years.”

She expressed fears that hope may come too late for many transgender people on waiting lists.

“It breaks my heart to think that there are people who won’t make their appointment because they won’t be there anymore. 

"This is not just putting pressure on trans healthcare but mental health services too which are already at breaking point.”

Saoirse was among the organisers of Cork’s first Trans Pride event which took the form of a protest in July outside Cork City Library. The motivation behind the event was to highlight the issues facing transgender people in modern Ireland.