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Treatment of trans in transition

Trans need official protocols

Transgender issues are becoming more visible. Last year’s Gender Recognition Legislation was mostly progressive and things are improving. However, it’s not all plain sailing for this community and their families. Families of transgender people face many challenges as their loved one undergoes a gender transition, and often have to shelve their own emotional needs as they battle recalcitrant public services.

Despite legislation that is seen as among the best in the world, there are still gaps. The problem is the lack of legislation for children under 16 years. This creates challenges in the school system with knock-on effects. Ironically before the recent legislation everybody was in the same situation, and every situation was technically up for negotiation. Now, trans people under 16 don’t exist.

The Passport Office had discretion to change the gender marker on a passport for young people. That is no longer the case: you can only have the gender marker changed on your passport if you have a gender-recognition cert or your birth certificate has been amended. Changes can be made to your PPS number to reflect the gender identity of a young person who is undergoing, and has proof of, a medical transition. That omits younger children who are socially transitioning. They feel let down and isolated. Parents are left trying to navigate a system that doesn’t recognise their children.

TransParenCI is a peer-support organisation for family members of transgender people, which is open to all family members over 18, not just parents. The group has grown from 14 people back in November 2011 to a massive 150 families. TransParenCI supports these families with the assistance of TENI. There are now four groups – one in Limerick, Dublin and Carlow, and the Transformers group for young people.

Families experience challenges when trans family members express themselves to be trans. Needs can be wide-ranging. In some cases, families experience a relational rupture as they struggle to understand what is happening with their loved one. It can cause conflict within the family and with external family, which in turn de-stabilises the family unit.

TransParenCI’s monthly meetings and annual residential sessionn endeavour to address these issues by facilitating the needs of the family and allowing them to take a journey. However, the parents often realise that their own emotional needs in many situations have to be set aside, as they engage with systems that are ill equipped to meet their child’s needs.

Healthcare and official treatment are a major obstacle that parents and families have to navigate. They can initially experience a foreboding about medical interventions. However, on further investigation and after speaking to other families, they realise that such options have been found to be safe and that an International protocol has been developed.

The treatment received is currently influenced by what area of the country the family resides in and the experience of health professionals in that area. Consultations are underway with the HSE about an official treatment pathway for trans young people and adults.

Health professionals throughout the country have been offered training through a partnership between the HSE and TENI. In 2015, 69 training events were delivered to over 2,000 staff. This partnership is having a positive impact on service delivery and patient safety. Feedback suggests high levels of client satisfaction. This approach is addressing some of the gaps. However, they need to be narrowed further and an official treatment pathway will help.

TENI, in partnership with parents, is calling for further changes in legislation. It is organising workshops with the Department of Children and Youth Affairs in July. The hope is that, over the coming months, the issues of legislation, education and healthcare are clarified, and resolved. In turn, families can then begin the journey of understanding their unique situation, and TransParenCI can continue facilitating the needs of all family members.

TransParenCI can be contacted through: office@teni. ie, Catherine@teni.ie or 01-8733575 (TENI) and 0870637933 (Catherine). Vanessa Lacey is Health and Education Manager, Transgender Equality Network Ireland (TENI). 

By Vanessa Lacey