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Access to Gender Affirming Healthcare in Ireland: A letter to the Irish College of General Practitioners

December 10th 2021

Advocacy, Medical, Transgender, Health, Ireland

As an organisation that advocates on behalf of our patients and clients on important matters that directly and indirectly affect them, we contacted the Irish College of General Practitioners (ICGP) to discuss how they can help trans and gender diverse people better access gender affirming healthcare.

Through patient feedback, and our relationship with Trans Equality Network Ireland (TENI), we were made aware of ICGP guidance on accessing gender affirming healthcare that we considered vague and unclear, and that ultimately may mean that many of our mutual and future patients could have treatment stopped or refused.

We asked Fintan Foy, the professional body’s Chief Executive Officer, if he and his colleagues would discuss our concerns and work towards developing guidance that didn’t discriminate against individuals receiving gender affirming healthcare support and treatment outside of Irelands (National Gender Service).

Mr Finton Foy replied to us asking us to clarify our concerns, which, in addition to reiterating our invitation to discuss the issues in more detail, we did.

We are currently in what we hope is a meaningful dialog with the ICGP and will continue to lobby for change. We will continue to update our audiences as and when we’re aware of any developments.

 

Sent via email: 20th October, 2021

Dear Fintan

Thank you for your letter dated 18th October and for directing us to the ICGP ‘Guide for Providing Care for Transgender Patients in Primary Care, and to the training and education opportunities available to HCPs.

Whilst we understand these resources to be helpful to HCPs providing general healthcare and Gender Affirming Healthcare to transgender, gender diverse, and questioning patients, we cannot see how it helps those HCPs who are asked to assist patients that have treatment recomedation from providers such as GenderGP.

In such circumstances, we understand the current situation to be as follows:

  • The position of the Irish College of General Practitioners – The ICGP advises HCPs to contact the National Gender Service, the Irish Medical Council, and/or a medical indemnifier.
  • The position of the National Gender Service – The NGS advises HCPs to contact their medical indemnifier and/or the Irish Medical Council.
  • The position of the Irish Medical Council – The IMC seemingly have no publicly available advice on how HCP’s can help

You have asked if we could clarify our request of the college in order to help you best consider the matter for further discussion, and we appreciate that opportunity, I will endeavour to reiterate our concerns and how we believe that ongoing dialog on the matters we highlight is the best course of action.

State-provided Gender Affirming Healthcare in Ireland is widely reported to be struggling with the number of patients needing access to timely provision.

During the last five years GenderGP has stepped in to provide a significant number of those patients access to safe treatment recommendations based on international best practices and standards, while without having to wait on years-long state waiting lists.

We believe that the nature of the advice given by the ICGP and the NGS, to HCPs concerning services like GenderGP, is vague and unclear, and will have the effect of many of our mutual patients having their treatment stopped.

For example, in practical terms, many of our patients rely on their GP to provide blood tests needed for monitoring by our medical team. It is not a neutral act for a GP to not provide this service simply because their patient has used our service.

We again invite you to discuss with us how we might focus on how we can work together to ensure the continuation of care of our mutual patients.

Kind regards

Adi Daly-Gourdialsing (she/her/hers) – Current Affairs and Engagement Lead – GenderGP

 

If you are affected by anything in this update and would like to contribute to the discussion, you can contact us via our help centre.

 

Contact GenderGP

 

If you are affected by the issues discussed in this update and would like to talk to someone you can do so by speaking to one of our wellbeing team.

 

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Author: Adi Daly-Gourdialsing (she/her/hers)

Adi is our Current Affairs and Engagement Lead, and is responsible for monitoring the landscape and ensuring GenderGP is connected to what’s going on in the community. Adi’s background is in organisational development, user services, and community building. She is particularly interested in finding solutions to the challenges faced by trans and gender diverse communities when accessing timely and supportive healthcare. Adi is a peer mentor for a London charity, is involved in grass-roots LGBTIQA+ athletics advocacy, and lobbies for the right to cleaner air for all.

Adi has climbed the same volcano multiple times but never quite been brave enough to look over into the fiery pit of lava.