There is a healthcare crisis taking place across the world, easily solvable, but born on a wave of prejudice and hostility. Where other healthcare challenges are being acknowledged and addressed, ending the neglect of publicly accessible Gender-Affirming Healthcare remains squarely off the political table, from London and Edinburgh to Stockholm, and Dublin to Washington.

With this lack of public provision, trans individuals have to either wait for years, or travel to different countries to get the healthcare they need.

A new study of 700 trans patients, published by the JAMA Surgery, revealed that almost half (49%) of US trans patients who had genital surgery had to travel to a different state in order to access their procedure. The patients who had to travel also had to pay additional costs for medical expenses which were not covered by their health insurance.

Having to travel to access Gender-Affirming care is a major burden on trans patients, and can lead to further complications when receiving their follow-up care.





Photographer: Duncan Shaffer | Source: Unsplash

Gender-Affirming healthcare in Ireland is proving yet more inaccessible. There is only one public trans healthcare facility, the Dublin-based National Gender Service. Due to the lack of public gender identity clinics or other public trans healthcare services, the waiting times at the National Gender Service can last between two and a half to three years for an initial session. The NGS does not provide gender-related surgery, nor does it provide services to under-18’s, leaving trans youth at further disadvantage.

Many trans people who seek gender-related medical care and cannot afford it privately have to travel to a different country to get treatment. Additionally, in Ireland, neither public nor private health insurance covers genital surgeries, forcing any trans person requiring surgery to travel elsewhere.

Recently, the UK’s Good Law Project has revealed that they have permission to go to court regarding the country’s failure to help trans people access gender-affirming healthcare in a timely manner.

Trans people have had to face life-altering and at times life-threatening waiting times within NHS healthcare. These delays began before the pandemic and have only worsened since. A member of the campaign stated that waiting times are equivalent to ‘torture’ pushing trans individuals requiring treatment to the breaking point. Two claimants, and Gendered intelligence – a trans-led organisation – will be proceeding to the hearing in the High Court on the 29th and 30th of November 2022.

One of the gender identity clinics provided by the Tavistock and Portman NHS Foundation Trust confirms that there continues to be a ‘high demand for appointments’ in their services. The Trust receives around 350 referrals each month while also having to provide healthcare to current patients. The result? Long waiting times, destined only to grow longer. The Trust acknowledges that this is a ‘national issue across all gender clinics’. As of April 2022, there are over 11,000 people on their waiting list, offering initial appointments to those who have been waiting for four years.

As more trans patients try to access Gender-Affirming Healthcare, it is vital that governments step up and take on a more active role. Equal Healthcare is a human right, and trans care that affirms the person’s gender identity and respects their dignity and selfhood is essential in a civilised society. However, with waiting periods lengthening, not shortening, and an increasingly hostile political environment in both Europe and North America, the pathway to Gender-Affirming Healthcare, and equal care rights, seems a daunting one.

Nonetheless, public attitudes towards the trans community are changing as evidenced by the outcry against the UK government’s conversion therapy ban excluding trans people. As Gender Affirming Healthcare is shown, through effective Models of Care, to be the best framework for supporting trans people, momentum for change is expected to build. However this change, sadly, remains to be hard-won, and cannot come soon enough.