The founder of the This Is Me – Trans Healthcare Campaign, Noah Halpin, recently took to Twitter to share his frustration at what he said were new requirements put in place by the Irish Gender Service that a patient’s parents’ be present during consultations, even where the patients are adults.
In a series of tweets, Mr Halpin outlined the situation for trans people seeking healthcare through Ireland’s Health Service Executive,
Under the guise of COVID, where they assumed that no one would notice, the psychiatric team at the National Gender Service have began insisting that adult patient’s parents be present at assessments. This is against the law. Breaches patient confidentiality, breaches patient consent, and is also an absolutely ridiculous, unnecessary and unethical forced requirement.
Following Mr Halpin’s thread dozens of trans people took to Twitter to outline their experiences with the Irish National Gender Service, with some alleging that they had been asked probing and explicit qiuestions by healthcare providers when they were still children.
One Twitter user wrote a thread about the questions they were asked while still a minor,
“When I was 17 years old i was sat in a room with a man i had never met before and asked to discribe how i had sex, if i liked it, what i liked, and the mechanics in detail. I was asked about every partner i ever had, if they were trans, gay, how far we “went together”. at 17.”
“17, is a minor, i was a child. this happened in a bright room with a nice man who was assuring me it was normal and okay. this was just nessasary, they just needed to understand. why? so i could be given a peice of paper confirming something i already knew, that i am transgender. i was a minor. a CHILD. being asked about my sex lift in detail so that somebody else could say i’m transgender. you know the worst part? this IS normal, i’m not alone in this. in order to access hrt, this “has” to happen. to adults and to children above 16”
Another trans man spoke of what he alleges is a similar experience, that he says happened to him when he was 15.
“At 15 years old I went to CAMHS to be diagnosed with gender dysphoria. Diagnosis is an archaic and exclusionary approach to trans healthcare. In that process, I was asked intrusive questions about my sex and sexuality. I was 15 years old. The psych was at least 50.”
Another trans person spoke of being alone, “in a room with a man I had never spoken to before who then proceeded to try to make me explain the details of my sexual assaults and tried to convince me to tell him when and how I lost my virginity.”
Human rights solicitor Wendy Lyon added her voice to those of trans people sharing their experiences,
“For the Doubters,” she wrote, “I have sat with a transgender person in the NGS clinic and heard the clinic staff defend these practices, insisting such intrusive questions are “necessary”.”
GenderGP’s founder, Dr Helen Webberley says sensitive questioning should be handled with care by practitioners and that it should be, “completely related to the condition presented, and there should be no doubt about why it is necessary. A patient should never leave the room wondering why the doctor needed to ask that.”
Mr Halpin said that the type of questions trans people are asked in Ireland are just one reason why they might not want a parent in the room,
“Putting aside legal standing alone… There are many reasons why people would not want their parents present. The line of questioning by the psychiatric team at the NGS [National Gender Service] is unnecessarily hyper sexualised, asking patients very intimate and detailed accounts of their sexual activity, as well as their childhood, relationship with their parents, past emotional/physical/sexual abuse etc…”
“This outdated and non evidential model of diagnostic questioning is traumatic enough for a person to go through alone. But to be forced, as an adult, to have a parent in the room at the same time is completely absurd and breaches all confidentiality/consent guidelines.”
Dr Webberley says that a requirement for a parent to be present during a consultation with an adult is infantalising and inappropriate.
“Can you imagine a sign in the waiting room saying, ‘if you feel your gender is different to the one on your medical records then please bring a responsible adult with you’?”
“Can you imagine the practice leaflet saying, ‘we have a range of interpreters at your disposal, please ask when you book – but if you are trans make sure you bring your parents.’”
“Can you imagine the out-patient letter reading ‘Please bring a urine sample, a recent blood pressure reading and someone who can explain how you are feeling?’”
Dr Webberley says that having another person in a medical consultation should be a decision made between the patient and their healthcare provider.
“When I have been in this situation I’ve planned together with the patient to work out how we can best help each other understand our position. I recognise that they are the expert in their body and mind, and I am the expert in medicine, health and healing.”
“When I am once again allowed to consult with patients, and I am asked ‘do you need my mum to be present?’ I shall answer ‘This is your consultation and I will do anything that you need me to to keep you well and safe. If at any time you want your mum here with you, then she is welcome. If you don’t, we will do just fine.’”
“Never, ever, ever would I have thought to enforce that another person be in the room simply because of the presenting condition.”
Dr Webberley states that treating trans people as if they are not capable of knowing their own minds is deeply offensive.
I’m tired of this nonsense. Cisgender decision-makers are enforcing their values and biases onto trans people. ‘They surely can’t know their own mind.’ ‘We need someone to verify that what they say is true’, it’s very frustrating. I can’t think of another demographic of patients who are so routinely infantilised by medical professionals.
Things won’t change for trans people, Dr Webberley says, until cis practitioners lay aside their own biases and focus on why they became healthcare Providers in the first place – to help people.
“Having a different gender to the one everyone else thinks you should have is a beautiful part of human variation. Let people be, offer them care, support, belief and understanding. Offer patients your expertise and lay your judgement aside.”
If you have been affected by any of the topics raised in this blog post and you would like to speak to someone, please visit our Help Centre to access our team of gender specialists.