Gender-affirming mental health care in Ireland

Note: We want to highlight at the outset of this article that people who are intersex and/or gender diverse deserve to live respected, fulfilling, and dignified lives and should not have their health-care needs be politicized, as is so common in the media lately.

Introduction and Definitions

The World Health Organization defines Gender-Affirming Care as “any single or combination of a number of social, psychological, behavioural or medical (including hormonal treatment or surgery) interventions designed to support and affirm an individual’s gender identity.” This type of care is often provided to people who’s lived experience and deeply felt understanding of their gender does not align with the sex they were assigned at birth. This disconnect between a person’s assigned sex at birth and their gender identity can happen when a person is born intersex, and/or when they are gender-diverse. Gender diversity is an umbrella term which includes people who are transgender, non-binary, gender-queer, and others who do not fit into traditional binary understandings of sex and gender. For the purposes of this article, we will be using the term gender-diverse to include anyone who’s gender identity does not align with the sex they were assigned at birth for any reason.

Mental Health Considerations

It is important to note the being gender diverse is not a mental health issue in itself. The mental health issues that gender diverse people can face often arise as a result of living a world that is hostile to their identity. Gender diverse people are more likely to experience prejudicial treatment, discrimination, and even violence as a result of their identity. This mistreatment can be perpetuated by strangers on the street, institutions such as school or workplace environments, or even by members of their own family.

Concerns can also arise due to gender dysphoria, which is a feeling of unease that can arise when living in a way which does not align with a person’s gender identity. The good news is that gender dysphoria is a very treatable concern which is alleviated through gender affirming care. For some people simply accepting and affirming their identity can be sufficient to alleviate feelings of gender dysphoria. Others may wish to transition (meaning to live aligned with their gender identity) which can involve social, psychological, behavioural, and medical interventions.

How Gender Affirming Mental Health Care works

Gender affirming mental health care is built on the assumption that there is nothing “wrong” with any person’s experience of their gender - there is nothing that needs to be changed or “fixed”. This is important because it is in contrast to the historical experience of conversion therapy so many were wrongly subjected to (a “therapy” where people tried to change their gender identity, which has been deeply harmful and has no research support).

In contrast, gender affirming mental health care hold that the client is the expert on their own experience of their life. It provides space to reflect, question, challenge, celebrate, and yes, affirm oneself in their experience of their gender. It is a space to un-learn harmful, transphobic beliefs that we can so easily internalize from society and grow in self-love, acceptance, and joy in oneself.

Gender affirming therapy is also a place to experiment and practice for developmental milestones unique to the gender diverse experience. I have worked with clients changing their name, their pronouns, their style of dress, and even their physical appearance. Therapy is often the place where clients can “try out” something new in a safe and supportive space for the first time to see if it fits for their understanding of themselves. For many gender diverse people, they never got to experience these developmental milestones when growing up because it is often not safe or possible to do so. Therapy can also be a place to practice for difficult conversations that will unfortunately likely arise as part of this journey, such as coming out to family and friends, or how to advocate for oneself.

Through this process we often see clients experience an increase in self-acceptance and compassion, personal growth, healthier relationships, a decrease in mental health concerns, and overall a better life.

Accessing Gender Affirming Mental Health Care in Ireland

We at Trua Psychological Services are proud to offer gender affirming mental health support for anyone aged 18+ in the Republic of Ireland. If you are seeing this type of support, we would love to work with you.

Sadly the pathways for accessing this type of support are generally quite limited in Ireland. According to the Transgender Equality Network Ireland (TENI) there are few public services available in Ireland and all of which currently operate on a wait-list. We would call on further support for increased access to both public and private care options for the gender diverse community across Ireland.

If you are looking for this type of therapy and using databases or directories to find a therapist, please do ask your potential therapist about their experience and perspective on working with gender diversity before committing to working with them. If your potential therapist gives anything other than an enthusiastic and supportive reply, they might not be the best fit for you needs.

Research Support for Gender Affirming Mental Health Care

There has been an abundance of peer-reviewed articles published in psychological journals which have highlighted the benefits of gender affirming care, and most reputable professional organizations including the World Health Organization (WHO), the American Psychological Association (APA), and the World Professional Organization for Transgender Health (WPATH) all highlight gender affirming care as the most beneficial intervention for working with gender dysphoria.

If you would like further reading on the research related to gender affirming therapy, please do not hesitate to reach out and we would be happy to supply citations and articles for your reference. We hope this was a helpful and informative guide to why we choose to use gender affirming therapeutic interventions with our gender diverse clients. If after reading you have any questions, concerns, or want to connect further, please do not hesitate to get in touch. Finally, if you are in Ireland and looking to access gender affirming services of your own, please use the button below to book a telehealth appointment. Thanks for reading!