In a country that repealed the 8th and waved rainbow flags in the streets for marriage equality, trans people are still being told to wait — not months, but years — for the most basic medical care. Behind the political photo ops and progressive posturing, a brutal truth persists: Ireland’s transgender healthcare system is a national disgrace.
Ireland ranks last among EU countries for trans healthcare access. The National Gender Service (NGS) operates under a gatekeeping model rooted in psychiatric assessment and outdated clinical pathways. Waiting lists stretch for over a decade. This is not a “service” — it’s an institutionalised barrier.
As a result, a growing number of trans people in Ireland are turning to DIY healthcare: self-sourcing hormone replacement therapy through unofficial channels, educating themselves through peer networks, and supporting one another in the absence of professional care.
This is healthcare by necessity, not by choice — a stark reflection of a healthcare system that has simply abandoned them.
This crisis has not gone unchallenged. Trans and Intersex Pride Dublin has become a rallying force for radical queer liberation, explicitly rejecting the corporate, assimilationist politics of mainstream Pride. Each year, thousands gather not to celebrate symbolic progress, but to demand material change — including a fully public, informed consent-based model of trans healthcare.
ROSA – the Socialist Feminist Movement — of which I am proud to be a part — has consistently stood on the frontlines of this fight. We link the struggle for trans liberation to wider battles against misogyny, poverty, and capitalist exploitation. The oppression of trans people is not an isolated issue — it is bound up with every fight for bodily autonomy and class justice.
Intersex Ireland, too, has played a vital role in challenging the medicalisation and pathologisation of bodies that do not conform to narrow definitions of sex and gender. Their advocacy has exposed the horrors of non-consensual surgeries on intersex infants, and reminded us that true healthcare must be rooted in consent, dignity, and diversity.
These groups — trans-led, community-powered, and politically unflinching — are doing what the state will not: demanding justice and building solidarity.
We don’t need more “consultations.” We don’t need another decade of reviews. We know what’s needed:
– An end to gatekeeping and psychiatric assessment protocols.
– A GP-led, informed consent model for gender-affirming care.
– Full public funding for all aspects of trans healthcare — including HRT, surgeries, and mental health support.
– Recognition and resourcing of intersex rights, with a ban on medically unnecessary interventions.
– Inclusion of trans and intersex voices in all healthcare decision-making.
This Is a Political Fight
The refusal to provide gender-affirming healthcare is not a bureaucratic oversight. It is a political decision — one that tells trans people their lives are negotiable, their health expendable, their dignity optional.
But we know better. We know that bodily autonomy is a fundamental right — not something to be rationed, debated, or delayed. And we know that only collective struggle will win it.
Our message is simple and non-negotiable:
Healthcare for all, on our terms, in our communities.
No gatekeeping. No waiting lists. No compromise.
Trans people are not a problem to be solved — we are a people rising to reclaim what has always been ours: our bodies, our rights, our lives.
— Sorcha Ní Fhaoláin, ROSA Socialist Feminist Movement
