Paul Murphy (Dublin South West, Solidarity)

I thank the Labour Party for bringing forward this important motion. We in People Before Profit will, of course, support it. My thanks also for the tireless activism of many trans activists, including those in Transgress the NGS, Trans Healthcare Action and TENI, who are pushing for rights to mean something and for decent healthcare in this country for trans people. Last weekend, I saw a TD who wanted the public to pay for a €1,000 La-Z-Boy chair for him suggesting that investing in trans healthcare is a waste of resources. If investing in healthcare is not a good use of resources, I do not know what is. Perhaps we should just get La-Z-Boy chairs instead of healthcare.

It should be clear to anyone paying attention that the Government is no friend, or certainly no guaranteed friend, of trans people. We see the dog-whistling that is going on in terms of migrants, asylum seekers in particular, and any marginalised group. It may be that the formerly progressive face of Fianna Fáil and Fine Gael has been abandoned. That is why the activism from below pushing for rights to mean something and for decent healthcare is so important to understanding that an injury to one is an injury to all and that in fighting for trans healthcare, we are fighting for a decent national health service that provides quality public healthcare for everybody in this country, regardless of their particular needs.

The truth is Ireland is failing badly. We are the worst country in the European Union for availability and accessibility of transgender healthcare. We have one gender clinic offering transgender healthcare to adults in Ireland and that is the self-appointed national gender service based in St. Columcille's Hospital in Loughlinstown. It has wait lists over ten years long and sees fewer than 160 people a year. The NGS and its model of care were not approved by the HSE or the Department of Health. The service's name was chosen by itself. It is a clinic within the Ireland East Hospital Group, not a national clinic.

It is no surprise that there were no trans voices involved in the creation of the NGS. Those running it do trans people a disservice by lobbying against any reform of this broken system that treats trans healthcare as something to be restricted and pathologised. In this clinic, transgender people must undergo a dehumanising and humiliating assessment process. They are asked inappropriate and invasive questions that have very little to do with gender identity or medical transition. In some instances, trans people have been denied important gender-affirming healthcare if they were diagnosed with ADHD or autism or for not answering inappropriate and sexualised questions in a way deemed correct by the clinic.

Yesterday, Transgress the NGS put online an interview, the existence of which I knew of but had not seen until then. It is shocking in terms of how invasive and inappropriate the questions being asked are. This should not be happening in a proper national gender service. These are some of the questions asked of someone seeking bottom surgery:

Can I ask you a bit about your mental illness?

When was the most serious episode of mental illness that you had?

Were you drinking at the time?

What type of drink do you like?

On Tinder, what was your profile then?

Were you experiencing a lot of erections?

What else did you experience in terms of sex drive?

Can you describe what it is about your penis and balls you notice or don't like?

Are you happy receiving as well as giving?

Are you capable of receiving an orgasm?

Would you use a strap-on or sex toys?

This is not the type of approach we should have. We should have an informed, consent-based transgender healthcare model led by GPs and nursing staff in primary care. We should look to Catalonia, which has an informed consent model in primary care that has been successfully in use since 2012, with a 36-day waiting list and 71% of adults receiving HRT on the first appointment, compared with the decade-long waiting list trans people face in Ireland.

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