Irish GP Action Project

Background

Trans people in Ireland self medicate for a variety of reasons, including problems with the public trans healthcare system and with the most widely used private alternatives. The centralised National Gender Service (NGS) is Ireland’s main provider of public trans healthcare. To avail of the NGS, trans people experience extensive barriers: years-long waiting lists, invasive evaluations, and inadequate treatment. Additionally, private trans healthcare services are not affordable for many people. For these reasons a recent report by Transgender Europe ranked Ireland worst in Europe for trans healthcare. 

We advocate for the adoption of a harm reduction approach to self medication by medical practitioners and other LGBTQIA+ groups. A harm reduction approach involves recognising that self medication is a reality—it is something people are doing and will continue to do regardless of stigma or a lack of appropriate support and medical care. This approach is facilitative rather than coercive and includes implementing practical methods to minimise the negative impacts associated with self medication.

GPs are in a position to significantly reduce the risks associated with self medicating including by 

• Providing blood tests to patients who are self-medicating

• Prescribing HRT to patients directly, including through ‘bridging prescriptions’ to shift self-medicating patients to a safer form of HRT

However, in our experience, many GPs are fearful or uninformed that they have the power to provide these forms of gender-affirming care to trans patients. They are also often unaware or unwilling to recognise that by not providing these essential medical services they are placing their patients at greater risk of harm.