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Hope: Insights after Transcare

Transcare was truly a multidisciplinary conference, with so many people from different places, professions, and backgrounds coming together to present research and discuss the needs and concerns of intersex, trans and gender-diverse people in healthcare. This was a busy time for us. Our volunteers presented research, held a roundtable discussion, and welcomed the launch of PATHI. Read on below to learn more about what we were up to over Transcare! 


Our Research

Person-centred trans healthcare, from the trials to the clinics: a concept analysis of self-knowledge among trans people

Sibéal Coll, Joann Kelleher, Lynne Taylor, Ryan Goulding


  • Dynamic process of gender identity discovery: Transgender individuals develop a deeply embodied sense of self, shaped by lived experiences, personal autonomy, and a rejection of restrictive, binary societal norms around gender.

  • Empowerment through informed healthcare decisions: Access to accurate information, supportive environments, and trauma-informed care enables transgender people to assert agency, reduce dysphoria, and advocate for their healthcare needs within often underprepared systems.

  • Outcomes of resilience and empowerment: Self-knowledge fosters improved psychological well-being, authenticity, advocacy skills, and the ability to challenge oppressive structures, contributing to a more empowered, self-determined identity in both medical and social contexts. 


Context and Preference When Choosing Dosage Forms in Trans Healthcare: A Review of Available Pharmaceutical and Risk Information in an Irish Context

Sibéal Coll, Andrea Crowley, Rosaline Keane Kelly


  • Trans people are not mentioned in standard reference sources used to inform practice.

  • Licensed medicines in Ireland were found to be on the market for an average of 28 years: despite misperceptions of our care being complicated and specialised.

  • Many other unnecessary barriers to access were found that could be impacting risk perception such as how difficult it was to access the information or how licensing varied. 

  • Ingredients of Irish medicines were compared against an European Medical Agency resource - few of them will be problematic. 

  • International trans-specific medical resources/guidelines might be hard to follow without some help or adaptation. 

  • It’s hoped that by pointing out missing information and context that this will inform irish guidelines. 


Our Roundtable

We held a discussion of the current state of trans healthcare in Ireland and potential solutions, breaking off into small groups to talk through various areas of trans healthcare.


Community Voice in Theory, Research and Policy

Key points included:

  • Delays in Community Projects: Research often holds up community initiatives, with community knowledge not recognised until formally published.

  • Poor Engagement: Alienating language, irrelevant questions, and redundant topics discourage community participation.

  • Meaningful Outcomes: The community wants research to have real-world impacts, such as policy changes or useful resources, rather than just academic achievements.

  • Power Imbalances: There is an unequal dynamic between researchers and the community, even with PPI panels, where researchers control the agenda.

  • Community-Driven Research: The community should drive the research agenda, setting priorities and assessing projects based on their relevance.

  • Framing of Bias: In trans healthcare research, community input is often seen as a bias, unlike other fields where patient voices are included.


Key takeaways emphasise the need for co-designed, community-led research that avoids unnecessary burdens and focuses on meaningful, community-centred outcomes.


Self-Advocacy & Informed Consent

Key points included:

  • Community or Individual: Advocacy is something that can be driven by an individual or by an entire community.

  • Training: Healthcare professionals need additional training to understand the concept of informed consent relating to the trans community. 

  • Know your Rights: It’s essential that members of the trans community know their rights so they can effectively advocate for themselves in healthcare spaces.

  • Professional Conduct: Provision of equitable care based on the informed consent model should be included in the code of conduct of each registerable health professional. 

  • Transparency: Both professionals and trans people need to move towards a space where being transparent is fundamental. 


Key takeaways emphasise that advocacy can be driven by individuals or communities, with trans people needing to know their rights to effectively advocate for themselves in healthcare. Additionally, healthcare professionals require more training on informed consent, equitable care should be part of their professional code of conduct, and transparency must be prioritised in all interactions.


Access to Medicines & Harm Reduction

Key points included:

  • DIY: Viewed as a suitable alternative in the current context where care is regularly denied and not easily accessible. Harm reduction needs to be implemented to ensure people can access this type of care safely and with appropriate knowledge. There was acceptance that even if care was readily available people may still choose to engage in DIY as the trust between the trans community and healthcare providers needs to be rebuilt. 

  • Community: There is a reliance on community knowledge to provide insight into safe dosing and medication administration in those who DIY. 

  • Medication: Acknowledgement that GAC medications are generally a safe medication. Concerns voiced about the potential that providers are prescribing doses which are too low due to fear. 

  • Knowledge: Onus on the community and the individual to have “expert knowledge” relating to medication administration, interactions, and more. 

  • Perspectives: Belief that there is a general mismatch between what the providers believe is safe and effective and what the trans person believes is necessary. 


Key takeaways highlight that DIY healthcare is viewed as a suitable alternative due to the lack of accessible care, with harm reduction needed to ensure safety and proper knowledge. Despite available care, some may still choose DIY due to mistrust in healthcare providers, relying on community knowledge for safe dosing, with concerns over low-dose prescriptions and a mismatch in beliefs about what is safe and effective.


Models of Care for Youth & Adults

Key points included:

  • Aligned Pathway: Ensure that our service is a single service for both youth and adults, not separate.

  • Co-Production: The model of care should be developed in co-production with the trans community, including young trans people.

  • Community-Based Care: Gender-affirming care should be available to trans adults and youth in the community within primary care.


The Launch of PATHI

Transcare marked the launch of PATHI, the Professional Association for Trans Health Ireland. PATHI is an all-island multidisciplinary organisation representing, supporting, and connecting those working to strengthen the health, rights and wellbeing of all trans and gender diverse people across Ireland. We excitedly welcome the launch of PATHI and hope to see it flourish in the days ahead! 



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