Nearly half of young people using gender services suffered depression, study finds

The National Gender Service is based in St Columcille’s Hospital in Loughlinstown, Co Dublin

Seán McCárthaigh

Almost half of all young adults attending gender services provided by the health authorities over the past six years suffered from depression, according to the findings of a new medical study.

Researchers found a high proportion of transgender patients aged 18-30 years attending the National Gender Service (NGS) suffer some kind of mental health issue.

The study also highlighted significant demographic changes among people seeking gender services in the Republic, with transgender males or people who were assigned female at birth now accounting for the majority of patients, unlike a decade ago.

The research, which reviewed the charts of 167 patients attending the NGS, which is based in St Columcille’s Hospital in Loughlinstown, Co Dublin, found 49.1pc experienced depression, with a further 15.6pc having a low mood and 26.3pc having anxiety. In addition, 12pc disclosed they had engaged in deliberate self-harm, with 15pc reporting suicidal ideation, while 3pc had actually attempted suicide.

The study also revealed 11pc of patients were diagnosed with autism spectrum disorder (ASD), with another 3pc having clinical features of ASD, compared to the estimated rate of 1.2pc among the general population of young adults.

Researchers from the NGS and UCD’s School of Medicine found transgender men, or people who were assigned female at birth now account for 62.3pc of patients attending the centre.

Transgender women or those assigned male at birth represent 35.3pc.

This is a reversal of the trend evident in the period 2005-2014 when transgender women constituted 73pc of all patients, with the remainder transgender men.

The study also showed more than 70pc of patients were on either gender-affirming hormone therapy or GnRH blockers, while 16.1pc had undergone surgical intervention.

The most common surgical procedures were bilateral mastectomies, which accounted for 22 of the 27 patients who had surgery.

However, only four of the operations were performed in Ireland, with the most common country for referral being Poland or the UK.

The study discovered one patient was using unprescribed hormones which they had sourced from a friend.

The annual number of new referrals for gender services at St Columcille’s Hospital has risen year on year from six in 2005 to 287 in 2020. Many of the changes are in line with international trends.

One of the report’s authors, Seán Kearns, said there were many theories why the greater proportion of patients attending the NGS were transgender males but none had been empirically tested.

Mr Kearns said one of the “most glaring challenges” facing the services was the current waiting time for a first appointment.

The average waiting time between referral and first assessment among those cases reviewed was approximately 16 months.

“There is an opportunity to explore additional, non-medical, gender-affirming services and initiatives that could be introduced while people are waiting to be seen, recognising that medical and surgical interventions are not the sole means of gender affirmation,” said Mr Kearns.

He said another challenge facing the services was access to surgery, with most patients having to go abroad for various procedures.

Mr Kearns said there was a sufficient referral rate for chest surgery to sustain a surgical service in Ireland which he claimed should be made a priority.

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