Gender identity is an ever-changing spectrum that is often misrepresented in the world of today. Mental health as it relates to gender is a contemporary and increasingly prevalent issue amongst the Irish population and across the globe. According to Transgender Equality Network Ireland, gender identity is best described as a person’s intense feeling of identification as male, female, or some other gender. This may or may not relate to the sex they were assigned at birth (TENI 2018). As part of this article,  we will present an overview on Gender Identity terms, prevalence, treatment and stigma.

There are a number of terms associated with gender ranging from ‘cisgender’, a term for someone who exclusively identifies as their sex assigned at birth, to ‘gender fluid’, defining one who has a changing or fluid gender identity (Trans student 2019). However, a universal term for members within this community is ‘transgender’, which is an encompassing term of many gender identities for those who do not identify or exclusively identify with their sex assigned at birth (Trans student 2019). These terms may appear confusing and overbearing at first but respectfully asking those concerned is likely to lead to further understanding for the layman and gratitude from respondents.

Varying and widely held inaccurate beliefs about the transgender community are difficult to ignore in the media and on social media platforms in 2019. For example, while many of us believe that it is impossible to know for sure that one is transgender before reaching a certain age, the overwhelming consensus of the psychological community is that gender identity is formed by the age of 2 or 3 (Tannehill 2017). Furthermore, if the child is still asserting a cross-gender identity at the age of 15 or 16, there is almost zero chance that this will change (Tannehill 2017). ​Dissimilar to other schoolyard-scenarios, parents of gender-nonconforming children are repeatedly criticised for encouraging them and exposing their child to bullying, perhaps the blame is more suited to be placed on those doing the bullying.

The size of Ireland’s transgender population is not known, although a recent peer-reviewed article published in the Irish Medical Journal suggests that the condition is no less frequent in Ireland than anywhere else. To put that into perspective, there are 700,000 estimated people who identify as transgender in the United States alone, roughly 0.3% of the population (Gates, 2011). That translates to over 14,352 transgender individuals in Ireland today. To add to those figures, it is estimated that 1 in 4000 people are receiving treatment for gender dysphoria in Ireland (HSE 2018). These figures are only increasing, as evidenced by a study conducted by Judge et al (2014), stating that 55 referrals were made in 2013 in comparison to only 5 referrals in 2006. The significance of this subsector of the population can no longer be denied.

WHO no longer considers ‘Gender Dysphoria’ to be a Mental Illness, and has reclassified it as ‘Gender Incongruence’, which is merely a Sexual Health condition.  (LifeSIteNews, 2018). Contrary to this development, it continues to predominantly be mental health services who receive referrals for people with gender dysphoria in Ireland. Here the individual is treated only for their relating mental health difficulties such as anxiety or depression. Other treatment options include hormone therapy and gender re-assignment surgery. Not to place an undervalue on the psychological aspects of gender dysphoria, Littman (2018) surveyed parents of children with gender dysphoria and discovered that nearly two thirds of those surveyed had a diagnosis of psychiatric or developmental disorders previously. Almost half having experienced trauma or attempted self-harm (Littman 2018).

People with gender dysphoria are predisposed to a higher risk of emotional and behavioural problems due to transphobic bullying, harassment, discrimination, stigmatization and other triggers for mental health difficulties (Headspace 2019). TENI’s Trans Mental Health and Wellbeing in Ireland report, is the largest survey of its kind conducted in Ireland (2014)​. Discoveries include the following:

• 44% of trans respondents said they self-harmed​.
• 40% had attempted suicide​.
• 22% attempted 2-5 times.
• 64% had been made fun of or called names
• 36% had been physically intimidated or threatened
• 16% had been physically assaulted

The following is an extract from one of the interviews featured in the study.

“These boys started​ throwing stones at me, when I ignored them, they took my wig and ran off.”

On a brighter note, the battle has not all been losses. In 2015, the Irish government passed the Gender Recognition Act, the same year as the marriage equality referendum in Ireland. This legislation provides a process for an individual to change the gender marker on their birth certificate and be legally recognized by the State in their true gender, resulting in at least 297 amendments since. Ireland became only the fourth country in the world to give people a right to a gender based on self-declaration. A significant step in the right direction for transgender activism in Ireland. Simply a little more empathy and kindness on our behalf or an attentive ear may well be the most significant impact we ourselves can make going forward.

It was both our pleasure and our privilege to develop and present this project on behalf of Dundalk Institute of Technology Department of Nursing, Midwifery and Early Years. Sincerest gratitude to our supporting lecturers and the PNA for facilitating the exposure and encouraging us every step of the way. Exerting a voice for the voiceless and continuing the fight for change has been a phenomenally rewarding experience for all involved. We hope that the discussion on Gender Identity turns into action in the very near future.

Reference list:

Bauer, G. R., Scheim, A. I., Pyne, J., Travers, R., and Hammond, R. (2015). Intervenable factors associated with suicide risk in transgender persons: a respondent driven sampling study in Ontario, Canada. BMC Public Health. 15, pp.525. 8. LifeSiteNews. (2019). News: Gender [online]. Available from: https://www.lifesitenews.com/news/world-health-organization-removes-gender-dysphoria-from-list-of-mental-diso [Accessed: April 5 2019].

Gates. (2011). How many people are  lesbian, gay, bisexual,  and transgender?. Available from: https://williamsinstitute.law.ucla.edu/wp-content/uploads/Gates-How-Many-People-LGBT-Apr-2011.pdf [accessed 9 April 2019].

Headspace.(2019). Gender Identity and Mental Health [online] Available from: https://headspace.org.au/assets/Uploads/Resource-library/Young-people/Gender-identity-and-mental-health-web.pdf [accessed 9 April 2019].

Headspace.(2019). Gender Identity and Mental Health [online] Available from: https://headspace.org.au/assets/Uploads/Resource-library/Young-people/Gender-identity-and-mental-health-web.pdf [accessed 9 April 2019].

HSE.(2018). Gender Dysphoria [online] Available from: https://www.hse.ie/eng/health/az/g/gender-dysphoria/ [accessed 10 April 2019].​

Judge, C., O'Donavan, C., Callaghan, G., Gaoatswe,G. And O'Shea, D.(2014). Gender Dysphoria Prevalence and co-morbidities in an Irish Adult population. Frontiers in Endocrinology. Available from:  https://www.frontiersin.org/articles/10.3389/fendo.2014.00087/full [accessed 8 April 2019].

Littman, L. (2018). Parent reports of adolescents and young adults perceived to show signs of a rapid onset of gender dysphoria. PLOS ONE. 14(3). Available from: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0202330 [accessed 9 April 2019].

Tannehill, B. (2017). Dispelling Myths, Misconceptions and Lies About Gender-Nonconforming Children. Huffpost [online]. Available from: https://www.huffpost.com/author/brynn-tannehill [accessed 9 April 2019].

Trans Student Educational Resources. (2019).  LGBTQ+ Definitions [online]. Available from: [online]. Available from: http://www.transstudent.org/DEFINITIONS/ [accessed 11 April 2019]. 

Transgender Equality Network Ireland. (2018). Trans Terms[online]. Available from: http://www.teni.ie/page.aspx?contentid=139 [accessed 9 April 2019].