The question came up in conversation with friends recently. The more I thought about it afterwards, the more convinced I was that it was incredibly important to use this column to talk about the issue.

With that in mind, I had the absolute pleasure of sitting down with Lilith Keeva Carroll – who works as the National Community Development Officer with TENI – and talking to her not just about her own experiences, but also about trans rights in general. It turned out to be a very educational conversation indeed.

Economic Status

From the start of our conversation, I am struck by the strength it must take to stand up and speak your truth when society isn’t ready to acknowledge – or could even be fighting against – you. Lilith came out as transgender at the age of 31, She recalls having to “block out the noise of society telling me who I should and shouldn’t be”; and “battling against the rigid gender roles that are thrown at all of us.”

Lilith speaks fascinatingly about the start of her transition and the new challenges with which she was faced. “I now moved through the world in a different way,” she recalls. “I was doing at 31 what girls did when they were 12: trying to figure out what works for you and learning things you previously weren’t able or allowed to do.”

There was a difference too in the way other people saw Lilith. “There’s a change in the world’s perception of you,” she observes, “moving from the feeling of erasure to then having to grapple with hyper-visability, where people would now read me as a woman, or a trans-woman, or I could even be misgendered.”

I’m interested to hear about the kind of help and support provided for trans people within the Irish healthcare system. How does Lilith rate it? “The models of healthcare that exist in Ireland are quite regressive,” she says. “When you look at the likes of Argentina, they have a much more progressive model in terms of healthcare and informed consent. You just have to look at the waiting lists and the personal testimonies of trans people, and their experiences with our healthcare, to see that it’s a real struggle.”

Lilith points out that, while top surgery (breast augmentation) is available for trans women, its equivalent for trans men (mastectomy) is not. As a result, the option of transitioning surgically represents a huge challenge in Ireland. Where relevant, trans people have to seek these operations elsewhere and, with the cost of surgery and travel starting around €10,000 – but often running considerably higher – a lot of trans people (including Lilith) have to turn to fundraising for their own healthcare.*
“When you look at the economic status of trans people, it’s incredibly low,” Lilith says, “and so a lot of people are stuck with this system, which acts as a barrier to their bodily autonomy. In Ireland, there are parallels between abortion rights, and the policing of women’s bodies in that regard, and trans people’s bodily autonomy and the policing of their bodies in society, either legally or institutionally.”

Healthcare System

Talking to Lilith, I have to think hard, again and again, about who is making these decisions around trans bodies? Who is creating the hoops that trans people have to jump through? “Not me,” Lilith laughs.

What she really means, of course, is that trans people are not involved in a decision-making process that hugely affects their lives and their well-being. The reality is that, whether they are seeking hormone replacement therapy or making a completely unrelated visit, serious barriers exist that block trans people from receiving the health care they need – and deserve. Lilith explaines that, in reaction to this, the community has had to take on the responsibility of providing support and information to trans people.

“Dealing with the health system, there isn’t a clear path,” she says, “so unfortunately it falls back onto the community to give each other tips and to share our experiences. At TENI we do the best we can to provide the information where the healthcare, education and sex education systems have failed. But putting that responsibility on the community does come with risks. Transitioning is a hard process anyway, but (it’s even more so) if you are struggling with your mental health or with being disabled. Or in direct provision or battling homelessness.

“The issues that affect wider society, hit trans people hard, particularly around housing and immigration. If you are an immigrant or person of colour or sex worker, these barriers that block trans people become even greater.”

Legislative Changes

All of these difficulties notwithstanding, Lilith still speaks positively about the role Ireland might take on, when it comes to the progression of trans rights globally. In this, she has been encouraged by the support she found within the feminist community in Ireland, compared to the UK and the USA.

“The approach here is inclusive and not based on colonialism,” she says. “A lot of the ideas of what a woman is supposed to be stems from a colonial past, that doesn’t exist in Ireland. I guess the best example of that was the ‘TERF’s Out’ movement around the time of Repeal, when UK feminists were coming over and attempting to impose their very singular feminist views and it just wasn’t accepted here.”

Transphobic attacks are more common in the UK and the USA than they are in Ireland and transphobic views can often find their way into the ideology of feminist groups. I ask Lilith how we might make sure these things don’t happen here.
“You see the young people that are coming in and that’s hopeful, exciting and encouraging,” she says. “It’s about defending that and making sure that it doesn’t get rolled back with the discourse that is happening either side of us. With the rise of the far-right (across the world), it’s important for us not to fuel or feed into that here. And if we don’t feed into it, then Ireland could lead the way for trans-rights.”

Progressive legislative changes have already been introduced in Ireland, including both the right to correct your gender on your passport; and recognising 16 and 17 year-olds transgender rights, provided they have the support of their parents. However, serious issues and challenges remain: for example, the law still doesn’t recognise the rights of non-binary people or trans people under the age of 16.

Cultural Identity

As we come to the end of our conversation, I too feel the hope that Lilith expresses about the potential for progress on trans rights in Ireland. She makes an analogy between the erasure that trans people have felt and the erasure that Ireland experienced as a country. “Asserting a belief in trans rights is very much linked to Irish cultural identity,” she insists. “Our feminism is so strong here because we have had to fight for our rights against the Catholic Church and our colonial past. Irish people have had to fight for everything – and, as a result, we know what we can achieve. There is still work to be done and, as a country, we need to address the ‘sweep it under the carpet’ culture that allows us to ignore issues.
“But I am really hopeful that Ireland can lead the way,” she concludes. “We are now in a place where we can define our future for ourselves, and carve out a space for the trans community and trans rights in Ireland.”

• You can find Lilith’s fundraiser here: gofundme.com/f/keeva039s-surgery-fund