Transitioning in Cork: Living my life as my authentic self

“A year ago, I never thought I’d even be able to reconcile with who I am.”

So said Saoirse Birmingham, who was born in San Francisco, California, to an American mother and Irish father.

She came to Ireland and studied in UCC, where she met her now wife and decided to build a life on the northside of Cork. However, the life she’s built is not quite what she planned at that time. Though arguably it’s far better!

You see, Saoirse previously presented herself to the world and lived her life as a man. She was 33 before she itted to herself that she was a woman.

“For a good few years before I decided to transition, I would get this building pressure and anxiety around gender identity, and that I couldn’t picture a future where I grow old, and I felt like I was piloting my body rather than inhabiting it. And then it would kind of ease off, and I would push it back down and ignore it.

“I was at kind of the peak of that cycle in October, and my wife and I had been talking about it that time around where I would usually keep it to myself. 

I had been looking into informed consent services for HRT but had still never actually said out loud, even to myself, that I was trans.

“When I got home from my first nail appointment I was showing them off to my wife, and we were talking about how I was feeling about my gender - she had been trying to cultivate an environment where I would be comfortable exploring who I was, though I was totally oblivious to that – and she asked me if I would be happier if I transitioned.

“I didn’t really have time to think about it and said, ‘Yeah, I would be’. So the first time I said it out loud was with my wife there ing me.”

Acceptance is the first step in overcoming any situation of ill feeling, and often the most difficult. But that doesn’t mean everything that comes after is easier, just because you know who you are. Saoirse quickly found this out while looking into the process of transitioning in Ireland.

“Legally, it’s been quite easy – thank God for self ID! One form and a €10 witnessing fee to a solicitor later, I’m legally the real me.

“That whole process took less than two weeks, including postage to and from the Department of Social Protection in Leitrim.

“I’m officially, legally Saoirse – got my Gender Recognition Certificate! I’m absolutely over the moon, now I just need to update my birth cert, port, payroll and pension info, public services card, bank info, medical info, Revenue info, college transcripts, and probably a million more things. And then do it all again for the American side of things. But hey, good problems!”

Medically, however, there have been a few more significant bumps in the road. Saoirse says transitioning through the public healthcare system feels like “being stranded on an island, waiting for a ing ship”.

And she did what many of us would – she took to the web to find out what she might expect from the public system as a transitioning individual, and she wasn’t put at ease. She found dozens of “heartbreaking” stories of humiliating and combative hours-long psychiatric interviews in an effort to ‘prove’ they are transgender.

Hopefully, Ireland will eventually adopt a model of gender-affirming care at the GP level, as some other places have.

Saoirse’s experience with private healthcare has been relatively better, but at a cost.

“You do pay dearly for every step of the process.”

She approached an informed consent service for adult patients, which included intake forms, an info-gathering session with a medically accredited counsellor, monthly hip fees, prescriptions issued by doctors in their network, medications and follow-up info sessions and blood tests, “all paid for ad hoc. I think I spent somewhere in the neighbourhood of €500 to €600 before I got my first prescription, which cost about another €120 to fill at the pharmacy.

“While private services are filling a gap in the public system that desperately needs addressing, they are still private companies dealing with the inherent tension of providing life-saving care for a group of people who are disproportionately poorer than average – myself very much included in that group – versus profit motives.”

The appeal of setting aside and paying money to go private, according to Saoirse, is “when you show up and say you’re trans, the response is more along the lines of, ‘Great, let’s get started and make sure you’re clear on what this will be like,’ as opposed to ‘But are you really, though?’

“We need total transformation [of public healthcare] in the practical realities of getting to see the relevant doctor, and I think also in the underlying assumptions on which gender-affirming care in this country is based, chief among them that we don’t know what is best for ourselves.

“Trans healthcare occupies a relatively unique niche in the medical system, in that being trans isn’t a disease or affliction externally recognised or tested for and cured or mitigated, but a state of being and identity that should be affirmed and nurtured. Things do not have to be the way they currently are.”

It’s easy to wonder why anyone would put themselves through a process that is at best arduous and at worst could be humiliating and dismissive.

But Saoirse’s transition journey has changed her life for the better.

I feel so much better, and more confident and excited. I think that has sort of spilled over into all areas of my life.

“You are the only person who knows who you are, whether transitioning is right for you, and what that transition might look like or entail.

“There are as many ways to be trans as there are trans people.

“So many people feel the exact same uncertainty, pain and fear, and you deserve to share in the overwhelming joy of being the truest version of yourself.

“And if you do decide to explore who you are or might be and come to the conclusion that you’re not trans, well that’s great, too! Now you’re living as the authentic you, on purpose.

“You deserve to be yourself, and you deserve to be happy. There is still time.”