Travelling for surgery during a pandemic; Trans* HealthCare

Fionn in hospital

It’s been over a year since the airports were closed down due to Covid 19 and we couldn’t go on holidays or to see family members abroad. I had to travel but it wasn’t for a sun holiday or for fun but it was for essential surgery. I know what you’re thinking… ‘Fionn, we are in the middle of a pandemic… why did you travel?’ Well, the answer is – I had no choice. 

I am FTM (female to male transgender).  There’s no public surgery options for trans* people like me in Ireland, meaning we have to travel abroad for treatment including during the Covid-19 pandemic. I would have preferred to have the surgery at home, but that wasn’t an option for us.

The doctor who previously carried out double mastectomies (Top Surgery) as part of the public healthcare in Ireland retired last year and has not been replaced. There is a limited private option, but this costs around €12,000 in Ireland and has a long waiting list, whereas Poland is half the price.

I had my first private Top Surgery (a masculinising procedure to remove breast tissue) in London in September 2019, but it did not work as planned as my surgeon left extra breast tissue and skin in my chest so I needed to have it revised. This surgery including expenses, time off of work, etc cost me around €10,000. However, my transition cost me around €15,000 as I had to use private healthcare for hormone treatment as well. 

Fionn recovering in hospital

In February, I went to Warsaw in Poland to undergo my revision for my first Top surgery. This surgery was booked nearly a year and a half ago before COVID. I had to travel abroad, like most trans people in Ireland. I was terrified. I was grateful that my friend Noah Halpin could come with me, but many people have to travel alone or at least get someone to travel with them. I was grateful that Noah could take 3 weeks out of his life to help me. Without him I don’t know what I would have done.

Top Surgery in Warsaw has a waiting list of around 2 years but costs around €4,500 with Dr. Lembas, a leading European specialist in this area. My understanding is that the bulk of his trans* patients are from the Republic of Ireland. Overall, this surgery cost me about €6,500, including flights, food, accommodation for myself and Noah, and medication.

The flight to Warsaw was stressful as there was no social-distancing on the flight and mask-wearing was not enforced. I had six COVID tests, (all negative) that cost me around €600. Four in advance of flying, one before surgery, and one before leaving Poland. COVID has made things much more difficult including paperwork and isolation before and after surgery. 

Noah & Fionn in Warsaw

Flying abroad for medical reasons is deemed essential travel but trans* people shouldn’t have to travel in the first place. Of course I’d like for it to be done at home but unfortunately the Irish healthcare system makes us go abroad, which I think is absolutely disgusting and unacceptable to send ANYONE abroad for healthcare that should be available in our own country.

Once again there was no social-distancing on the return flight and again mask wearing was not enforced. We tested negative for Covid-19 the day before they flew home, and were isolating together in Noah’s.

Unfortunately I developed a seroma, a build-up of fluid in my chest. I was told by my surgeon in Poland to go to my GP to get it drained but unfortunately my GP said he wasn’t trained to do it so I was referred to A & E. When I arrived at A & E I was told they couldn’t do it because I had surgery abroad. After some time of explaining my situation and that I would have been sent over by the HSE scheme that I was told to come back in 2 days to have it drained. I was in a lot of pain and the fluid moved in my chest making it uncomfortable  and making me nauseous. I was told that I would have an emergency appointment within the plastics department but when I rang them they told me I was discharged (without me knowing). I rang my local health care clinic and talked to a lovely nurse who told me A  &E shouldn’t have refused me and a GP should do it. Sadly, my GP will not as he said he isn’t trained.

Where does this leave me now?

I’m lost. I’m disheartened. I’m upset and mad at the healthcare system in this country that discriminates against me and members of this community.

The lack of training in our health service for trans* people is extremely apparent to me since having my surgery abroad. There is essentially no aftercare for trans* people in Ireland. Every doctor is sending me to another doctor and nobody seems to know what to do for me. 

I contacted my surgeon in Poland and he told me that the drainage is very simple and he even gave me tips about doing it at home with a friend. This shouldn’t have to happen to me. Ireland needs to look at investing in surgery options for trans* people in Ireland, and training GPs so that they’re aware of the aftercare they need to give trans* people who have gone abroad.

The only real way of me getting anything done is for me to fight. I’m lucky that I am able to do so and lucky to be in a Students’ Union that will help me fight, I’m lucky to have many friends who will help me fight. But sadly not everyone is a fighter. Some lose this battle. But it shouldn’t be a battle to be yourself in the first place.

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