More and more people are seeking the assistance of the Trans-Team at the Landspítali University Hospital. A clinical psychologist, who’s a member of the team, says that the team tries to provide the best help they can, but more funding and manpower is needed.
“The increase has been massive in the past few years, I would guess around two individuals on average seek our consultancy each month,” says Elsa Bára Traustadóttir, clinical psychologist at the Landspítali University Hospitals Trans-Team.
According to Elsa the team tries to provide the best help they can. However more funding and manpower is needed . “None of us are on the team full-time, they’re part-time positions that we have along with other obligations. There used to be two clinical psychologists on the team but now I’m the only one. I wish more people were added to the team, we’re under a lot of pressure to meet new people wanting to enter the process but we’re swamped and unfortunately, there are waiting lists for surgeries. This could be resolved with more funding.”
Speaking of waiting lists, it has been pointed out that long waiting lists can be dangerous for trans people, who are at higher risk of depression, and are at higher risk of suicide, than the rest of the population. That it can have serious consequences. “That’s true, but we try to give people their first appointment as soon as we can. Then people sometimes need to wait to get an appointment with me, sometimes not. Now the wait can be between two-three months, but I don’t expect that will last for long. We try to reach out especially to individuals dealing with mental issues, they are in priority, and give them and others the best possible help.”
“I wish more people were added to the team, we’re under a lot of pressure to meet new people wanting to enter the process but we’re swamped and unfortunately, there are waiting lists for surgeries. This could be resolved with more funding.”
The people who seek the Trans-Team’s help are people who seek any sort of procedure or treatment to help with “gender correction”. But according to Elsa they are not necessarily individuals who want to undergo a extensive gender reassignment surgery, since (extensive or not) “gender-confirming” surgeries (for example genital surgery) are not essential to every trans person’s identity. Some of the team’s clients now are merely asking for a partial “correction” to make them feel more comfortable in their own skin. The starting point for most people is to have hormonal treatment (the for wait for the can be at least three months after a patient gets a diagnosis, which can take at least six months) and Elsa says that many people leave it at that. “Hormonal treatment often causes enough changes in appearance so that people feel much better afterwards. However, most trans men also want to have their breasts removed but often that’s enough surgery for them.
Most of the people who come are just people who want to exist in our society as having a different gender than what was assigned to them at birth, different than what the National Registry claims they are. It’s more about being able to go about your day being perceived and treated as the gender that you identify with and want to be recognized as.”
Elsa says that the increase in people seeking for partial “gender correction” procedures can to some extent be explained by the fact that a couple of years ago, health authorities ceased trying to assign only female or male genders to people. Nowadays, there isn’t the demand that people either identify as male or female but Elsa explains that that kind of viewpoint was understandable to begin with. “That’s how the medical sciences saw the world, that there were only two genders and people wouldn’t be asking for medical help unless they wanted to go all the way in gender reassignment surgery. We just didn’t realise how broad the LGBT spectrum was and we just didn’t understand gender variance struggles. Now we realise that there aren’t just two genders and that not everybody is just either male or female.
But also, twenty years ago, Icelandic health authorities just didn’t have any solutions for trans persons, we didn’t start offering them services until 1997. Before that, people were just told to move to Sweden where this kind of service was very advanced. Until one day, one trans man refused to do that and practically camped out in the reception of the Directorate of Health and waited and waited until the Director of Health gave up, called some doctors and said something had to be done,” Elsa recalls. And that was the beginning of medical services being offered to trans people in Iceland.
“They thought it would be around two individuals a year who wanted to undergo gender reassignment surgery and to start with, it was mostly thanks to the interest of a few local physicians who wanted to explore this field. And because it was thought that people would want to undergo extensive gender reassignment surgery, health authorities wanted to tread carefully and not perform irreversible procedures on someone unless they were absolutely sure it would improve their lives.
“… we just didn’t understand gender variance struggles. Now we realise that there aren’t just two genders and that not everybody is just either male or female.”
So, twenty years ago, the definition had to be very clear because we simply didn’t realise that people could be something other than male or female. Now of course, we know that people aren’t necessarily either or, that nobody is 100 percent male or female. Our main focus now is to make sure people aren’t living with psychological pain because of it.”
Today the Trans-Team consists of doctors, plastic surgeons, endocrinologists, a psychiatrist and a clinical psychologist who is Elsa, a speech therapist and a family counsellor. And it’s clear that things have changed. “We’re the ones who meet and guide the individuals when they seek help and make sure they receive the medical assistance they need. We’re not preoccupied with how people define themselves, to be honest, we couldn’t care less. Our number one priority is to help people deal with psychological pain. Though trans people aren’t mentally ill, some of the people who see us and struggle with incongruence when it comes to gender also experience anxiety, dysthymia, work difficulties etc. We also guide the way in terms of services for that group.”