Álfur Birkir, the new chair person of Samtökin ’78, the queer organization of Iceland, says the healthcare system in Iceland is in need of funding for queer programs.
It’s a funny thing to say when the entire healthcare system is falling apart at the seams with staff shortages and a lack of funding in general. However, Álfur says “we need to push for money within that for trans-specific healthcare. We just can’t get lost in the shuffle.” He adds: “I am doing advocacy. These are systemic problems, yes. We do not pay our healthcare workers enough and they don’t want to stay. That’s going to continue to be a problem and none of our other problems will be taken care of until that one is solved.”
“In the last two years, only four gender reassignment surgeries have been performed and people have waited more than 16 months.”
In his opinion, the wait for gender affirming healthcare services is still too long. “Since we’ve had this gender autonomy act the waiting list for trans medical care has become longer. I think that’s because people feel that the medical support they need hasn’t increased in accordance. Rightly so, they are entitled to medical support but the capacity hasn’t matched it,” he says, pointing out how even if parliament moves a step forward the healthcare system may still be a few steps behind, not ready to implement the freshly penned law.
“Within Iceland the gender autonomy act needs some corners smoothed out a bit. It was approved in 2019/2020 but there are still exemptions. For example, intersex kids have some conditions that are entirely social and not medical that allow surgical alterations. And that’s a permanent alteration on the body of a child at the age of 6 months. It’s just crazy,” he says.
Then there’s a long wait and some uncertainty when you finally do get into the program. “The trans teams for both adults and children are doing the best they can or are improving what they can. But we’ve also heard stories that they’re saying they’re improving things but that’s not what’s actually happening. We just need to have these conversations and be the middleman,” says Álfur.
“Trans people are in a situation where they can’t really criticize the team that’s giving them their life-necessary healthcare. They don’t want to jeopardize their own position. I think that it’s important that we get people into the system as fast as we can but I also think we need to smooth out the timeline of care a bit. Of course, we’ve had covid, but we haven’t had a bottom surgery since December 2020. It’s a very long time for someone to wait. We just have to make sure we’re not lost in line when it comes to the healthcare system getting the assistance it needs. I mean, that might take 3 years. For a lot of people waiting for surgery for another 3 years is just not possible,” he clarifies.
These waiting periods and uncertain timelines can also disrupt the most sensitive time during a person’s transition, particularly if they’re going through puberty. “Eleven months is a long time in the life of a child who is undergoing unwelcome puberty. In the last two years, only four gender reassignment surgeries have been performed and people have waited more than 16 months.”
Álfur recognizes that it’s a small country and a small department of healthcare workers that are serving the queer community. He mentions that pointing out the ways the system needs to improve is paramount while also appreciating the overburdened staff trying their best day to day.
Read the full length interview with the new chair of Samtökin ’78 here.