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Left Behind at the Margins: Advancing Trans-Inclusive Universal Health Coverage in Ireland

Project description

From exclusion to equity in Irish healthcare

Despite healthcare being a human right, transgender and gender-diverse (TGD) people in Ireland face significant barriers, including stigma and long waitlists. Supported by the Marie Skłodowska-Curie Actions programme, the TransHealth project will investigate how Ireland’s health system includes or excludes TGD individuals. By combining surveys and interviews with TGD people across five cities and analysing government policies, the project aims to identify specific obstacles to care. Working directly with TGD organisations and policymakers, the project will co-produce practical recommendations to improve services. Ultimately, the project’s goal is to reduce unmet health needs and provide actionable policy tools to ensure Ireland’s healthcare system is truly universal, inclusive and aligned with international equality standards.

Objective

This fellowship investigates how Ireland’s Universal Health Coverage (UHC) system includes—or excludes—transgender and gender-diverse (TGD) people, and identifies policy levers for change. Despite UHC being a recognised health right, TGD populations remain disproportionately excluded due to stigma, fragmented services, and intersecting vulnerabilities. In Ireland, gender-affirming care is centralised, waitlists are long, and commitments under UHC remain misaligned with lived realities.
The study applies a mixed-methods, intersectional case study across five hubs (Dublin, Cork, Limerick, Galway, Waterford). SO1 foregrounds TGD experiences through 30 semi-structured interviews and a descriptive online survey (n 75). SO2 uses Intersectionality-Based Policy Analysis (IBPA) of Sláintecare/HSE/EU instruments (2017–2025) and ~10 policymaker interviews, triangulating with SO1 to map barriers and enablers. SO3 convenes a participatory workshop with TGD organisations, providers, policymakers, and academics to co-produce feasible recommendations.
Expected outputs include a UHC-aligned gap analysis, joint displays linking lived experience to policy, a validated Policy Recommendations Guideline, two open-access articles, a policy brief, a closing roundtable, and public-facing outputs (webpage, briefs, webinars, media). Impact spans science (transferable UHC/TGD methods), policy (Sláintecare-ready levers), society (reduced unmet need), and economy (resource optimisation).
Hosted at UCD’s School of Nursing, Midwifery & Health Systems under Dr John Gilmore, the fellowship combines methodological rigour, Open Science, GDPR-compliant data management, and co-production. It contributes to the EU LGBTIQ Equality Strategy, the European Pillar of Social Rights, and SDG 3.8 while equipping the researcher with Horizon Europe–ready skills and strengthening career prospects across academia, health systems, and policy.

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HORIZON-TMA-MSCA-PF-EF - HORIZON TMA MSCA Postdoctoral Fellowships - European Fellowships

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Call for proposal

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(opens in new window) HORIZON-MSCA-2025-PF

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Coordinator

UNIVERSITY COLLEGE DUBLIN, NATIONAL UNIVERSITY OF IRELAND, DUBLIN
Net EU contribution

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€ 268 568,64
Total cost

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