Up to a few months ago, a friend of mine was dating a drug addict. They had been together for about two years when she finally had had enough of the drama, the mood swings and the police knocking at her door. She finally got out of the relationship running and screaming, hopefully never to look back. 

Another friend of mine dated a professional conman. She was with him for about three years during which he had 12 fake IDs and gave her seven stitches in her cheek. When she got out of the relationship she had four broken ribs, and for a while she had to move into three different safe houses. 

When either of these friends narrates their stories to other friends, they usually get a few shocked faces and a few curious questions but, soon enough, the focus goes back to the next glass of wine and business as usual.

I get fairly the same reaction when I mention that I once dated a man who had a medical condition that affects one in 10,000 people and which has a mortality rate of 41 per cent. But when I go on to explain that the condition I’m referring to is gender identity disorder (transgender), I end up picking people’s jaws from off the ground, and the questions never seem to stop coming. 

Despite this first-hand experience of people’s contrasting reactions, it still amazes me how the mere mention of anything related to transgender, intersex or transvestite can shock even the most open-minded of human beings.

People find the concept so difficult to grasp that they are even sceptical about the very existence of the condition. I believe that this is because very few people have been exposed to it first hand – primarily because it is quite rare in itself and secondly because those suffering from it usually prefer to stay under the radar to avoid stigmatic repercussions. 

In my experience, people find it easier to accept and understand the condition when there is inter-sexed genitalia in the equation, but almost impossible to comprehend when the person in question is not born with any outwardly or physical ambiguities, that is, when the person is not born with ‘different’ genitalia but simply grows up feeling as if they do not fit in the gender that their body dictates.

So, yes, whilst some of my friends dated conmen, criminals and even politicians, a few years back I dated a man who, 35 years earlier, had been born inter-sexed and then brought up as a girl. For the sake of this article I will call him Paul.

When Paul was born with ambiguous genitalia, the medical decision taken was to ‘fix’ his private parts to look like those of a girl and to bring him up as such. The decision was based simply on the fact that, medically speaking, the prognosis was better that way. After all, it is easier to surgically form a vagina than a penis.

The surgery went well and to all intents and purposes Paul now looked like a girl and the name on his birth certificate became Paula.

Paula was put in a pink baby-grow and was always told that she was a girl.

Despite not knowing about her medical condition, despite being dressed as a girl, sent to a girls’ school and brought up as a girl, Paula never ever felt comfortable in her own skin.

As a child, Paula’s favourite game was to sneak into her brother’s bedroom and wear his school uniform. She also gave herself a boy’s name and ‘as a favour’ asked her family to refer to her as such whenever they were indoors. ‘As a game’, she also insisted on peeing standing up, despite the obvious difficulty this position posed.

When Paula hit puberty she was put on artificial female hormones in order for her secondary female characteristics to develop. This is when she hit rock bottom. Whilst as a child she could get away with looking like a boy, now, with the hormones doing their job, she couldn’t get away with it anymore.  

By the age of 18, Paula started to feel that she was seriously well on her way to losing her mind.

She started to feel attracted to women but did not feel gay because she wanted people to see her as a man, treat her like a man, and to be a man. She struggled to stay on the straight and narrow and went through unimaginable hardships until finally she managed to raise enough money to have a sex change overseas. As you can imagine, the pain was not just physical and emotional but also financial, which, as with everything else, only makes matters worse.

Anyway, Paul’s is not my story to tell so I will stop here with the details of this particular case. What I’m more interested in – and elated to see – is that finally a government committee is evaluating adult gender reassignment surgery. This means that, in future, gender reassignment treatment and surgery could be offered free of charge by the NHS and carried out either locally or overseas.

At the end of the day we need to get it into our heads that people who need this type of surgery needs it as much as someone who needs a kidney transplant. It is not a choice to feel the way they do, and it could very well lead to death because being constantly unhappy and uncomfortable in one’s own skin is likely to result in suicide.

As things stand today, gender reassignment on children is performed on the NHS at Mater Dei, but when it comes to adults, only part of the reassignment process is available and not at Mater Dei but in private clinics. The entire procedure, which is usually the only solution for people with this condition, is not available locally and costs an arm and a leg – to the tune of €20,000 to €30,000.

Considering that people suffering from such a condition find it very hard to get a job because of their mental state and also because of the stigma that surrounds them, relieving them and their families of this added burden can only be a good thing. Yes of course, the arguments against offering this surgery on the NHS will be that there are more pressing conditions and situations that we should prioritising, but it’s only those who haven’t been touched by or experienced this condition first hand who will argue this way.

Gender Identity Disorder is a real condition with potentially grave consequences. Many of those affected become socially isolated, either by choice or through ostracism, resulting in dangerous levels of low self-esteem. The feeling can be so pervasive that the lives of some individuals revolve only around activities that do not heighten their gender distress. Most become obsessive with what is referred to as “passing” as the opposite sex. And, worst of all, a 2011 study concluded that the suicidal ideation among patients with gender identity disorder, but no other psychiatric disorder, is as high as 72 per cent.

I am writing this on the morning of the Eurovision Song Contest – one which is likely to see Austria’s Conchita Wurst win – and, just to clarify the situation, Conchita is not transgender. He is not even a transvestite. Conchita is a drag artist who makes a living out of – and has fun – dressing up the way he does for performance purposes. His interest is not in passing himself off as a member of the opposite sex, otherwise he’d shave his face – right?

The message Conchita wants to send out is that we should be able to do whatever it is that we want to do, and achieve whatever it is we want to achieve, despite our appearance. A bearded lady is usually frowned upon and marginalised. I hope that Conchita manages to prove otherwise.