Inequality

Inequality 

Discrimination is an overwhelming issue in Irish society. There is a multitude of ways the State systemically disadvantages women, particularly those of minority ethnic backgrounds, traveller and Roma inclusive. Below are three issues among many we must address to further our goals of economic justice, security and equal access to healthcare. 

Period poverty 

Menstrual hygiene products are necessities, not luxuries, and should be treated as such. No woman, girl, intersex, transgender, or non-binary person who menstruates should suffer the physical and mental health impacts resulting from a lack of access to period products.

To ensure the dignity of each citizen is upheld:

1.     We urge both houses of the Oireachtas to pass the Period Products (Free Provision) Bill 2021. This would ensure the general availability of period products free of charge within schools, education institutions and public service bodies. 

• We stress the State must guarantee that the homeless and those in direct provision centres have access to these essential items.
• We further ask that a proportional supply of hygiene products be placed in all bathrooms to help validate those struggling with gender identity and gender expression. 

2.     Amend the Health and Safety guidelines to give period products the status of essential hygiene products, akin to toilet paper, to mandate their availability.

3.   Ensure period products are a tax-deductible expense so businesses may afford to freely provide them.

Equal Right to a Nightlife 

As highlighted by today’s media, there has been an increase in spiking, particularly by means of needle injections and date rape drugs in drinks. We are eager to see the standard of accessibility and safety in the nightlife sector be drastically improved. We implore the government to fund and regulate a standardised accreditation that can be awarded to venues that: 

1.     Create a specialised response protocol for customers that suspect they have been spiked. This should be then made clear at the entrance of their establishments. This encourages venues to move away from a system where vulnerable people are thrown out to the streets late at night.

2.     Provide training to supervisors and security on how to assist when reports of sexual harassment have been made by staff or customers. We specifically recommend the recently announced vulnerability training courses being launched by the Department of Tourism, Culture, Arts, Gaeltacht, Sport and Media.

3.     In recognition of evolving standards for inclusivity, assure that facilities are accessible to those with disabilities and gender non-conforming individuals.

Ultimately we believe licensing should be connected to measures put in place to protect customers, and we hope the State invites industries to join discussions on this issue. 

Health Care Inequality 

We aim to inform people of ways in which the HSE and other leaders of Irish Healthcare can better address issues that specifically affect women, and hope to encourage more fruitful discussion. We recognise that the budget is already set and the financing of all these improvements may be delayed. However, challenges within our healthcare system should be publicly known so that issues pertaining to women's health are recognised, acknowledged and addressed through open discussion.

Women’s Care Requirements:

When revising the SláinteCare plan, we ask the Department of Health to apply particular focus to the following issues: 

1. Menopause Care

• 1 in 9 women develop breast cancer and often experience worse symptoms of menopause. Breast cancer survivors cannot be provided with hormonal replacement therapy to treat their pain, along with many other individuals who for example may have premature ovarian failure or intercurrent diseases. This leads to a drastic decline on their management options for menopause.
• Many women cannot afford to buy hormonal replacement therapy, thus exacerbating a lack of access to appropriate care. 

We call upon the Department of Health to build on the work they are already doing to increase access nationally to menopause care, and that specialised care is readily available to all those who require it.

2. Gynaecological Appointment Delays

That there are 30,000 women who have been waiting over 18 months for their first gynaecological appointment and that it becomes a recognised priority. 

3. In-Vitro Fertilisation Services

Despite the European Parliament’s call for universal access to infertility treatment in 2008, Ireland is one of only three European countries that does not provide public funding for IVF. This has created a financial barrier that is insurmountable for many, and further impounds the already traumatic experience.

We wish to outline that there is a need to fund IVF services in the public system.

4. Free Contraception for Women

We welcome the government's commitment to the introduction of free contraception, but express a hope that it will be expanded to women of all ages who require contraception, and not just the 17-25 year old age cohort, although we endorse that this is a good place to start.

Unconscious Bias 

Many women are systematically ignored and invalidated by the current healthcare system. A vast number are turned away by professionals on the basis of a combination of stigma, systemic racism and socio-economic inequality. This is a traumatising and invalidating experience many suffer and cannot be allowed to continue.

1. We wish that the following issues are acknowledged by the State and are reviewed by the Department for Health:

• Endometriosis being dismissed as ‘normal period problems,’ contributing to an average 9 year delay in diagnosis. 
• Women suffering from chest pains that are less likely to be addressed as cardiac-related issues. For example, women have a starkly higher misdiagnosis rate for heart attacks than men. 
• Women with dark skin being falsely assumed to have a higher pain tolerance. 
• The drastically higher rate of maternal and perinatal mortality in pregnancy in black women than white women. 
• Young women presenting with symptoms of PCOS, endometriosis, adenomyosis, cervical cancer and other illnesses denied access to care solely based on age.
• The need for enhanced national services to support gender affirmation.

This unconscious bias is a failing in the healthcare system which should be dealt with in a swift manner. Hence, we urge that the government develop unconscious bias training for all medical staff. We advise the State to create a campaign that promotes its Intercultural Awareness Programme, but also builds upon its foundation to recognise bias towards gender, disability and membership of the LGBTQIA+ community. Furthermore, development in this programme should invite collaboration from specialised Non-Governmental Organisations.

2. Tackling systemic failure that disadvantages marginalised groups’ access to healthcare services

• Implement the Patient and Public Involvement (PPI) model in research projects to promote all patient involvement in health service design and delivery. (Women’s Council of Ireland)
• Fund interpreting services for healthcare institutions as this is currently self provided. Furthermore, it must be ensured multilingual services are available online so migrants can fully understand what their healthcare options are. 

The State cannot rely on the family of non-English speaking patients to translate as this is a violation to the patient’s right to privacy.  

• Streamline access to maternity care and counselling services for those in Direct Provision, who are five times more likely to develop mental health issues.

Neurodiversity in Women

Neurodivergent women (for example with Autism, ADHD, Tourette’s syndrome) are often denied essential resources and interventions as a result of underdiagnosis or misdiagnosis. Most research on neurodiversity focuses on men and how they present with symptoms. It is essential the State funds research to recognise symptoms in girls and diagnose them swiftly.

1. We ask the Minister for Higher Education to provide resources for the ground-breaking research on neurodiversity in women. This should include how symptoms present differently in women. 
2. In the Minister of State for Disability’s first Autism Innovation Strategy we ask there is an investigation taken into models such as DISCO that are more effective in identifying autism among women.
3. We ask the Minister for Special Education to ensure that in their review of the Education of Persons with Special Educational Needs (ESPEN) Act 2004 they provide further specialised whole-school training to accommodate all children who present with different symptoms of neurodiversity, further providing appropriate supports. 
4. Enhanced support for the screening of autism in adults and children who don't present with typical indicators. The HSE Autism Programme Board is due to pilot a new method of assessment and “intervention" for those on the spectrum, we ask that it be implemented nationally with specific reference to the barriers females have faced to diagnosis.