"A person just disappears"

In Russia, sex change is prohibited. This can lead to deaths

The State Duma adopted in the first reading a bill prohibiting any actions aimed at changing the floor. The ban applies to both medical interventions - surgical operations and prescribing hormonal replacement therapy, and changes in the Gender column in the passport and other documents.

According to the current (so far) legislation, transpersons must pass a medical commission and get a certificate of the established form in order to contact the registry office to change documents.

The parliament is going to change two federal laws - “On Acts of Civil Status” and “On the Basics of Protection of the Health of Citizens in the Russian Federation”, which will partially deprive the rather narrow social group. There are less than 28,000 translies in Russia. Only about a hundred surgical operations are carried out per year as part of affirmative therapy, they are carried out by only five surgeons. To go through the doctor’s commission and get a certificate of form 087/y, most transperson contacts private clinics, fearing discrimination in state institutions. They will recognize each other in advance how and where the commissions go, go to other regions. The refusal to make a diagnosis receives only 6.1% of those who applied.

Hormone replacement drugs are needed for life. The cessation of admission or even a short -term break can be dangerous.

Trans-woman L. 31 years old, she made the transition seven months ago. She began to take hormone replacement therapy, went through the commission and received a certificate to change the gender marker in the documents. The adaptation process has begun. She worked with vocal specialists to achieve the desired sound of the voice. On the day of our conversation, she received a notification that the new birth certificate was ready. There is still a change in the passport.

The first signs of gender dysphoria - personality disorders, in which the floor established at birth does not correspond to the internal sense of gender identity, L. remembers from early childhood. It was not possible to communicate with peers, to be interested in what occupied the rest of the boys, to dress in typically men's clothing. In adolescence, this led to an attempt by suicide and the followed forced hospitalization.

- There was a relationship with the girls. But it is impossible to make someone happy if your only thought is all the time: "I want to escape from here, I want to close the door." Thoughts came that maybe I am just gay, or that from birth there is no ability to affection, love, similar emotions. I really wanted to understand what is wrong with me.

Due to problems with the motivation and heavy episodes of apathy, protracted depression, L. threw the institute, could not find a job and stay on it, became indifferent to her health and body, went into a binge. She stopped leaving the house.

“I will do anything, just not to return to that existence.” If you have to get drugs in the black market, I'll go to it. On hormone replacement therapy, without any antidepressants, psychotherapy, I was able to defeat severe depression. Until December last year, in order to go outside even once a month, I had to prepare for several days. I could not communicate with people. Even just call the courier of delivery or talk with friends online was a huge problem. I did not manage to decide on the transition, even realizing myself. After the onset of hormonal therapy, it turned out that the world has paint, there are smells, food has a taste! For many years, I distinguished only salty, sweet and acute ... Literally after a few days of taking hormone replacement therapy, I first felt that vanilla, it turns out, has a smell, and an amazing, very bright taste. I can go out somewhere, I can talk to someone or even several people.

According to Yana Kire-Sitnikova, a transgender researcher, transgender people in Russia do not apply for a diagnosis and help for several reasons:

• Lack of money for contacting doctors and the passage of the commission (56.0%);

• Fear to face incorrect treatment by doctors (34.1%);

• Minority (23.1%);

• The passage of the commission is difficult and takes a lot of time (20.9%);

• The diagnosis is not required due to the lack of plans to undergo operations or a change of documents (8.8%).

Transpersons are faced with discrimination in the field of employment, many are engaged in sex work, as a result of which they undergo higher risk of HIV infection and sexually transmitted diseases. Low self -esteem and the desire to confirm gender identity also contribute to the prevalence of risky sexual practices. Many consume alcohol and psychoactive substances.

According to the largest studies in the United States, 12% of the trans-people had sex work experience, 29%-the use of prohibited narcotic substances, 40% made at least one attempt at suicide. The prevalence of HIV among trans-women can be 49 times higher than the same indicator among the general population.

When I asked L. what would happen to her if, due to the new law, access to medicines becomes impossible, she replied:

- Death. Dysforias very much affects the personality, it destroys. A person stops choosing life, stops taking care of himself, getting out of the house, being treated, avoiding danger, eat ... He just disappears.

Egor Burtsev, clinical psychologist,

has been working with transgender people for more than ten years:

- The greatest concern now is about transpersons 18–25 years old. Those who have not yet had time to make a transition or just started hormonal therapy, ”he says. - Many people experience panic, anxiety, think to leave or try to urgently go through the commission. Someone about this law plunged into apathy and depression. For people who are fighting all their lives with gender dysphoria, which destroyingly acts on the psyche, fear of rollback, the inability to continue to receive help - great stress. This can lead to suicides in the community. The older generation is more calm, because they experienced the times when they had to sue for the change of documents, the operations were mandatory, and the drugs had to be taken out.

In Russia, several public organizations provide assistance to trans-people, they help with the commission of the commission, recommend specialists, provide free psychological and legal advice, help fight bureaucratic difficulties and form the supporting community.

Mark, volunteer of one of these organizations:

-The simplest explanation of how the transition for a person with a dysphoria is felt-your body first ceases to be perceived as something foreign, alien, abnormal. This happened to me literally after the first administration of the drug ZGT, my arms and legs became mine, I began to feel them like mine. I went to a psychologist in the process of transition, but the sessions only confirmed that my problem is physiological - in the body, not in my head. Many people, even from Trans-community, do not understand that operations, for example, is an important thing for many, but one-time. You can accumulate money, go abroad and survey. But access to drugs of hormone replacement therapy is what we need for life, our health and life depend on this. The ban, of course, will entail the growth of the black market, the risks of interruptions in taking, buying fakes, the change of drugs that is not controlled by the doctor to those that will work out. And for Trans-Muzhin, these are also problems with the law, since testosterone preparations are strictly controlled by the state. The cessation of taking hormonal replacement therapy is not only a forced reverse transition and a strong dysphoria, but also a blow to the endocrine system and in fact - death. Trans-like that got to the places of conclusion is another very vulnerable group. Yes, now they are subject to discrimination, bullying, violence inside the penitentiary system, but according to the law, if the passport is changed and there is a certificate, it is possible to at least transmit drugs. This is all of course, difficult, but real. If this is banned, any hit even in the police department for 14 days will be a direct danger to life for us, and any sentence to a long conclusion is mortals.