Trans activists called on the State Duma not to ban gender reassignment
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A bill banning Russians from changing their gender in medical and legal terms will be considered by the State Duma on Wednesday. In this regard, activists of the Russian transpersonal community sent a petition to parliamentarians and the Ministry of Health of the Russian Federation demanding to abandon the initiative. They warn that denying trans people the opportunity to transition will worsen their mental health, increase their risk of discrimination and violence, leading to increased substance use and involvement in sex work, and ultimately increase their risk of contracting HIV.
The State Duma will consider in the first reading on Wednesday bill on the prohibition of sex reassignment operations, with the exception of cases of treatment of congenital anomalies in children, as well as on the prohibition for the registry offices to update documents based on medical certificates of sex reassignment. initiative recall, were introduced by the deputies of all five Duma factions, headed by speaker Vyacheslav Volodin. On Tuesday, the media quoted MP Irina Filatova, who noted that the Ministry of Health has not yet submitted an opinion on the bill. Ms. Filatova had a question: what does the ministry really care about? In this regard, the press service of the department recalled that the Government of the Russian Federation sends comments on bills to the State Duma, and the Ministry of Health submitted its proposals within the time limits established by the regulations.
Meanwhile, change.org posted petition, addressed to the State Duma and the Ministry of Health, with a request to withdraw from consideration the bill, “limiting the possibility of changing the civil sex and receiving medical care for transgender people.” At the time of publication, it was signed by about 3 thousand people.
The author of the petition, transgender researcher Yana Kirei-Sitnikova (formerly a member of the Yabloko party, Gleb Sitnikov), points out that the possibility of changing the civil sex has existed on the territory of Russia since 1926 (circular of the NKVD of the RSFSR No. 146). In 1991, the first Soviet clinical guidelines on transsexualism were approved. In 1997, the federal law “On acts of civil status” was adopted, which provides the opportunity to change gender if a “document issued by a medical organization” is presented.
“Medical and legal assistance to transgender people has a long history in the USSR and Russia. Stopping or tightening the standards for its provision will lead to a serious deterioration in the health and well-being of transgender people,” the petition says.
According to Yana Kirey-Sitnikova, those who, for some reason, put off changing documents, now “rushed to do it.” She claims that there are known cases of refusal of civil registry offices to citizens on the basis of a law that has not yet been adopted. If it comes into force, transpersons will face a host of medical problems, Ms. Kirei-Sitnikova believes. She cites data from her own study, according to which among Russian trans women 99% need hormone therapy, 73% need vaginoplasty, 50% need mammoplasty. Among Russian transmen 98% need hormone therapy, 92% need a mastectomy, and 68% need a hysterectomy. It is still possible to receive such medical assistance in Russia under compulsory medical insurance, but only after the decision of a commission of a psychiatrist, psychologist and sexologist.
Depriving trans people of the opportunity to make the transition, according to the activist, will worsen their mental health, increase the risk of discrimination and violence, which will lead to increased substance use, involvement in sex work and an increased risk of HIV infection. Without documents corresponding to their gender identity and self-expression, trans people will be afraid to contact healthcare facilities, Yana Kirey-Sitnikova is sure.
Note that the exact number of transpersonal Russians is unknown. According to world statistics, this is 0.2-0.5% of the population. Thus, in Russia we can talk about hundreds of thousands of people.
“Transition is about helping you find your own identity. This leads to a decrease in the risk of depression and suicide in these individuals, their drug and alcohol addiction. That is, a well-established qualified procedure makes it possible to reduce the burden on official health care, ”says psychiatrist-sexologist Oleg Starostin. Mr. Starostin pointed out that in Russia until 2025 the International Classification of Diseases of the 10th revision (ICD-10) is in force, according to which transsexualism is a diagnosis. In this sense, the bill, according to him, is illogical, because it deprives patients of the opportunity to receive care under the current ICD-10.
“The devilry that has unfolded in Western countries around the topic of transgender people is unacceptable for our country,” Valery Fadeev, head of the Human Rights Council (HRC), comments on the petition. “Deputies do not want to allow this. And they can be understood. In no case should you promote the topic of transgender people, advertise it. What is being done in schools in some Western countries is unacceptable for us, and I support the deputies who stand guard over morality. But these people with such a not that distorted, but non-standard psyche should be treated with the utmost care, if possible.
According to Mr. Fadeev, in order to avoid the risk of suicide in this group, it is necessary to “responsibly and at the same time more carefully” approach the permission to change sex.
To consider each case, including predicting a person’s behavior in the event of a refusal to transfer, the head of the HRC points out, special commissions could (this is how the process is now arranged in Russia).
Yana Kirei-Sitnikova notes that in Russia it is possible to buy almost any hormone without a prescription, but if the law is passed, more people will do it illegally and without consulting an endocrinologist; doctors currently operating in the Russian Federation will probably move their practice to neighboring countries, so access to operations will remain, but they will become more expensive. Since this is not the first attempt to limit the rights of trans people, Ms. Kirei-Sitnikova has hope that this time the bill will not be adopted due to the intervention of the Ministry of Health, since “unlike deputies, a significant part of doctors understand the medical and scientific specifics of transgenderism.”
However, the ministry has already stated that they are in favor of strict regulation in this area. There are a number of objective medical situations that must be considered, such as those associated with congenital genetic abnormalities. The issue in each such case should be resolved on the basis of a limited circle of medical organizations of a high expert level, the department believes.
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