Transition is the process of aligning internal and external gender characteristics with one’s expression, which helps transgender people express their gender identity to a certain extent, which they decide for themselves. Medical gender confirmation, on the other hand, represents the alignment of internal and external gender characteristics with gender identity with the help of hormone therapy and surgical interventions. The transition process is different for everyone and may include: psycho-social support, hormone therapy, surgical interventions, or a combination of multiple interventions and treatments.

But transgender people in our country face inequities in access to health care. In addition to the stigma and discrimination they suffer from health professionals, they also have limited access to services they need in their everyday lives. Transgender people who decide to start a process of medical gender confirmation face even greater obstacles, caused by the lack of information about the basic steps for obtaining hormone therapy, but also the lack of quality hormone therapy, the small number of medical staff familiar with the needs and problems of transgender people and the unavailability of surgeries for medical confirmation of gender. Because of this, transgender people often navigate the labyrinths of the health care system when they want to access the process of starting hormone therapy. The most common questions they ask are: “Which hospital should I go to?”, “Which doctor should I see?” and “Are hormones covered by the State Health Insurance Fund?”.

Therefore, we explain the steps to access hormone therapy…

Before starting the process of receiving hormone therapy, transgender people should first consult a psychologist and a psychiatrist, from whom after several sessions they will receive a finding and opinion, with which they should consult their family doctors. If a person does not have a family doctor, TransFormA offers help in choosing such a doctor. Then, from the family doctor, the person should ask for a referral to an internist who refers transgender women to an endocrinologist, and transgender men to an endocrinologist and a gynecological examination. The endocrinologist then directs patients to do blood and genetic analysis and to check hormonal status. After completing these tests and receiving the results, the endocrinologist prepares a report with prescribed hormone therapy, which the family doctor prescribes on a prescription.

For help or consultation, TransFormA is at your disposal and is available at transformamk@gmail.com, on Facebook and on Instagram.

What is transgender?

Gender is a set of bodily and genital sex characteristics, as well as secondary sex characteristics. Gender is inscribed at birth as a biological determinant according to visible anatomy.

Gender is a sociological and cultural manifestation of identity established by a societal idea of what it means to be male, female, neither, or a mixture of the two. Gender identity is the manifestation of one’s own gender through an inner sense of self or in other words personal gender identification. Gender identity is not visible to others. Gender expression is the way people express gender identity through name, pronouns, clothes, behavior and other gender characteristics.

Gender may or may not always coincide with birth sex and exists independently of it. When sex and gender coincide, it is a question of cis-gender and it is a cis-gender person. If gender and sex do not match in any way, it is a matter of transgenderism and a transgender person. Transgenderism is a comprehensive term for both: a transgender person whose gender identity does not match the gender assigned at birth, as well as for persons who express themselves differently from the gender assigned at birth.

Legal gender recognition is a process in which transgender persons officially change the personal data that refer to gender designation in their personal documents. This process may involve several legal procedures such as changing the first and last name, changing the gender marker or the social security number in personal identification documents.

Social transition

Some of the steps you can take in the transition process refer to processes related to the environment in which you live, work and express yourself. These steps may include sharing with family, friends and colleagues, using the chosen name and addressing it with the appropriate gender.

Medical confirmation of gender

Every transgender person who wants to start a transition process with medical gender confirmation needs a medical team, consisting of family doctor, psychiatrist, psychologist, internist, specialist, gynecologist and endocrinologist. This team should be sensitized to work with transgender people, but also familiar with the key needs and problems faced by the transgender community.

E.D.

Photo by Daniel Liévano, courtesy of TheGreats.co