The process of gender affirmation and transition (Reading)

Transition is dealt with differently in the legislation of each country, so we recommend that you familiarise yourself with the practice used in your country. In any case, the process must begin with a personal decision to transition, prompted by the feeling that one’s gender identity does not match one’s sex assigned at birth. In some countries, a diagnosis and a number of medical examinations (endocrinological, internal, psychological, etc.) must be made prior to HRT or GAS. Part of the diagnosis can be the so-called Real Life Test, i.e. a person should start to live in the gender role with which they identify before the gender affirmation surgery.

Regarding the legal aspects, The Council of Europe demands that its member states provide for legal gender recognition, but 30 countries in Europe have robust legal procedures, and currently only 7 do not demand that trans people undergo sterilisation, or medical interventions, divorce, or a psychological diagnosis or assessment. These abusive requirements, or the lack of legislation altogether, mean that most trans people have to live with documents that do not match their gender identity. Gender recognition goes beyond  an administrative act: it is essential in order for many trans people to be able to live a life of dignity and respect.

Many countries in Europe still require trans persons to undergo sterilisation before their gender identity is recognised. The Human Rights Commissioner has critically remarked that “Transgender people appear to be the only group in Europe subject to legally prescribed, state-enforced sterilisation”. Other requirements may include diagnosis of a mental disorder, medical treatment, invasive surgery, assessment of time lived in the new gender identity, and being single or divorced. Such requirements violate a person’s dignity, physical integrity, right to form a family, and right to be free from degrading and inhumane treatment.

A relevant concept to be familiar with is gatekeeping.

Gatekeeping

Gatekeeping means controlling and limiting the access to the processes of gender affirmation. This happens most commonly in the medical field where transgender people can be denied the right to transition. Arguments by medical gatekeepers center around the belief that transgender people are wrong about their identity ( which notion is transphobic in itself), and they need to undergo months or even years of therapy before they can be allowed to transition.

Gatekeeping is  a form of transphobia, which we will discuss in the next reading.