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“Russia will ban everything for transgender and non-binary people, leading to an underground surgery market,” say human rights activists

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On June 14, Russia’s lower house of parliament, the State Duma, passed a bill banning “sex changes” (the wording the authorities use to describe some stages of a transgender transition) through surgery and changes in legal documents in its first reading. The Duma has already issued a statement saying that “sex changes are a myth,” leaving an exception only for children with congenital abnormalities. Members of the Duma Committee supported the bill, and recommended that the body pass it.

As two experts who work with LGBTQ+ people explained to The Insider, the Duma insists on the use of the incorrect and transphobic term “sex change” and wants to pass the toughest version of the bill, which would ban everything for transgender people – from changing one's documents to undergoing surgical manipulations. In the end, the legislation will lead to an underground surgery market and an increase in cases of gender dysphoria (stress and dissatisfaction with one's assigned gender role), said the experts.

Nef Cellarius, coordinator of the LGBTQ+ transgender peer counseling program for the group Coming Out (Vykhod):

“‘Sex change’ is an incorrect term used to simplify [the concept]. But no one in the LGBTQ+ community speaks that way, it’s considered incorrect and transphobic to say that, as “medical sex” is made up seven different components, and not all of them can be “changed.” If we say that a t-person (a transgender person) “changes sex,” we obviously don't expect him to be able to change, for example, chromosomal – aka genetic – sex. So what sex are we talking about?
It is to avoid creating these medical conflicts that the term “transgender transition” is used. It's the same thing, but more tactful and without any questions about its substance or meaning. Transgender transition in Russia today involves three independent processes. A trans person can perform one, two, all three, or none.
The legal transition is a change of identity, the medical transition involves changes to the body, and the social transition is integration into society according to one's gender identity. Again, you don't have to do the ‘full package.’ There are people who, for example, change their documents and make a social transition, but don’t resort to medical interventions. Or, conversely, there are those who take hormone therapy, but don't change their papers for whatever reason. It is equally correct to say that all three people are going through a transition.
At the moment, the Duma is considering the toughest version of the bill, which would prohibit absolutely everything, including a change of documents and any medical manipulations, whether it be surgery or hormonal therapy. And this is a real nightmare for many transgender and non-binary people.
Unfortunately, even now there are people who are secretly taking hormone therapy (HT). It's worth noting that HT is a major component of the medical transition. Hormone therapy is often a sufficient treatment for a person to stop experiencing gender dysphoria. HT provides noticeable changes to one’s appearance if properly selected by a competent doctor.
Taking hormones on your own is dangerous to your health and can lead to irreversible consequences, including putting an end to the whole transition process. Unfortunately, even now there are people who are doing it themselves [without medical supervision]. We fear that with the law coming out, there will also be an underground surgical market, which could certainly lead to terrible consequences for the health and lives of transgender people.
And no one ‘changes sex’ in a passport just because a person looks like a man, for example, but the person's documents are female. Even now, in order to change a gender marker and be allowed to undergo surgery, a commission of four specialists is required: a sexologist, a clinical psychologist and two psychiatrists. By the way, a patient's observation before the commission can take up to two years, so it’s not always a quick process. It’s possible to change one’s documents only with a positive conclusion of the commission. With the introduction of the new law that will not be possible either.”

Igor Kochetkov, human rights activist, one of the founders of the Russian LGBT Network:

“A transgender transition is not a legal concept, but rather a sociological one. It refers to the entire process – including a person's social adaptation. It can start long before surgical and legal actions and continue throughout one’s life, and even after it is done, as full integration is a complicated thing. In my opinion, it’s better not to use the phrase ‘transgender transition’ in the context of this law.

The notion of a ‘sex changes,’ which is present in this bill, was invented by these illiterate State Duma MPs, who also passed the law on [LGBTQ+] ‘propaganda.’ It was then that the concept of ‘sex change’ first appeared in the legislation, and what it is is not entirely clear. In the old legislation there’s a concept of ‘sex change,’ and by this we mean a very specific thing – a change in one’s civil status records. The ‘sex change’ concept was used in Russia’s law on civil status acts back in 1998, and that law is still in force.
This bill, which the Duma is going to consider in two readings today, includes the abolition of this provision, that is, the fourth paragraph of Article 70 of the law ‘On Civil Status Acts.’ The possibility of making entries in the acts of civil status and the possibility of changing the gender marker is destroyed, meaning legal ‘sex changes’ would be prohibited.
As for medical actions, it doesn’t mention operations – it says ‘any medical interventions.’ I do not know what is meant by this, but I assume that there will be some clarifying wording in the second reading. At least the Ministry of Health will insist on that. The committee of the Ministry of Health assumes that the bill requires legal and technical revision in terms of terminology and clarification in terms of the laws ‘On Health Protection’ and ‘On Civil Status Acts’ being synchronized.
When the responsible committee passed the ‘propaganda’ law in December, they also wrote that the wording needed to be clarified, but they did not clarify anything. [Russia’s] state apparatus has entered a stage of chaos where they do not follow their laws, or their regulations, or their recommendations – or rather, they give them, but do not follow them. So it’s unclear whether anything will change in the second reading.
In fact, the law prohibits people from getting the medical care they need because no one cancelled the ICD-10 diagnosis of transsexualism. [It describes] a condition in which a person needs medical care. That’s a fact, because that condition leads to gender dysphoria – that is, serious stress, depressive disorders, and risks of suicidal behavior. In this condition, people need professional medical care, and here this law prohibits medical professionals from providing medical care. For the practice of Russian law, this is a precedent that is dangerous not only for transgender people, but for all of society. Tomorrow they may pass a law that will forbid the provision of care to diabetics. What if they have some ideological considerations about that?
Carrying out a ‘sex change’ at home is impossible – it's not even an abortion, which can technically be done at home. If we're talking about surgical procedures, can you take out your appendix at home? And those are much more complicated things. There are genital surgeries, breast surgeries, and so on. If a man tries to cut off his own penis at home – they say there have been precedents of this – and if such a man is saved, he will probably just be placed in a psychiatric institution. Of course, that won’t be grounds for a change of identity. There will be no such grounds now.”

In December 2022, Russian President Vladimir Putin signed a law completely banning the “propaganda” of non-traditional sexual relationships and transgender transitions. According to the law, one can can be fined from 50,000 ($600) to 800,000 roubles ($9500) for LGBT, pedophilia and “sex change” «propaganda» among individuals of any age. The vague wording of the law may cover anything that seems similar to LGBT “propaganda” to the authorities. In May 2023, Kommersant reported, citing the head of the State Duma Committee on Family, Women and Children's Issues, Nina Ostanina, that amendments would be introduced to the State Duma to ban transgender transitions in Russia, as well as the official change of one’s gender marker in legal documents without a surgical procedure.

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