Sexologists will "treat homosexuality"
Prior to the preparation of a bill that would infringe on the rights of trans people, the Ministry of Health issued an order according to which sexologists' offices could appear in Russian polyclinics and neuropsychiatric dispensaries. The document was published back in November last year, but it was with the adoption of the new bill that its purpose became clear. Now sexologists will have to provide assistance to those who suffer from "mental disorders associated with sexual development and orientation" or have problems with gender identity, as well as people with "family-sexual disharmony, sexual dysfunction." At the same time, the sexologist has the right to apply "coercive measures of a medical nature."
Regional authorities actively began to fulfill the order of the Ministry of Health this year, after a heated discussion of the bill banning "sex change". So, in the hospitals of the Khanty-Mansiysk Autonomous Okrug, sexologists intend to "treat homosexuality," the district health department told Ura.ru. The department clarified that sexologists will "help individuals suffering from mental disorders associated with sexual development and orientation, disorders of gender identity and sexual preference."
As clinical psychologist Yegor Burtsev told The Insider, it will be almost impossible to open the offices described in the order, and every year there are less and less qualified sexologists in Russia. Transpeople, on the other hand, can only hope for specialists with a good education who will not try to “correct the situation” when people are forcibly sent to them, as required by the authorities.
“Now it is important to note that, as an addition, it is proposed to open offices for the treatment of LGBTIQ+, offices of sexologists in each district clinic. Let's start with the fact that it is almost impossible to open these offices, the number of sexologists in Russia decreases every year. There are even fewer qualified specialists, because we do not train sexologists separately, but train them from psychiatrists. Recently, the opportunities for this training have been significantly reduced. Two points remained in St. Petersburg and Moscow.
Doctors are different, and some doctors understand that in such cases it is impossible to treat anything, as it was in Soviet times. Now science has advanced much further, people are learning and, I hope, they are learning well. It can be assumed that good specialists, even if someone is sent to them – although an adult cannot be sent by force, but only a teenager – they will not do this behind closed doors. Let's hope so, but we are well aware that there will be those who will try to rectify the situation.
What will happen to hormone therapy?
To make the "medical transition", some transgender people opt for hormone therapy. Often it is enough for a person to stop experiencing gender dysphoria, explained The Insider in the LGBTQ+ group Exit.
However, the new bill prohibits hormone therapy, and self-administration of hormones is dangerous to health and can lead to irreversible consequences. According to psychologist Egor Burtsev, some trans people had problems accessing drugs and tried to get them on their own due to supply problems:
“As for hormone therapy and surgery, we know that not only transgender people, but the entire population of Russia lives without following any laws, but trying to find loopholes to get around them. In hormone therapy, everything was not always good with supplies – sometimes they were interrupted or not delivered to the regions. At that time, people were simply looking for the opportunity to purchase hormone therapy in sports mix stores, in illegal semi-underground stores where these drugs could be bought. What quality they are is the question.
Now, probably, the same thing will happen. As we have seen, there are exceptions for intersex people, so people will start looking for all sorts of genetic abnormalities – which, however, some people have – and on the basis of this they will receive hormone therapy. In addition, hormonal therapy is prescribed by gynecologists, urologists, andrologists and endocrinologists. I think that all this will be possible, the main thing is to understand where to go and how to prepare. Plus, there are always friendly doctors.”
“In the 90s, people performed operations on themselves, lost their testicles or a penis”
The psychologist commented on the ban on surgical procedures contained in the bill. According to the new amendments, it is prohibited to carry out medical interventions aimed at changing the sex of a person, including the formation in a person of primary and (or) secondary sexual characteristics of the opposite sex. The psychologist clarified that the practice of the 1990s, when some transgender people performed these operations themselves under local anesthesia or alcohol, could return to Russia.
"Organ-carrying operations without grounds in Russia and in many other countries are not done. There are opportunities to make them in other countries for some other reasons, but it is difficult to do this in Russia. I am very afraid of the return of the practice, when in the 1980s, 1990s and early 2000s, some transgender people performed these operations on themselves, roughly speaking, just with a knife under local anesthesia or alcohol. This is especially true for transgender women who have lost their testicles or penis in this way. It's terrible and horrible, but it happened. I hope that these radical situations will not happen, but they are not excluded. Demand creates supply and, probably, in some semi-underground clinics they will do this: doctors are intimidated, but this is not excluded. Another option is for people to travel somewhere and receive this help.”
In fact, people will be able to try to make the transition abroad, but this requires additional costs, the psychologist continued. At the same time, it will be impossible to get an opinion from a doctor in another country, but it will be impossible to return to continue the transition in Russia, including changing the column in the passport. According to the draft law , a “document on the “sex change”” issued abroad will not even be the basis for making changes to the birth record in the registry office.
State Duma banned international diagnosis
The new bill and its justifications by officials contradict the Tenth Revision International Classification of Diseases (ICD-10) of the World Health Organization (WHO). In the ICD there is such a diagnosis “F64. 0, transsexualism" is officially defined as "the desire to live and be perceived by others as a person of the opposite sex, usually accompanied by a feeling of discomfort from one's anatomical sex or a feeling of inappropriateness of one's gender." According to the psychologist, the State Duma, by banning people from trans-transition, essentially banned the diagnosis, but no one canceled the operation of the ICD in the country – it is according to this classification that diagnoses are still made in the Russian Federation.
“In fact, the State Duma banned the diagnosis. It is still in the ICD-10, according to which Russia lives. Imagine that we would suddenly ban, for example, the flu. It's all unproductive, it interferes with work. They would just ban the flu and treat it – and deprive people with the flu of the opportunity to have children or something like that. This is complete absurdity. It turns out that the State Duma by a majority of votes, without conferring with the Ministry of Health, and even putting pressure on the Ministry of Health, prohibits the diagnosis. This in itself is not a wake-up call about trans people, but about what is happening, and what can happen in the country, and what can be done to anyone.
Now not much is written about trans people, unfortunately, there are many jokes and undermining even among the opposition media. This is a wake up call. As someone who works in the field of public health and develops experience with vulnerable groups, I can say that vulnerable groups are being discredited: people with HIV, people with tuberculosis, people who use drugs and sex workers. They will start with these vulnerable groups and prohibit them from providing services, but it is possible that in this way they will get to any psychiatric diagnoses. The next step is like in Stalin's times, when people were sent to psychiatric clinics for treatment simply for dissent. It can go far."
The fact that Russian President Vladimir Putin is a direct continuation of Stalin and personifies the “neo-Stalinist regime” was previously stated by historian Yuri Pivovarov in an episode of The Insider podcast “Honestly.”
"It will get even harder"
The psychologist emphasized that all of the above will negatively affect transgender people. They have previously encountered problems when coming out, and now both the family and society will adopt all the new theses of the authorities and propaganda, which will finally taboo the topic and prohibit transgenderism in Russia:
“Unfortunately, gender dysphoria is treated with hormone therapy, surgery and changing the gender marker. This is part of affirmative therapy, that is, therapy that helps trans people not experience problems with physicality, with social interactions, and so on. Withdrawal and denial of these medicines to people is a direct risk of depression, self-harm and suicide, despair and problems with the family. If earlier it was not easy for trans people to come out, now many families will listen to what the authorities say. In fact, transgenderism is completely prohibited in Russia. Teenagers or young people who are dependent on their parents are now at a huge risk. It has always been difficult for them, and now, probably, it will be even more difficult.