The manual for medical and healthcare professionals on providing services and support to trans persons in the transition process presented in Sarajevo

In September, Sarajevo Open Centre published the publication for medical professionals and healthcare workers on providing services and support to trans persons in the transition process, in scope of the “Positive Action Programme for MSM & Transgender People” project that is supported by ViiV Healthcare UK Ltd. The manual “Medical Aspects of Gender Reassignment” is written by trans activists and medical experts from Montenegro, Croatia and BiH. The manual presentation took place on 14 September 2018 in the Sarajevo hotel Courtyard by Marriott where the authors, trans activists Jovan Ulićević (Montenegro) and Liam Isić (Bosnia and Herzegovina), together with psychiatrist Tea Dakić (Montenegro), presented the manual’s content, and pointed to the issues transgender persons face in the domain of healthcare and legal protection.

The aim of this manual is raising awareness on the needs of transgender persons, on providing adequate healthcare services and support to transgender persons in the transition process, as well as opening the discussion on specialisation of medical professionals in the gender reassignment procedures. To the presentation the organisers invited the medical and legal experts from the Bosnian-Herzegovinian healthcare institutions, in order to present to them the broader picture of the current situation regarding transgender persons’ protection, and ways to improve their status in BiH. Also, the relevant stakeholders from politics, institutions that promote and protect human rights were invited, as well as the ones from the domain of social protection, NGOs that provide psychological counselling and support, and doctors from expert medical associations.

In her part of the presentation, Tea Dakić, MD, presented the evolution of the concepts that relate to gender identity, the outdated and offensive terms in the field of mental health, the improvement of knowledge on the transgender matters, as well as the shifts in social attitudes, policies, laws and human rights standards. Jovan Ulićević and Liam Isić presented their parts of the manual that relate to the trans specific services and support that trans persons need in the gender reassignment process, and pointed out the need for Bosnia and Herzegovina to establish teams and educate its medical experts who could follow the process and lead the medical gender reassignment procedures in BiH, as well as the need for healthcare institutes to establish the duty to cover the costs of these procedures from their health insurance fund.

Contributions to writing this manual were made by the medical experts who deal with the gender reassignment and have long experience in working with transgender persons. The manual is unique in the region and represents a significant step towards improving the regional trans specific health care. In order to cover all the healthcare spheres for transgender persons, the process of writing the manual included a psychologist, psychiatrist, endocrinologist and surgeon who wrote about the medical gender reassignment procedures, while trans activists wrote about the problems and needs of transgender persons and offered guidelines for adequate, trans specific, inclusive and available health care, based on depathologisation, individual approach, informed consent and viewing transgender varieties, above all, through the context of variety of identities.

The human rights of transgender persons are violated in many countries, with several exceptions – the countries that started dealing with solving the issues transgender persons face (Malta, Ireland, Norway, Denmark, Belgium). However, countries in the Balkans region do not belong to those exceptions, which means that the protection of human rights of transgender persons here is at a very low level. When it comes to the rights of transgender persons in BiH, it is extremely important to start talking about this topic, having in mind the fact they do not have the needed health care, nor legal protection, that derives from the non-existence, lack of regulation and implementation of legal solutions. These are all reasons for writing more about this topic, so publishing this manual and its presentation are of great significance for the struggle towards fully exercising the human rights of transgender persons.