What services are available to trans people in Kyrgyzstan?
Kyrgyz Indigo publishes a new study "Mapping services available to trans people in Kyrgyzstan in medical institutions" with a list of medical services and contacts of specialists available to trans people in Kyrgyzstan.
Thanks to the document, you will learn the terms and get acquainted with the news concerning the International Classification of Diseases of issue 11, with an overview of Kyrgyz realities affecting the quality of life and access to services for trans people.
2019 was an intensive and productive year, including in the context of research. Kyrgyz Indigo continues to initiate and conduct, support research that highlights different areas of life of LGBTI people.
We present our new study on mapping services available to trans people in medical institutions in Kyrgyzstan conducted by Kyrgyz Indigo with the support of the Eurasian Coalition for Men's Health (ECOM). This study is the second in Kyrgyz Indigo, conducted and designed entirely by people from the community.
The first such study on the attractiveness of HIV services for GBT communities can be found here. The creation of such analytical materials is an important indicator of professional growth and increasing the potential of both Kyrgyz Indigo and the community itself.
Demographic data.
The study, which covered the capital and regions of the country, was conducted in Bishkek for three months. The purpose of the study is to map the services available to trans people in medical institutions in Kyrgyzstan. In general, the study covered 21 people: 13 trans people took part in focus group discussions, 8 in in-depth interviews.
The age of the respondents (-b) is from 19 to 28 years. Over the past 12 months, respondents needed various services related to regular illnesses, as well as HIV and mammoplasty surgery, in connection with treatment after a transphobic attack.
Most of the respondents received the medical services they needed. Respondents did not receive services due to the discrepancy of the passport appearance or lack of financial resources. Some respondents expressed a desire to receive hormone therapy and undergo surgery.
Respondents mostly receive services from non-governmental LGBTI organizations, where they are redirected to friendly medical professionals who have already interacted with trans people and have not had negative feedback within the community.
Public [services for us are those] where you don't have to show your genitals.If the problems [related to health] are simple, then they are served normally, — FGD participants
The main conclusions of the study:
Centralization of trans-specific or trans-friendly services is very high. Services related to medical and legal transitions are available only in the capital. Services in the context of HIV and other sexually transmitted infections, as well as in the context of tuberculosis, turned out to be the most accessible for trans people in the country. However, according to the international TRANSIT guidelines (two TRANSIT-based trainings were conducted by CI in Bishkek), without access to trans-specific services related to transitions, preventive programs will never be effective. The work should be comprehensive and trans-friendly.
The service map shows that services may be virtually inaccessible to trans people due to a variety of factors.
— If there is a service, then in Bishkek,
— If in Bishkek, then only a few doctors;
— If there are several doctors, then only a few can be friendly;
— For the whole country, one specialist from the units may have experience, — from the long-term
practice of observing trans people.
A trans person can contact a medical specialist IF:
- lives in Bishkek or can come;
- knows where a friendly doctor is located;
- knows how to explain the discrepancy between appearance and passport data,or has a passport that correlates with appearance (rarely concerns friendly doctors);has confidence and little sensitivity to ignorance of trans issues from specialists;there is an opportunity to take time off from work (which a trans person could hardly find);no need to take off your outerwear (rarely concerns friendly doctors);no need to take off underwear and show genitals (rarely, but also applies to friendly doctors);there is money to pay for the reception or the expected purchase of medicines after visiting the doctor;takes care of his health;there are no other specialists or strangers in the doctor's office.
The incentives for obtaining services in such cases are:
Support of close people (family, friends);
Knowledge about the organization and its resources;
Previous positive experience of contacting a (friendly) doctor, including someone else's experience;
Severe pain / persistent illness;
Free or low cost of treatment.
The study is also practical, along with recommendations, there is a map of services in Kyrgyzstan and a voluminous list of trans-specific services marked whether it is available or not, with addresses, contacts and responsible persons, there is information about international projects providing services, including to trans people. In the document, the organization describes the methodology, but also the research tools created. The report touches on previously little-studied topics about the relationship of trans people with ambulance work, about involvement in sex work, the difficulties of intersex people in need of a transgender transition.
Based on the results of the study, the following recommendations were developed:
State structures:
To continue demonstrating the political will aimed at recognizing transgender people as citizens and guests of the country who have the right to protection and protection of health through access to medical care, care and treatment, including access to medical goods and services, emergency medical care, other health-related services, as well as the availability of state and municipal medical institutions and the private health sector.
To develop and adopt a national mechanism that comprehensively prohibits discrimination on various grounds, including on the basis of gender identity.
Make efforts to implement the activities of the Government's program to overcome HIV infection for 2017-2021 and the plan to implement the recommendations of the Committee on the Elimination of Racial Discrimination together with trans communities.
Promote the opening and operation of a separate clinic (or within an existing institution) with medical, psychological spectrum services, with medical specialists providing trans-competent services and knowing the specifics of the physical and mental health of transgender people, where preferential medical care for transgender people will be provided.
Initiate and support research on transgender people, including HIV prevention and factors affecting vulnerability and increased risk of HIV, such as migration, involvement in sex work, stigma and discrimination.
Support initiatives to train medical professionals in the context of transgender people's health.
To conduct a study to assess the number of trans people for the effective work of prevention programs in the country.
LGBTIQ organizations, initiatives and interested non-governmental, international organizations:
To achieve decentralization of services for transgender people: to create partnerships and systematically train medical specialists through KSMIPiPK, to develop opportunities for informing trans people in other areas besides Chui (including in the national language).
Plan and conduct training for medical students on transgender issues and the specific health needs of trans people.
To support and develop LGBTI initiatives in other areas besides Chui: to invest in organizational potential and development, to prevent burnout of local activists.
To inform LGBTI communities about transgenderism, diversity of trans communities, including in the context of different sexual orientations, non-binary, to develop loyalty to various mental health conditions, people involved in sex work, taking psychoactive substances.
To lobby for the supply of high-quality feminizing hormonal drugs to the country and access to them.
Inform transgender people about the availability of various medical services, about tools for monitoring and evaluating the quality of services provided to inform organizations about reproductive health.
Consider various channels of informing those transgender people who do not have access to NGOs or the desire to go there, for example, through trans people acting as equal informants.
Conduct research on intersex people, including those with a transgender identity, to understand the community and its needs and needs.
To conduct a study on trans-feminine (and possibly trans-masculine) people involved in sex work to fill the information gap, describe existing challenges and barriers.
To participate in the implementation of the country plan for the transition from ICD-10 to ICD-11: to create a working group to discuss the examination procedure for transgender people, including the possibility of creating separate offices in the interim or temporary integration of examination services in the CSM.
The full report of the study on mapping services available to trans people in medical institutions in Kyrgyzstan can be found here.