19/01/2024 | Writer: Gözde Demirbilek
We asked Peer Counselor Utku Kutbay from Muamma LGBTI+ Association about their studies on mapping gender affirmation process.
We asked Utku Kutbay about the studies on mapping gender affirmation process conducted by the Muamma LGBTI+ Association. We talked about how they started to carry out this study, what they wanted to achieve with this mapping , what kind of difficulties they faced while working on the project and his personal observations about the mapping study, the fourth edition of which has been recently published.
“We have had several meetings with trans+ people who want to contribute to us”
When did you start mapping gender affirmation process and what led you to start?
The idea for carrying out a mapping study on the gender affirmation process took shape with the establishment of the peer counselling service unit of our association. Before becoming a peer counsellor, I was a member of the volunteer service unit of the Social Policy, Gender Identity and Sexual Orientation Studies Association (SPoD). Here we already had a list that we had used in our consultancy work. This list was quite similar to our study in that it contained information about the cities where the gender affirmation process was being carried out. But the list was in need of an update. As we thought that this could be a good evaluation for the new service unit of Muamma LGBTI+, the peer counselling, we decided to take a closer look at it. Thus, we tried to reach out to trans activists and closed trans groups to update the information there. We held several interviews with trans+ people who wanted to contribute. We unveiled the information we had gained from their experiences by sending them the questions we had created beforehand. We then visualized this information through a filter and finalized the study. We shared it with institutions that provide consultancy to LGBTI+ people in the field of LGBTI+ rights. The study was launched a year and a half ago. We have updated it four times to reflect the new information that has come to light.
The main need underlying the study is the uncertainty caused by the lack of a standard for the gender affirmation process. We believe that this study is essential to remove this uncertainty and to clean the dirty data.
What is the aim of this study?
The main purpose of the study is to help LGBTI+ people who want to start the gender confirmation process or who want information about the process to have access to this information. In addition, the gender confirmation process has a multifaceted impact on people, both financially and emotionally. With the implementation of this study, a number of people have told us that they do not need to change their city any more. That is very valuable. Through our work, we have been able to facilitate people’s processes by making information visible. So much so that the belief that the gender affirmation process is only taking place in two central cities like Ankara and Istanbul and it is still quite dominant. This study also shows us some facts in the long process. We can see that LGBTI+ people do not have easy access to the right to health. This situation is becoming more difficult with the changing economic conditions. In addition to this, the fact that health services in Turkey are becoming even worse with each passing day is another fact we came across while updating the study. We have seen that in many university hospitals the process of gender affirmation cannot be carried out due to a lack of doctors and many departments have been closed. In this sense, our mapping study is also a picture of Turkey.
“The biggest challenge is that the data is constantly changing”
Where do you get information about the general situation in hospitals? Do you have any means of verification of the information you have at hand?
We get all the information through the experiences of LGBTI+ people who have already started the affirmation process or who have applied for it. I define our study as a living study, a study in which there can be constant changes, additions and subtractions. That is why we feel it is important to update the information we have collected. In order to verify the information, we have also tried to contact health facilities or the health workers who work there. We have also met with experts who have provided us with information, although the responses have not always been positive. In general, our sources of verification are the people who contact us. Many people took part in the study to provide information. In this sense, we can say that it was a collective work.
Are there any challenges you face when integrating data for mapping?
The biggest challenge is that the data is constantly changing. For example, let’s imagine for example a hospital has a team of experts who take the initiative to run the transition process. If some of these experts retire or leave the hospital, the transition process can no longer be carried out there. This is a very immediate and changeable situation. As a result, follow-up is a time-consuming and labor intensive process.
“The bureaucracy caused by the legal aspect of the issue is at a point that wears people down financially and emotionally”
Since you started monitoring, have you seen any significant changes in the number of hospitals offering gender affirmation procedures, in the attitudes of health professionals, in the length of bureaucratic processes for clients?
I would like to do a little bit of an explanation of the four updates that we have had so far. We were able to see the existence of the gender affirmation process in some cities that we had not heard of before in the first period when we started the study. That was something that made us very happy. However, we were informed that in many hospitals the process was no longer being carried out in the latest updates. There are of course a number of reasons for this. Earthquakes, changing hospital capacities, not having enough health professionals are some of these reasons. Recently, due to the lack of experts, we have seen that some polyclinics in some hospitals have been closed. Looking at the overall picture, this situation is in line with the migration of health workers abroad.
If we focus on the situation in hospitals where the gender affirmation process is taking place, we see that homophobic attitudes of doctors have increased recently. People can be subjected to certain practices that are incompatible with the affirmation process. To tell the truth, experts are very inadequate in responding to people’s requests for information. There are still outdated psychological tests that are carried out as a matter of procedure. People are still able to access the right information through their peers.
But aren’t there any role models?
Role models include specialists who are experts in their field and who have trained their staff in this area. In general, there are good examples to be found in well-established university hospitals in large cities. Transgender group meetings are organized in some hospitals. We find this to be very valuable.
These bureaucratic obstacles are the most prominent need of the clients who contact us regarding the gender affirmation process. Although the situation in the hospital can be managed in some way, the bureaucracy caused by the legal dimension of the issue is at a point that wears people down financially and emotionally. The study and adoption of role models from the international arena can help to transform this bureaucratic obstacle.
How can users of relevant platforms who are in the process/thinking of starting the process follow a path against the information pollution on social media regarding the gender affirmation process?
There is so much misinformation about this issue that there are groups who deceive people, especially about the process of gender affirmation, who frighten them by deliberately spreading false information, and who earn economic income by advising people and increasing that income day by day. Individuals as well as institutions and organizations concerned with the dissemination of correct information have a responsibility here. When it comes to the economic dimension of the problem and the gender surgeries, I see that the search for the most suitable place is dominant for people. At this stage it is important to learn experience from more than one person. People can get experience transfer from activists who work on the issue in non-governmental organizations or civil initiatives. Kapsama Alanı and Trans Istanbul Initiative are two of the relevant civil society organizations working on sexual health of transgender people. I think it is important to contact with similar communities and associations in order to access services and resources.
Translation: Selma Koçak
Tags: human rights, media, life, health
