Transgender people in the Republic of North Macedonia face a number of problems, including stigma and discrimination by society, as well as by state institutions. The biggest problems the transgender people face are the lack of a law on regulating gender recognition and the presence of discrimination and stigma in accessing health services.
More about how transgender people are accepted in the Republic of North Macedonia and what is their access to the adequate health services they need, speaks Predrag Jovanovski in this interview.
How does the society in the Republic of North Macedonia accept transgender people?
– In general, I think that we are not accepted at all, to the extent that there is no room for discussion on the topic of acceptance by society, in many aspects. Starting from the environment, the educational process, the healthcare and other state institutions that offer services, also other institutions such as banks, all the way to the system that practically does not recognize our identity, and thus directly establishes the practice of direct discrimination.
However, there are positive exceptions like acceptance from the inner social circle, which does not always happen all at once, but still improves the quality of life of the individual.
Have you ever been discriminated on the basis of your gender identity? Tell us about your experience?
– The very impossibility to change the sex marker in personal documents and the poor quality of healthcare system and it’s services I see and experience as a kind of the strongest discrimination, which in itself entails a number of other situations of discrimination, as well constant exposure to the risk of it. Given that a simple service in a bank, or a simple health service is a huge challenge, which is delayed only because of the ‘different’ treatment, I can freely say that I experience discrimination at least once a month.
Do transgender people in the Republic of North Macedonia receive all the necessary health services?
– No. Getting healthcare services precedes a series of consultations with people from the community, who have experience, searching for sensitized doctors, who regardless of your gender identity will provide you with appropriate service, no matter what the problem and need is – subjectively, I don’t consider that as an appropriate health protection.
On the other hand, the lack of information and disinterest of doctors on transgender people, the medical transition, the whole process and the ignorance of the specific problems inherent in the community, for me personally is totally absurd and unacceptable.
In short, in order to receive adequate health services, we need to have complete health care that is accessible, non-discriminatory, and medical staff that is not only sensitized, but also educated about the health of transgender people.
What transgender people in the Republic of North Macedonia need most from a health point of view?
– As I mentioned, first of all we need sensitized, but also educated doctors who will be able to answer to our problems, and also to be available here for us.
We also need a more accessible medical transition, not only from an endocrinological point of view, but also from a surgical one. Simplified and easier access, from a systemic, administrative, but also financial aspect. Here I would like to mention the need for surgeons for gender reassignment surgeries in the country, in order to have a more accessible but also cheaper process, unlike the option we have now, which is a trip abroad for the same surgeries. Greater availability of hormones, especially estrogen in ampoules, which is not yet available in our country.
Do you think transgender people are at high risk for HIV?
– Although the MSM population and gay men are the main focus as a risk group, transgender women are still the most risky group for HIV, so I would say that we, as a whole community, are affected from it.
What is the access of transgender people to HIV and sexual health services?
– The services offered by public health institutions are avoided, and are almost never used due to the unaware medical staff, the discriminatory attitude, but also the unchanged documents.
The services offered by the non-governmental sector are practiced due to the staff that is sensitized, the relationship with the client, but also the availability to them.
How do you feel life is going generally? What are the best areas of your life? Are there elements you wish you could change about it?
– Overall well, excluding my unchanged documents and the related institutional issues, I would say my social life is pretty okay. However, there are certain circles of people who do not have prejudices and are accepting us as who we are.
I am most satisfied with the fact that I started my medical transition, and almost all my close people supported me in that, but also with the fact that there are more and more people who are open to diversity and do not discriminate. I am pleased that there are organizations and activists who not only fight for more rights, but also help and give emotional support, but above all are there for the people from the community.
The only thing I would change for now are the documents, ie the law on legal recognition of gender and the possibility to change the sex marker in personal documents, which I am sure will facilitate and improve the quality of life of all the people in the community.