Human Rights and Health of Trans* People

in Eastern Europe and Central Asia

Position Paper

On the International Day of Transgender Visibility 2017, the Eurasian Coalition on Male Health (ECOM) declares its position on human rights and health of trans*[1] people.

We stand beside trans* people around the world and especially in Eastern Europe and Central Asia. Trans * people are inseparable part of us and we work together to achieve our mission.

We recognize the diversity of trans* people and gender identities or a preference for not having any identity, and we respect the right of everyone to self-determination of gender and sexuality.

We recognize that trans* people are an especially vulnerable group, subject to stigmatization, discrimination and human rights violations, particularly related to their access to health services.

Trans* people from Eastern Europe and Central Asia still remain invisible to the general public and to health programs in our region.

  • The problem of constant violation of trans* people’s human rights rarely become a priority on the agenda of human rights and health organizations.
  • There is very little research done on trans* people.
  • The service providers don’t take the specifics into account; trans-feminine people are included in MSM programs, while trans-masculine people who have sex with men are excluded from prevention programs even to a greater extent.
  • Stigma impedes possible self-organization of trans* people and, as a result, their voices are left unheard and the resources aren’t sufficient to build capacity of their community.

We recognize the grave problem of legislative gaps impeding the legal recognition and implementation of human rights, which includes, but is not limited to the following issues:

  • The right to self-determination of gender identity is not ensured in the national legislation.
  • Absence of regulations to make changes to official documents to confirm a person’s gender identity. Regulations requiring surgical interventions (sterilization) for the legal recognition of gender, as well as unclearly formulated regulations, giving the freedom to interpret them at one’s will.
  • Identification documents don’t adequately reflect gender identity, which results in limited access to a range of services, such as health and education, as well as employment and voting processes.
  • Absence of laws and regulations ensuring the effective provision of gender-affirmative services and care.
  • Absence of anti-discrimination laws ensuring equal rights to work and education, parental rights, equal rights to marriage and adoption.
  • Criminalization and stigmatization of sex work, which can be a possible source of income, especially for trans* women.
  • Some countries in the region still criminalize same-sex relationships.

We recognize the particular vulnerability of trans* people to HIV and the following factors that contribute to this vulnerability:

  • Transphobia and a very low understanding of the challenges trans* people face in health care and HIV services.
  • Violence against trans* people.
  • Involvement in sex work and unprotected sex.

We emphasize program gaps in health care, including HIV-related services:

  • Pathologization of trans * people. Transgender identity is still defined as a mental illness, which infringes an independent decision-making process for trans* people. Trans* people are treated as mentally ill in some countries.
  • No assessment of trans* people health needs, including in HIV-related services, insufficient research data on EECA in general.
  • Lack of HIV prevention and treatment services focused on trans* people.
  • Failure to present the data on trans* people, when in HIV projects, trans* people are considered the same target group as MSM or are not included into target groups altogether.
  • Lack of activities to train and raise their awareness of healthcare staff.
  • Insufficient systematic research in impact of hormone therapy on the risks of HIV infection and transmission, drug interactions, other health effects, as well as the exclusion of trans* men from testing of biomedical HIV prevention tools.
  • Violation of reproductive rights, including the requirement to prove one’s sterility to change the gender marker in the identity documents.
  • Lack of free access to gender-affirmative procedures and surgery for those who need it.
  • Failure to recognize trans* people as experts by the medical community, which obviously makes any consultations or interactions with local trans* communities impossible.

We recognize other rarely addressed challenges that trans* people face:

  • Clinical depression with suicide attempts.
  • Dependence and use of drugs and alcohol.
  • Sexually transmitted diseases.

We recognize the high vulnerability of trans* people living in such special conditions as:

  • Prisons, psychiatric clinics, refugee camps and other closed settings.

Taking into account these key challenges, the Eurasian Coalition on Male Health (ECOM) reaffirms its commitment to promote:

  • Health of trans* people and realization of their human rights.
  • Mobilization and strengthening of the trans* community.
  • Cooperation and solidarity between trans* people and other communities vulnerable to HIV.
  • Better understanding of trans* people’s needs and improve legislation to ensure equality, respect for human rights and dignity of trans* people.

[1] In this document, the term trans* is used to describe transgender people, nonbinary and gender nonconforming people, including (but not limited to) transgender, transsexual, gender queer, bi-gender, agender, etc. This corresponds to the terminology adopted by GATE, Global Action for Trans * Equality (

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