How are gender reassignment operations performed? Plastic surgery for gender reassignment abroad. Operation: from man to woman

Gender reassignment even today is not done very often, despite the fact that many people want to do it. It is worth realizing that an operation aimed at changing sexual characteristics is an extremely labor-intensive and lengthy process that affects all systems and organs of the body.

In order to understand how gender reassignment occurs and what its inherent risks are, you should learn about the main stages of this difficult procedure.

Main reasons

Features of preparation for gender reassignment depend on states a, on whose territory this operation will be carried out. In our country, as a rule, you will only have to deal with bureaucratic nuances that relate to changing documents. However, for a person with a firm intention to change his body and bring it into line with his sense of the world, this is not the worst problem.

It is impossible to say exactly what motivates people to resort to gender reassignment surgery. Only one thing can be stated: this desire is not considered a symptom of some kind of psychological disorder, because transsexualism is present in the official classification of diseases at the international level.

In most cases, before changing gender, a person has already adapted to the updated appearance. He uses appropriate hairstyles and outfits, may introduce himself by other names, etc. All this contributes to the fact that at one fine moment such a person will come to a specialized clinic and ask to change his body in accordance with his sense of self.

Preparatory activities

Preparing for surgery begins with a psychological examination, a thorough examination of the body and passing all the necessary tests. The patient must decide how labor-intensive and drastic the operation awaits him and how many procedures he will need to go through. In that situation, if he agrees with all the warnings, the doctor prescribes him a course of hormone therapy.

The specialist must make sure that the body can stably tolerate all prescribed medications, because after the operation the patient will have to take them for the rest of his life.

Hormonal drugs

When changing sexual characteristics Not only organs change, but also the general hormonal background of the body. It is noteworthy that it is hormone therapy, and not organ surgery, that is decisive for transformation.

The use of estrogen makes the body more feminine: the contours of the face soften, the hair in some areas of the body decreases, and the melody and pitch of the voice increases.

Androgens have the opposite effect, making the voice deeper, facial features rougher, and hair growth more intense.

It is immediately worth noting that in the Russian Federation there are some problems associated with the prescription of medications after gender reassignment, so some patients independently select medications for themselves, exposing their own health to significant risk.

The essence of sex reassignment surgery

Sex reassignment surgery is a procedure in which change of external genitalia to organs characteristic of the opposite sex. Here it should be understood that even if the operation is successful, a person will not be able to conceive a child. In addition, obtaining pleasure from sexual contacts will also be questionable.

Changing gender from male to female takes much less time. In this case, the plastic surgeon removes the penis and forms a vagina from fragments of the gastrointestinal tract and the remains of the genital organ. The transformation from a lady to a representative of the stronger sex lasts at least a year and a half. First, the surgeon removes the female reproductive organs. And only after ten to twelve months does he begin to form a penis using the female clitoris.

Additional procedures

After surgery and hormone therapy, gender transition usually ends. However, some individuals decide to go all the way, continuing to make changes to their body. Additional procedures include:

1. Hair removal using a laser beam;
2. Introduction of implants to increase bust volume;
3. Facial correction using fillers.

Rehabilitation period and consequences

Rehabilitation after such an operation is complicated by psychological adaptation and physiological restoration. If the preparatory measures were carried out according to all the rules, and the patient has no somatic pathologies, then the contraindications are minimal. The risks associated with transgender transformation are physiological and psychological.

The following possible complications can be classified as physiological:

However, almost all of these complications are reversible. After surgery, surgeons always give their clients the necessary recommendations that will allow them to avoid or at least reduce postoperative consequences. If difficulties do arise, you should immediately inform a specialist about this.

Regarding psychological risks, then they are primarily associated with an emotional crisis. It also happened that people who changed their sex died from suicide or begged doctors to return them to their previous sexual characteristics, since they initially did not want to look like that.

If you have this kind of problem, you should talk to professional psychologists or people who have already changed their gender. You can also write a book about your life or publish a blog on the Internet.

Cost of reincarnation

On the territory of the Russian Federation, such an operation will cost a very tidy sum: to make a woman out of a man, you will need about one and a half million rubles. For ladies who want to become men, the amount will be twice as much. Some people, in order to incur as little expenses as possible, turn to so-called medical tourism. For example, they go straight to Thailand, where you can change your gender from female to male for 400-700 thousand rubles.

However, not only the cost of transgender transformation deserves attention, but also the level of quality of the operation. It is not customary to save on medical services, although in Thailand such operations have been practiced for a very long time, because the local specialists have extensive practical experience.

Genital reconstruction operations are considered one of the most difficult. They take a long time, and the complete gender reassignment procedure, which is carried out, takes more than two years.

When changing gender to male, in addition to changing the genitals, if desired, the shape of the calf muscles is changed, the chin is corrected, and liposuction of fat deposits is performed.

Stages

Contraindications to gender reassignment are:
– mental illness;
– alcoholism;
– homosexuality;
– age up to 18 and after 60.

Breast removal surgery

Ovariectomy

Genital reconstruction

Therefore, most people prefer phalloplasty - a long and complex operation that requires tissue transplantation, but which creates a full-fledged penis of adequate size. Thanks to the placement of an erectile prosthesis inside, it has the ability to perform penetrative sexual intercourse. The operation is carried out in three stages. All stages take about a year.

In the postoperative period, physical and psycho-emotional stress is limited, sexual activity is prohibited, and regular visits to the doctor are recommended to monitor the condition.

Gender reassignment is an operation that is performed in many countries, including Russia. But not everyone is allowed to undergo such a procedure. You need complete confidence in your action, emotional stability and an understanding that it will not be possible to return everything back.

Instructions

Gender change is typical for those people who were born “not in their body.” The percentage of such cases in the world is not large. A person feels uncomfortable in his own body and is not ready to put up with inconsistency. Usually these emotions arise in childhood, and then only become more and more conscious.

To decide on a sex change, you need to see a sex therapist. A specialist will help you understand your needs and suggest what is worth trying in order to make a final decision. Usually heterosexuals go, but underneath this desire there may be a desire for homosexuality. It’s worth trying an unconventional relationship at least once in order to understand for sure whether there is a substitution of concepts and aspirations. Before operations, a conclusion from a sex therapist is required, with whom the person has been observed for at least a year.

Before you decide, consult a psychologist. After all, there is a long period of adaptation ahead. And this is almost always a very difficult moment. People with all types of temperament are not able to decide on such a period; many are not ready to endure such severe stress. He will also tell you how to prepare for the operation, how to approach this decision without doubt. The specialist will not dissuade you, he will simply tell you about the pros and cons, and will allow you to look at this transformation from different angles.

Before this, a period is necessary when a person begins to take special medications. Hormonal substances prepare the body for gender change and make the process safe. This changes external characteristics, reduces hair growth, and changes sexual arousal. Usually this process lasts at least a year, and during this time the patient can decide for himself whether he is comfortable in the new state and whether he is ready to take the final step. During this period, observations are also made not only of the physical body, but also of the psyche.

But before you go to the doctors, try living the life of the opposite sex. Today, a woman can easily dress up as a man and vice versa. It's better to do this in a place where they don't know you. Rent or buy an apartment in another city and start a new life. Live as if you have already changed your sex and have had all the surgeries. Find a job, try to meet interesting people, make interesting acquaintances. Learn to enjoy this life. But remember that this is not a game, but an experiment. If you don’t get bored after two or three years, if you really feel like you were born in the wrong body, then you should go to the surgeons.

note

The maximum number of sex reassignment operations today is carried out in Thailand; Iran ranks second in the world.

Tip 3: How often are gender reassignment surgeries performed in Russia?

Gender reassignment operations are not performed anywhere. After all, the biological sex of a person with whom he was born cannot be changed even with a scalpel. In the case of confirmed transsexuality, it can only be adjusted in the direction of gender - with hormones, cosmetology and surgery. But no one knows how often this happens in Russia. There are no statistics on transsexual operations. At best, they are classified under the heading “Plastic Surgery”. On par with mole removal.

MtF and FtM

Moreover, no one in the Russian Federation knows the exact numbers of the total number of vehicles, most of which have not completed any of the operations. Only plastic surgeons take them into account. One of the few countries where such statistics are still available is the United States - largely thanks to the tolerance of American society and the developed medical insurance system. According to North American researchers of the phenomenon of transsexuality, approximately one in 2,500 residents was subjected to surgical intervention at one time. And every year in this country from 1,500 to 2,000 operations to correct biological sex are performed.

High price

Not everyone, for example, knows that having begun the process of hormonal “transition”, in the slang of transsexuals - “transition”, most TS quickly lose not only their former families, friends and social circle, but also their jobs. And with it the sources of existence and material well-being. This applies to a greater extent to MtF, who are forced to expose themselves to serious external changes. With their emphasized femininity, they are unpleasant to most men.

Naturally, the lack of money and at the same time the need to provide for children and ex-wives, and many TS who had the physiology of their biological sex before the start of hormone therapy, do not allow expensive operations. Moreover, they are only available in non-state clinics at commercial prices and without the right to receive sick leave and a disability group.

Only the simplest and most popular removal operations, such as bilateral orchiectomy and mastectomy, which give the right to change documents, cost 30 - 40 and 110 - 140 thousand rubles, respectively, in mid-2014. Moreover, without taking into account passing the commission and obtaining permission, preoperative tests, multiple trips, as a rule, to St. Petersburg or Moscow and back, and other expenses. In addition, prices for operations are regularly increased and are not controlled by anyone.

No one is engaged in statistical accounting of the operations themselves, which are usually performed by plastic surgeons in their free time and for cash without paying taxes. And the only legal document concerning Russian transsexuals’ “transition” and subsequent operations - No. 311 of the Ministry of Health - has long ceased to exist.

Types of operations

Feminizing surgeries performed by MtF transsexuals include
- bilateral orchiectomy, that is, or removal of the testicles;
- penectomy: removal of the penis;
- vaginoplasty: formation of the female genital organ using the method of penal inversion from one’s own skin;
- mammoplasty: breast enlargement and repositioning;
- liposuction: elimination of “excess” fat deposits on the abdomen and waist;
- facial plastic surgery - the nose (including grinding down the bones of the skull), as well as cheekbones, chin, jaws, eyebrows and eyelids;
- by changing the voice, done on the chords.

The list of masculinizing operations for FtM transsexuals includes
- mastectomy: removal of the mammary glands and reduction of the area of ​​the nipples;
- ovariohysterectomy: removal of the uterus, fallopian tubes and ovaries;
- vaginectomy: closure or removal of the vagina;
- phalloplasty and urethroplasty: creation of a male genital organ from one’s own skin;
- metoidiplasty: creating the same thing, but from the clitoris;
- silicone implantation, including in the chin and calf muscles;
- liposuction of the chest, abdomen and buttocks (performed very rarely).

Suicide

According to unofficial data provided on forums, approximately 85% of vehicles attempt to die on their own initiative and under the influence of numerous external factors. And if in 2017 the World Health Organization decides to depathologize transsexuality and remove it from the “Psychiatry” section of the International Classification of Diseases, it will deprive several tens of thousands of Russian MtF and FtM people of the opportunity to go even to private clinics.

In addition, TS will no longer be able to visit psychiatrists, undergo commissions, obtain certificates of permission, or perform operations. They will not be able to live and work with the “correct” documents or create families. It will be impossible for them to even emigrate. This means that the number of suicides of people driven to despair and in a hopeless situation will only increase.

Instructions

Take hormones for one and a half to two years and get tested for your body’s hormonal levels. See a psychologist. Register with an endocrinologist, sexologist and psychiatrist. Obtain from the latter the diagnosis F64.0 (“Transsexualism”) necessary for future surgery and change of documents.

Take care of your health, since hormones for transsexuals, especially feminizing ones, have serious side effects and are dangerous for the body. Partially compensate for these phenomena by taking vitamins and a healthy lifestyle, without alcohol and smoking.

Come for an interview with the head of the commission that issues paid permits for biological sex correction operations and has the necessary license. There are only two such commissions in the country, in Moscow and St. Petersburg. At his direction, take several paid psychiatric tests from a commission psychologist within two to three weeks. Receive a commission call. Its date depends on the results of the tests passed.

Visit the commission and receive a certificate of permission. Refusal will follow only if you have poor test results, and psychiatrists and psychologists have doubts about the correctness of the initial diagnosis of F64.0. Contraindications are psychiatric diseases, alcoholism, drug addiction, homosexuality, antisocial lifestyle, absence of visible signs of HRT.

Join transgender forums. Monitor plastic surgery clinics in Moscow and St. Petersburg and find out which is the best place to have surgery. If you have money, a foreign passport and, preferably, knowledge of English, then it is better to go to one of the clinics in Thailand. With a certificate from the commission to the selected surgeon or call him.

Agree on the type, date, time and cost of the unscheduled operation. Such operations are not carried out free of charge. They can only refuse you if you have some serious chronic illness. For example, HIV, hepatitis C, liver cirrhosis, severe diabetes. But usually they don’t refuse, but take additional precautions.

No earlier than two weeks before the operation, do a clinical and biochemical blood test, a coagulogram, a general urine test, as well as tests for HIV, syphilis, hepatitis B and C. If you are undergoing an operation under general anesthesia, for example, or a mastectomy, removal of milk glands in FtM (female-to-male transition), then a fresh electrocardiogram is also needed. A blood group test is taken if you do not have a note about it in your passport.

If the operation will be performed in the groin area, remove any possible hair with a razor. You can have a light dinner the day before, but eight hours before surgery you should avoid eating and drinking. Some doctors also recommend temporarily stopping hormones, but this is not a requirement.

Give the surgeon a certificate of permission from the commission and a report from the clinic where you had your preoperative tests. Sign the contract, pay the money. The cost, for example, of bilateral orchiectomy and castration in MtF (transition from male to female) is 30 thousand rubles. The cost of vaginoplasty is over 200 thousand.

If the operation is performed under local anesthesia, such as a bilateral orchiectomy, then carefully listen to the surgeon's instructions. Answer the questions asked to check your status. In FtM, everything - mastectomy, hysterectomy (removal of the uterus and ovaries) and phalloplasty (creation of an artificial penis from one's own skin) - is done under general anesthesia.

When leaving the table after completing the operation, be careful. If you are going home immediately, as is usually done after an orchiectomy, to save money, most MtF, then ask someone from your family or friends to help you in advance. Be sure to drink or eat something light after surgery - yogurt, kefir, banana. For the first two days, stay in bed.

If the operation is more complex, then try to stay in a paid hospital for several days. It will not be possible to go to the general free ward due to the lack of a new passport and legal recognition of the gender reassignment. Find out and write down all the surgeon’s recommendations for treating the operated area. For example, like bougienage during vaginoplasty.

note

Transsexuality appears in a person by nature, and subsequently is not eliminated or treated. Hormonal and surgical therapy partially removes only its main symptom - dysphoria. This is a discrepancy between a person’s appearance (biological or passport sex) and his gender (mental) content - towards the latter.

An important condition for obtaining the commission’s conclusion is the so-called coming out. Translated from English - “opening”. This means that an MtF transsexual, born in a male biological sex and possessing only male documents, must live in society as a woman for at least a year. With an appropriate name and feminine appearance. And the FtM transsexual is obliged to live as a man with a masculine appearance.

Without transsexual surgery in Russia, it is almost impossible to change documents, find work and a livelihood.

Helpful advice

Be sure to get a certificate from the surgeon about the operation and a copy of the clinic’s license. After recovery, you need to come with them to the registry office to change your birth certificate and full name. After which you will receive another certificate from the registry office - to change your passport and all other documents.

Gender reassignment is not surprising these days, but people who have changed their gender always attract a lot of attention. Especially if they are stars. We have compiled for you a complete list of stars who were unhappy with their gender from birth and radically changed their lives.

Transgender and model who lasted on America's Next Top Model for almost the entire 11th season.

The most active defender of the rights of those who have changed their gender, acting in films and singing on stage.

The daughter of singer Cher changed her gender in 2010, becoming Chaz. Due to hormones, he gained weight, but then lost a lot of weight.

The famous transsexual from the show Drag Race with a gorgeous figure, constantly appearing in magazines.

Norwegian model. She starred in a film about gender disorders in children.

The first transgender model to work for Vogue since 1980.

A model from Canada who became famous in a lawsuit with the organizers of Miss Universe Canada because of her transsexuality.

Even when she was a man, she and her brother Andrew Wachowski produced The Matrix. Now the Wachowskis remain successful producers, and Lana is clearly happier. By the way, Andu recently also became Lilly.

Transgender and socialite, muse of the famous photographer David LaChapelle.

The world's first transgender male model, now called Andreya. Works with the largest brands.

A transgender doctor who now changes gender to others.

Famous Israeli singer.

In love with Igor Bulychev, she changed her gender and became a woman.

The world's first transgender politician, member of the New Zealand Parliament.

Participant of Dom-2, who since childhood dreamed of being a girl.

A model from France who changed her gender at the age of fifteen.

A popular Argentine model who changed her gender back in 1976.

Kardashian's stepfather, an Olympic champion, father of six children, is now gradually changing gender.

Star of the series "Orange is the New Black." Since childhood, the boy felt like a girl, and even tried to commit suicide, but in the end he had sex reassignment surgery. Now Laverne is an Emmy-nominated open transsexual.

A German athlete from the Olympic team who left the team because she became a man.

The winner of the program “Holland's Top Model”, from childhood she felt like a girl, although she was born in the body of a boy.

Famous Brazilian model, collaborating with the Givenchy brand and others.

As you can see, there are quite a lot of celebrities who have changed their gender, and many of them have actually become happier and more beautiful.

The material is intended for persons over 18 years of age

He is 25 years old, he has never been a woman and has always tried to prove it formally. Some people are accustomed to gender stereotypes, others are in favor of erasing boundaries, and still others have to fight their exclusivity and strive for an unattainable norm. It is difficult to fit into society, but it is possible, despite the lack of a legislative procedure. The Internet gives the false impression that transgender people are perverts, porn actors, posers and generally indulge in a lot, but this is not always the case: we simply don’t see those who are integrated.

Russian legislation says practically nothing about gender reassignment, but suggests doing it this way: first do the operation, then change the documents. On the one hand, this is true: first the real state of affairs changes, then the formal one. To avoid scammers who change their minds about going to the surgeon with a new passport, people need to be required to change their gender surgically if they are so sure of their desire. On the other hand, changing a passport only after surgery forces a person to go under the knife and operate on fragile organs. It is not the change of documents that follows the change of gender, but the change of gender is forced to obey the need for a change of documents. The person looks like a man and is a man, but has a woman's passport. To resolve the contradiction, it is not enough for him to simply change the document - he must cut out his genitals.

Nikita, like many other transgender people, does not want to have lower surgery. He did not find such legislative practice in Russia and created his own precedent.

The Village spoke with him about what defines a man as a man.

About self-awareness

Since childhood, I have been irritated by being addressed in the feminine gender. All philology infuriated me: verbs, pronouns, possessives, adjectives. Even at an unconscious age, I flatly refused to wear dresses. It probably looked normal: there are girls who love pants and cars, then they grow into women who prefer sports rather than beauty salons. I was interested in boys and I wanted to be equal to them. That is, I was an equal: we jumped around the garages, I was even the leader in our games. But from the very beginning something was wrong: I did not perceive myself as a girl.

Everyone wanted to see me in a skirt, and I tried to live up to that. I started wearing dresses to my classmates to make my classmates happy, they kept saying that it suited me. One day I had a serious experience of self-acceptance. I had almost no women's clothing, more and more shirts and pants. I took something from my mother, dressed like a woman and went for a walk. It’s summer, I’m wearing a top with a vulgar neckline and a frivolous skirt, a severe sore throat has not yet passed and I have no voice. I’m walking along the Moskovsky railway station, and I’m met by a homeless-looking man. And in his eyes you can clearly see: “I want!” I am away from him - he is towards me, I take a step to the side - he is there too. And then I tell him in my hoarse voice: “Man, fuck off.” It was funny to me that I had a feminine appearance, and at that moment I felt everything: this is not me.

I wasn’t satisfied with skirts for long and went back to my grinders and jeans.

In high school, a dramatic story happened to me, a love triangle. Two friends fell in love with me, and I fell in love with one of them. It was so hard because I couldn’t confess to her. Now I can speak openly, but then, of course not. Long before hormone therapy, I only had guesses about myself. One day we had a funny conversation with that friend who was in love with me: they say, somewhere in distant Thailand they are doing operations, you can become a man, and we will be happy together. Yes, this is great, of course, but they make monsters out of people. I thought for a long time with horror about such operations; I did not see good examples.

This is Nikita

One day I tried on what it was like to be a man. A friend invited her to go on a trip with her to a nature reserve, where a group of people study animals, count tracks in the snow and keep records of the population. We talked before, arrived, and she introduced me: “This is Nikita.” I thought: “Okay, let it be Nikita.” Then there was no turning back, but only in one company. When your name is called differently, it’s like going through the looking glass, and I wanted to go back there. They called me that because that's how it should be. The new name first appeared in December, then in January I was introduced to Nikita in yet another company. I thought hard and already in March I decided to undergo hormone therapy.

About hormones

The Internet told me everything: how such people live in America, how they get out of this situation. I can’t imagine how people used to come to such decisions on their own when there was no information - no way, probably. I looked at the forums, asked people what and where they buy, they told me about pharmacies in Moscow. I needed omnadren. I marked several points on the map, literally at the first one, somewhere near the Ministry of Foreign Affairs, I bought five packs - a supply for a year. I didn’t wait for medical confirmation that I was transgender; I started injecting hormones illegally. I was 20 years old.

Hormone therapy begins to work from the second day. First, the sensitivity of the genital organs changes. The ovaries stop working, the breasts become deflated, and the clitoris enlarges. The first three months are wildly painful because the change occurs very unevenly. I don’t know how to describe it biologically - as if the foreskin grows later than the clitoris grows. My mother breeds Maine Coons, and it’s the same with them: the kittens grow their back legs first, but the front ones remain small, and in childhood they look like rabbits. It’s a strange comparison of genitals with kittens, of course, but biology in general is a tricky thing.

While you inject hormones, the female body does not work, if you stop - will return to its place.
The male reproductive system is “disposable”: Irreversible castration occurs after hormone therapy

Changing your voice takes about six months. Fat is gradually redistributed - it leaves the hips and chest. Instead of a woman's belly, a man's belly may grow, but there will never be cellulite. The shape of the face changes, hair begins to grow. While you inject hormones, the female body does not work; if you stop, it will return to its place. The male reproductive system is “disposable”: after hormone therapy, irreversible castration occurs. The testicles have shrunk, and goodbye. This seems to confirm that men are for evolution, and women are for stability, and will adapt to any changes. Unlike the fragile male reproductive system, the female one is very mobile. For me this is lifelong therapy.

Now I’m in recovery, I’m not taking hormones and I’m not in the best shape. Sometimes I look at myself in the mirror and think: “You’ve gone crazy, bad.” I couldn’t afford to buy the drug - I was dumped at work, and prices also skyrocketed because of the dollar. Previously, five ampoules cost 500 rubles and, they say, the state bought 80% of their cost. Now one ampoule costs 800 rubles. To function normally, I need at least two a month. The body requires high doses, it processes testosterone quickly, and levels can drop. Yes, I had no money at all because of the setup with work at a construction site, even for two ampoules a month. The contractor took payment from the customer and did not pass it on to us. I was left without a salary and let my team down and didn’t pay the guys. Completely rock bottom, after that I sat for a month and looked at the ceiling, ashamed and bad. Self-esteem dropped below zero. Now I started working, today I took the first injection, everything will soon return to normal.

It’s interesting that before the rollback I thought that PMS was a woman’s whim. I didn’t have this, but now I suddenly started feeling it every month. For exactly a week it seems to me that everything is bad, people are terrible, life is at zero. I look at myself from the outside and think: hey, guy, isn't that day just approaching? Well, yes, I tell myself, life is shit, you are depressed, but it’s just because of hormones. How do women even tolerate this?

About the commission

Some people get the certificate quickly, within six months. I, being a good person, chose the long way and did everything according to the rules. We don't have rules though. Laws do not prohibit gender reassignment or describe how to do it legally. We find ourselves outside the law. There are many sources of information, but they are unreliable. Before the age of 21, it seems that you cannot get a certificate stating that you are transgender. I was 19, and I decided to register in advance - I needed to be observed by a psychiatrist for two years. I went to St. Petersburg for a commission, for some reason I decided that it was better there. It was possible to do this in Nizhny Novgorod Lyakhovo, but I didn’t know that then.

When I arrived at the commission, I already looked like a man. I was the only one - people of indeterminate gender were sitting around. I have a negative attitude towards such undercooked creatures; they confuse me. A glamorous guy was sitting next to me, throwing such hot glances at me - he was curious why I looked so good here.

Before the commission there was a test with funny questions - draw a non-existent animal, choose a color. You pass it, then six months later you are invited to a commission. If you don't have schizophrenia, then this is a quick procedure. A couple of days later they gave me a certificate. They confirmed that I was transgender, and from that moment on I could legally buy hormones, have surgery and change documents.

About changing documents

I look like a man, my name is Nikita, but there is another person in my passport. When I presented it, they said to me: “Are you kidding me, or what?” I had to show a mole on my neck and tell him that this also happens. I tried not to use my passport. This is a big hemorrhoid: not going by train, not getting a job. I only traveled by bus between cities. Some places require at least a photocopy of your passport. My girlfriend is good at photoshopping and we made a fake copy. She took a photo of me as if I was 14 years old and wrote that I was Nikita. And it worked. Generally speaking, I could do everything using my passport; it depended only on my desire to explain the situation.

First you cut your body, then you receive documents about it. I was forced to go under the knife

Changing documents looks like this: you come to the registry office, talk about the need for a gender change, present a certificate from a doctor. They either say “okay” or “go to court.” Documents are changed based on a court decision. I can’t say that we have a terrible government and bureaucracy, if you want, you can do it all quickly. The only problem is that at the registry office you need to present a certificate of the operation performed. First you cut your body, then you receive documents about it. In America it’s the other way around: first the passport, then the operation. I was forced to go under the knife.

I thought about surgery. I didn’t want to cut myself in Russia for little money, but I wasn’t ready for big and high-quality money in another country. I thought and thought and decided: why not become a rebel? Yes, we refuse to change your passport without surgery. But if suddenly you cannot withstand anesthesia or there are some contraindications, is the path to a normal life closed to you? Forcing people to undergo surgery is a violation of human rights. I searched and found the TransPravo organization.

We did not know about cases of gender reassignment in Russia without surgery, but such examples were found in the UK and elsewhere. I wanted to change gender only on the basis of hormone therapy. For a long time it was not possible to find a hormone specialist who would understand not only the thyroid gland and have the necessary knowledge about transgenderism. I found a competent trans-friendly woman in Moscow, I had to go to her several times for one piece of paper. He explained this: I’m already a man and I’m not going anywhere, help me confirm this so as not to create problems for me or the state. She was understanding and issued a certificate with the following content:

“Patient so-and-so has a diagnosis of F64, is on hormonal therapy, as a result of which a hormonal gender reassignment occurred. These changes are irreversible on their own; it is recommended to change the passport gender from female to male. The recommendation is based on the Order of the Ministry of Health No. 311, according to which “the generally accepted radical measure for transsexualism is the psychosocial adaptation of the patient to his conscious gender.” Such adaptation involves a change in hormonal and PASSPORT gender.”

So I highlighted it in capitals: “passport.”

The registry office did not approve the form, we rewrote it twice, then I successfully filed a claim. I was advised to write in the application that the lack of an approved form is not a basis for refusal, that there were precedents for changing documents without surgery in other countries, that I now live as if with a fake passport, and that being forced to undergo surgery is a violation of human rights. I was lucky, the judge was adequate and promised not to ruin my life. If in another city someone wants to change documents without surgery, now they can use my precedent. With the court's decision, I, satisfied, went to the registry office. At the registry office they first gave me a birth certificate, I changed my name and took my mother’s maiden name. Then he changed his name in his passport to a man’s, and then changed it again and changed his patronymic. I haven't known my biological father since I was three years old and I listed the name of the man who raised me - the love of my mother's life. I think that's fair. Then I had to change all the other documents - SNILS, INN, there were no problems with this, people with stacks of papers don’t care. It is more difficult to change the certificate - firstly, you need to wait until July for the general enrollment, and secondly, you need to explain to the school director, they say, remember such a girl - there was no such girl.

I felt like a revolutionary: the first person in Russia to change gender without surgery. The other day it turned out that it was not the first, not everything was so bad, there were still precedents. But those people attracted lawyers and had a long trial. Everything went smoothly for me.

About the military ID

When I changed my passport, I needed a military ID. Unpleasant story. I went to the military registration and enlistment office, the doctor looked at me through his glasses and said: “Well, you probably should make yourself an artificial scrotum...” I wanted to answer him that the scrotum does not define me as a person, but it seemed like he would have sent me to hell for this. I am unfit for service due to my vision, but my category should be determined by the psychological “disease” F64. I wouldn’t want a trace of this to remain in my documents; I don’t want to shake a piece of paper every time that I changed my biological sex. I want to finish this story and forget about everything. Now I'm figuring out what can be done. They say that transgenderism may be removed from the list of psychological diseases next year. I wouldn't want to be labeled as a psycho.

About the absence of a miracle

Many people think that there is one magical moment when you change gender. But this is not the same as dyeing your hair blue. Firstly, you cannot become a man: I have always been a man, and I needed correction of my biological sex. Moreover, the correction is not in the full sense, without an artificial scrotum. Secondly, it turned out that this is a longer process of adaptation of oneself and society in relation to oneself. At first you obsess over your body, then you think that you drank a magic potion and everything will be fine, but this does not happen.

You can't become a man instantly. When you have tried and they begin to regard you as a man, other problems appear: you yourself cease to perceive yourself as a man. It turns out that you don't have a lot of things that the average guy has. I need a normal job. I know what it’s like to earn 70–80 thousand a month or 300 rubles a day, and now I want to earn good money. It’s sad that no matter how much I want, they won’t take me into the army. If I could rewind everything and be born normal, I might have joined the Navy. I want to function in society as a man - to assert myself. This is not about conforming to stereotypes; the stereotypes of a rude, brutal and redneck man are not for me. It's a complex question of what masculinity means. It is not only external, but also social.

About other people's perception

There are three groups of people: adequate, compassionate and inadequate. This is a normal human perception: when they show you strange people on TV, you think - they’re crazy, they’re hurting themselves in vain. I really think there should be fewer people like me. You can’t call it wrong, it just exists, like children with cerebral palsy - and I want there to be fewer of them and us. Transgender people are sometimes killed, there is even a day of remembrance. They often face cruelty, even physical violence. Although I have not met anyone who is completely inadequate, more compassionate. They once wrote an article about me, it turned out mediocre, but with great sympathy. I realized that ordinary people cannot cover this topic. For everyone it seems that this is a choice: I wanted it and changed it. But this is not a choice, it was so right away. I didn't change gender, I've always been a man. You can’t say “when he was a woman,” such people were never women. My mother was impressed by one film after which she accepted me. This is probably the only time when everything was shown beautifully and truthfully in a movie. Of course, we couldn’t do without tear squeezers. Standard plot: an Islamic girl is not understood by her family, it’s hard for her, she suffers and doesn’t understand herself, there is conservatism all around. Mom was imbued with it, called me in tears and said: “Please forgive me, I finally realized your problems.”

I often see m2f, that is, women from a male body. They are often exaggeratedly feminine. Society seems to have exaggerated ideas about female sexuality. Maybe I'm just judging by what I saw on YouTube. Some want to live on display, while others, on the contrary, want to hide.

Now I have a problem communicating with men. I really don't like it when men behave unmanly. For example, I had a colleague who was a typical closet from the area. We took care of animals - a low-stress job that didn't require too much paperwork. At the end of the day you need to take out a bucket of dirty water. When I arrived for my shift, the bucket remained in place: my colleague did nothing. Perhaps I have a warped view of a man, but it seems to me that he should have shown responsibility. I do not slander anyone and do not shift my responsibilities. This person is perceived as a man based on external signs - I am outraged by such a discrepancy.

Hemingway has a novel in which the main character's penis is shot off. At first he worries about this, and then he realizes that masculinity lies elsewhere. So I am: I was born with this problem, I brought myself into line with my gender, I create for myself ideas about what is masculine, and I strive for it.

About activism

I am comfortable in my gender, I don’t want to blur the boundaries. Post-gender theory is relevant now - I do not share it. In my opinion, it is stupid to deny that there are women and men. Perhaps I look like a gay man - but so what, at a construction site I carry sacks in an unpretentious manner, spit and throw shit at lazy people. I'm heterosexual, but I can't organize a parade of heterosexuals. I don't want to stand out. I'm not an activist, I don't see any motivation for this. I don't understand who needs this. It seems like I want to, but it’s unclear why. Let activists do what they like, they will help someone. In general, I am one of those people who ran around with spray cans and stencils during the Bolotnaya era and wrote: “Putin is a thief.” Yes, I could have been sued long ago: illegal trafficking in anabolic steroids, forgery of documents, extremism. I called people to a rally, it was important to me. I didn’t participate this year, though.

I don't want to stand out.
I'm not an activist, I don't see any motivation for this

There's this guy at my work whose badge says "Maria." In my opinion, he is in a tight spot, and he is uncomfortable when his colleagues address him by his female name. I always want to go up to him and say: “Guy, I have the same problem, maybe I can help you?” This has nothing to do with parades and the fight for your rights. I have knowledge and can give advice. If someone finds himself outside the law and outside traditions, we need to help him integrate. This is what I'm doing.

Photos: Cover, 1 – Ilya Bolshakov, 2 - personal archive of the hero