As an LGBT+ rights activist and leader of the Federation of Sexual and Gender Minorities – Norway, one of my jobs is to hear clinical abuses as I follow transgender people trying to be officially recognized according to their gender identities. The ad hoc medicalized method is the only route to constitutional reputation in Nepal, but it violates Bangladeshi court orders and global laws. It needs to change desperately.
A new report from Human Rights Watch includes records of trans people who have pursued clinical investigations to confirm that they have undergone gender reassignment surgeries. This includes specialists looking at and touching their testicles and chests, and commenting on how well their bodies match prejudices.
The issue of constitutionally recognizing gender identification is not new to Nepal. Our Supreme Court broke ground in 2007— it was one of the primary judiciaries in the world to totally embrace the principle that transgender people deserve to self-determine their gender on constitutional documents. It has been clear for over 15 years that in Nepal, as in human rights law, the legal process for changing our genders should be completely separated from any medical interventions we want to choose for ourselves to change our bodies.
But somehow in the course of the years, various officials have come to believe that it is necessary for people who want to change their gender on official documents to prove that they have had medical intervention. That misconception spread and the government has not stepped in to make it clear that it is not required.
I know the hallways of Kathmandu’s main hospital well because I have witnessed this medicalized process dozens of times.
Each time I talk to someone who wants to undergo the process, I warn them about how the doctors will treat them — and about how the experience at the bustling central government hospital in Kathmandu will violate their privacy. I also tell them how, in truth, this process is entirely unnecessary and contrary to human rights. Their identity is theirs alone, but because the government of Nepal hasn’t clarified its legal gender recognition procedure, this ad hoc process has emerged — and appears to be the only route to changing their legal documents to list their true identities.
Each time a new trans person comes to me asking for assistance, I counsel them that the process will be unpleasant, and that it will violate their rights. Some of them choose to walk away and avoid the experience, but some choose to undergo it. It’s their only option in the current policy environment, and it is heartbreaking to witness my brilliant and resilient peers undergo the medicalized process— and then wait for months if not years as the government processes the medical files and issues them new documents.
Sadly, despite wide-ranging support in our government for LGBT people, and a lot of good policy change over recent years, we are still struggling with the over-medicalization of legal gender recognition for transgender people. As a transgender woman, I find it painful to witness my community go through these horrible experiences 17 years after the Supreme Court made it clear that “self-feeling” was the only requirement for legal gender recognition. But I know our community is strong, and that we won’t stop pushing for a policy that respects our rights.
We are hopeful because our Supreme Court has consistently articulated that transgender rights are human rights. We are hopeful because international law and global medical best practices, such as the World Professional Association for Transgender Health Standards of Care, make it clear that there should be no medical interference in self-declared legal gender recognition. And we are hopeful because we know that our culture has long celebrated gender fluidity, and our government has been praised for its record on LGBT rights.
What we need now is real, tangible policy change. The government needs to clarify that the process for changing a person’s legal gender is separate from the process that person may or may not choose to medically alter their body. What we talk about with our doctors is our private business; it should have no bearing on what our legal documents say our gender is.
