The heavy price to pay for a sex change in Turkey

Filiz Gazi/ DUVAR

In Turkey, the minimum age required to get sex reassignment surgery is 18. In order for one to change one's gender section on an identity card, the procedure must be conducted at a state hospital. Sex reassignment surgery is available in Turkey's major cities like Istanbul, Ankara, Izmir and Antalya. 

According to trans people that had gone through such surgery, the preferred country to receive such operations is Thailand - where an age-old sex change industry has existed. They told me sex reassignment surgery was a lot more affordable there than it is in most countries.

Indeed, those operations are not only risky but costly, though prices vary according to the procedures, whether vaginoplasty and testicular implants. One person I spoke to told me such procedures are a life necessity, and for this reason trans people go at great lengths to save up for them.

For those trans women and men that die following a procedure, no legal procedure can be launched against the doctor in question. Negative results that occur following the surgery are seen as complications. Since most people that undergo these procedures don't have an accompanying person at hospital, they undergo the process by themselves.

“Some of the sex change procedure expenses are covered by the state. For example: vaginoplasty, phalloplasty, hysterectomy, mastectomy and salpingectomy procedures. But breast augmentation surgeries for trans women are not covered because the state considers them an aesthetic operation,” said Pembe Hayat Association social services expert Doğu Kan. 

Kan added that the doctors themselves often view these procedures as a way of earning extra money and charge trans people extra fees for their operations, and these fees change according to the operation.

“Today [the price] for a vaginoplasty surgery is not the same as that for a phalloplasty surgery. Phalloplasty surgeries are more expensive, because there is this factor involved: In Turkey there are not many doctors who are experts in the field of micro surgery or who have received education and who have improved themselves in conducting these surgeries,” Kan said, adding that another main problem is that trans women in particular may or may not be happy with the results of their procedures, a situation which can create major problems for that person. 

“In our society, since LGBTQ people are seen as sick and perverted, it is difficult for them to find jobs. While there are those who engage in sex work with their own will, there are trans women who are forced into it. Trans men also face many difficulties when it comes to their working life. They can put you to work without insurance. Since you are LGBTQ for the most part they don't pay you the salary they deserve. If you are trans, the rent for your home could be twice as much,” Kan said. 

Güney İmbat, a former Pembe Hayat Association volunteer who now works in the project sector, explained the complicated process that one is required to go through to receive an operation at a state hospital in Turkey: 

“First, you have to obtain an appointment with a psychiatrist from a state hospital. You begin attending regular appointments, and the purpose of these appointments is to determine whether or not you have a trans existence. This takes at least six months, and can take as long as two years. Afterwards, the psychiatrist directs you to the endocrine department, where hormonal procedures are started. Then, for surgery you must apply to a court. After obtaining approval from the court, you can get the surgery, and then you can change your name and gender on your identity card,” İmbat said. 

İmbat, who is trans, was only able to tell their mother about their recent surgery, which was very expensive and which they to pay off with a salary worth two years of work.  

“First I said that I was trans, then I said that I was going to have surgery. 'We can't tell your father this,' my mother told me. I told her I understood. 'Since we can't tell him this, I can't come [afterward],” she said. During the two-week recovery period, my partner accompanied me. If it wasn't for them, believe me I don't know what I would have done, İmbat said. 

“Due to the fact that surgeries are at times conducted in back alleys, people have die as a result of them. While there have been those in the past, at the moment there are no trials [concerning this issue],” said lawyer Emrah Şahin.