'I Want to Practice My Profession Comfortably As Trans Woman'

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Toprak is a 22-year-old student of medicine. She has two years to graduate. She is trying to get her new ID as a woman before she graduates because when she has the diploma, she wants it to belong to her, not to the sex that was assigned to her.

Born in Antep, she got a very high score in the university entrance exam and came to İstanbul to study at İstanbul Faculty of Medicine. She doesn’t receive support from her family, they haven’t met since she came out.

Toprak needs financial support to have the sex reassignment surgery. She has launched a crowdsourcing campaign for this.

When she became a doctor, she wants to hang her diploma on the wall with pride but she is worried that she will be subjected to discrimination as a civil servant since gender section of her ID reads male.

“I want to break the prejudices and demonstrate what trans women can achieve. We study in many fields. I want to practice my profession comfortably as a trans woman studying medicine. I need this support to be able to have this surgery. I want a world in which trans people succeed, not being burned to death”.

As a trans woman medicine student, Toprak told bianet her university life, future plans and sex transition period.

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Could you tell us about yourself?

My name is Toprak, I’m 22 years old. I am a 5th grade student at İstanbul Faculty of Medicine. I am trans woman.

Have you always been in İstanbul?

No, I was raised in Gaziantep. I won the exam and went to Science High School. I studied there for four years and came to İstanbul to study at the university. I’ve been living in İstanbul for five years.

How is the university life going?

First year was a bit quite because I hadn’t started my transition process and I hadn’t come out. I was defining myself as gay at that times. After a year, when I started to live as an open gay, I started to endure some difficulties but mostly with my family. It didn’t have much impact on my university life. I didn’t face any bad reactions due to the educational and cultural level of my professors and classmates.

I had one incident during my trans transition process, that’s my only trauma at the university.

We saw it on social media that a professor at İstanbul University had made transphobic statements in a course. Were you in that class? Could you tell what happened?

Yes, a professor was lecturing on hypogonadism. Pituitary glands, endocrine hormones, testhesterone, ostrogene, etc.. The subject has nothing to do with trans but I realized where he would go with it.

Finally, the professor linked the subject to trans and said, “Sometimes some men with no ovular in their womb and say ‘I’m going to become a woman’. Those are psychopath. We refer them to psychiatry”.

He took off his own ID from his wallet said things like, “This is blue ID. They struggle to get pink IDs”. There were as many as 250 students. I was sitting at the backmost, the lecturer doesn’t know I’m trans. 70-80 students burst in laughter with the lecturer.

Then I stood up and said, “Who are you calling psychopath? I’m a trans woman”. He was surprised because he didn’t expect a trans woman to be in the hall. He turned his behind and started to read out the slide.

I told him that he said this before everybody, therefore he needed to explain it in front of everybody. ‘Come see me after the class, I’ll make the explanation then’, he said.

The person who did this is an endocrine, he works in a field which trances are very intertwined with. I’m very surprised with it, didn’t anyone take action against him? Because he is a very phobic person.

So, did he make any explanation in the hall before the 250 people?

No, and I exposed him. To be honest, I didn’t expect to spread this much. I mean, I thought it would spread among LGBTI activists and people would learn about this person.

Course of events has changed when the Turkish Medical Association (TTB) supported me.

How did the TTB support you?

I had shared this incident on Twitter and the doctors from the TTB saw it. They invited me to their General Council meetings, they were very interested in. TTB’s support came a few days after the incident. I faced some bad things at the school during that four days.

What happened? I am curious about attitude of the students as well as administrators

Faculty of Medicine students have this political stance…more precisely, they don’t have a political stance, they are apolitical. They prioritize their career and ignore everything else. For instance, they treat people neither negatively nor positively, they are neutral. School’s stance is like this too. They are far from the country’s agenda.

That’s why, they tried to remain neutral but club of the feminist students at the school were very supportive. They prepared a text, 11 other clubs signed it and it was released as a declaration. I didn’t experience any bullying or verbal violence. I’ve been supported a lot except for Twitter.

How was the approach of school administration?

They first launched investigation against me.

Why did they launch investigation against you?

For having exposed the professor.

Did they issue a warning against the professor?

No, they didn’t issue any warning, of course until the TTB stepped in. They managed it like we’re in primary school. They summoned me and said things like, “Why did you do that? What happens here stays here. Why did you spread it to everyone?” I cried only on that day, I felt very bad.

Then my phone rang, it was the TTB calling and invited me to the General Council. When the TTB stepped in, this professor’s transphobia was heard in the world of medicine as well. Then it reached celebrities and they denounced the incident on social media. I didn’t think that it would be heard this widely.

How did the investigation proceed after these developments?

I learnt that the investigation launched against me was dropped and an investigation was launched against the professor.

I testified at the investigation against the professor and he deposed. Frankly speaking, I enjoyed seeing him waiting at the door for his deposition.

Then, they informed me that he received a punishment.

What punishment did he receive?

I do not know exactly; but, they told me this: The authorization of the professor to take the oral examination for the internal medicine was taken away. Internal diseases is a very important branch of medicine and it is a big honor to take its oral examination.

The solidarity expressed to me during this period did really good to me. When I saw the power of solidarity, I decided to start a fund for my surgery. A transgender woman friend of mine who studies architecture told me that she opened a fund for herself and recommended that I do the same. I have launched the campaign. Because I need to undergo the surgery urgently.

Why is it urgent?

Unfortunately, at the moment, my gender is indicated as male on my identity card. In Turkey, one has to first undergo the surgery in order to change the identity card.

I fear that I will not be appointed as a doctor before getting the woman identity card. For the last two years, security investigations have been conducted against doctors and I am of the opinion that my being a woman with the identity card of a man will have an impact on my appointment. I am in the fifth year now, I will graduate in a short time. That is why, I need to have the surgery before my graduation.

For transgender people, the most important problem at the diploma is the name. We have to change our names before graduating. If you change it afterwards, there will not remain any indication showing that the diploma is yours; it is as if the diploma automatically became invalid. I have recently changed my name on the identity card. I actually started my gender transition process one year ago. Everything went very fast.

In which field of medicine do you want to specialize?

Internal medicine or gynecology. There are also other fields such as psychiatry and surgery which concern the LGBTIs more, but the points we have to take to specialize in these fields are very high. We will see.

You spent this year working. How was your working experience at hospital?

We study for long years, but once we complete the first three years, we get in touch with patients and move away from the school. I like it.

The vast majority of my professors support me; so do the students.

There is a perception of transgender women in society and whoever does not fits in that perception is not called a transgender woman. I have not received a bad reaction from the patients until today because they do not know that I am transgender.

Frankly, I refrained from patients, we see how the relatives of patients attack the healthcare workers. It was just a few days ago that a relative of a patient hit a doctor’s head with a pavement stone. What this person would do to a transgender woman…

That is why, I do not tell the patients that I am transgender.

Both as a medical student and a subject who has gone through it, can you explain to us how the gender transition process proceeds?

You apply to the psychiatry, it has to be a university hospital. The place where you can apply in İstanbul is either Çapa or Cerrahpaşa University Hospitals. They observe you for six months the most; then, they first refer you to the psychiatry service, then to the endocrine. At the endocrine service, they do a hormone test and you start taking hormone medication. This process last for approximately one year.

The Social Security Institution (SGK) covers everything except for the hormone medication. The hormone medication costs around 150-200 Turkish Lira (25-35 Euro). But the doctors have started to issue a medical report for the hormone medication. This being the case, the SGK covers the medicines as well.

How does the hormone process go?

(For transgender women) Testosterone are taken out of the body and oestrogen are loaded. Each hormone has effects. Your emotions change, the hormone perceived by the receptors change after all, the codes change, I mean.

For instance, when I experienced the transphobic incident at the lecture hall, it had been just a couple of months since I started taking hormones, I was emotionally very fragile.

This state lasts for the first six months. When the body gets used to it, it starts tolerating it. I do not feel in this way now.

Does the surgery process start after that?

The most important of all is the surgery. At this point, transgender men are luckier because the mastectomy (having the breasts removed) and hysterectomy (having the uterus removed) operations are covered by the SGK. Since these surgeries involve surgically removing a body part, it does not vary from doctor to doctor much. But the operations involving the creation of something such as vaginoplasty are very risky.

The SGK covers this operation; but, there is no doctor doing this surgery within the scope of the insurance. Even when there is such a doctor, it is hard to trust the doctor doing the operation.

Why?

Because, in the medical education, they teach nothing about the transgender transition process. If the person wants, he or she improves oneself in that field. If the person in question has not received that training, then he or she cannot do the surgery.

The names of the doctors who have specialized in this field must be known among the transgender individuals.

Yes, since this surgery is of crucial importance, I want a person as good as possible to do the surgery. It was just two years ago that a transgender woman died during the surgery. She was an activist who lived in İzmir. But it was stated that she died due to the complications stemming from her. If the doctor had done a mistake, he or she would have surely received a punishment.

What kind of complications can occur at the surgery?

There are treatable complications and bigger complications. The high incidence treatable complications are things like infections or clitors dryness. For instance, a friend of mine did not have the surgery by a good doctor and got an infection; she was operated again and had to stay in hospital for three weeks. Another friend of mine had dryness in her clitoris because her nerve cells were not appropriately bound together; she had a second operation and had to stay in hospital for a months.

I do not to want to have any complications. Moreover, I do not want to be away from school and fall behind in the class in such a case, there is a compulsory attendance.

How much does the gender transition surgery cost?

Around 20-30 thousand Turkish Lira (3,600-5,400 Euro). (ÇT/TK/SD)