in the situations of TG and TS people
- in different countries around
- by Lynn Conway
Copyright @ 2002-2006, Lynn Conway.
All Rights Reserved.
[Note: This page and website focus mainly on the situations
of MtF transitioners.
For more about the situations of FtM transitioners,
see the website of
FtM international and
also the Successful Transmen page.]
- Lynn's webpages about transgenderism
and transsexualism are written from
the perspective of someone living and transitioning in the United
States of America. However, transsexualism and transgenderism have always been
"international." Girls from all around the world have
often looked out beyond their own country's borders
when trying to escape the gender traps they've found themselves
in. Every country has always put a different spin on how it treats
TG/TS people, and transitioners can often find special advantages
in medical services or jobs or citizenship in some other country
than their own. Lynn herself had to go outside the United States
for her SRS back in 1968, at a time when those surgeries were
seldom permitted here.
- Every aspect of transition and post-transition life is affected
by one's nationality and culture. Different countries have vastly
different customs, social traditions, cultural taboos, legal
rules, and bureaucratic regulations regarding TG/TS conditions
and transitions. One's nationality thus has a huge effect on
how difficult it is to complete a TG or TS transition, and the
degree to which a transitioner is accepted by society and has
opportunities for a fulfilling life after transition.
Historically, many non-Western cultures have
and accommodated transgender people, and in a wide variety of ways. Even when such
cultures were not politically or militarily colonized by Western countries,
their desire to imitate Western values often resulted in the repression or
elimination of their gender minorities. In some countries, traditional gender
minorities are remembered through oral tradition, while in others they barely
survived, perhaps “underground” or in geographically-remote areas considered
“backward.” Now that Western culture has begun to accept gender and sexual
minorities, these other groups are also emerging from the shadows. Examples
include the Polynesian
takataapui of the Maori culture in New
of the Arabian peninsula, the
of Mexico, and the
Two-Spirit people of the Native North Americans
(including the nadle of the Navajo and the
winkte of the Lakota). Another
important example is the Hijra, who exist in large numbers in India and
Bangaladesh (see below). And surely there
- We can visualize the huge country-to-country variations in TG/TS life,
among even the western countries, by making basic comparisons of things like
(i) the ease
of access to transition services and medical treatments, (ii) who pays for these
services and treatments, (iii)
social responses to the conditions, (iv) degree of recognition
as women after transition, (v) legal status before/after transition,
(vi) variations in the freedom to "start a new life",
and (vii) access to employment before, during, and after transition.
- United States:
- By most measures, the United States is now the best country
in the world for TG/TS transitioners. At present,
transition expenses are rarely covered by health insurance, and must be paid
out-of pocket by most transitioners
here. However, the wide range of good employment opportunities in the
U.S. provides many transitioners with the means to support themselves
and pay for expensive procedures before, during and after transition.
Many companies even support "on the job TG and TS transitions"
here. No other country provides such wonderful opportunities
for women in the workplace and in life in general, and many post-op
TS women can go on to have fine careers and lives here.
- The U.S.
also has a long social tradition dating back to our frontier
days of "starting over again somewhere else". Family
bonds are not as strong here as in most countries. Instead people
build "extended families" among their friends at work
and in their recreational activities. Not feeling the constraints
of a traditional society, and being able to build lives far beyond
their birth families and communities, people here do not fear
pulling up roots and moving and starting over. Fortunately, most
states in the U.S now enable post-op women to obtain revised birth
certificates and other ID after TS transition, and to have full
legal rights as women, including the opportunity to marry men.
All these things work to the great advantage of transitioners
- The U.S. has also made rapid progress in formal civil rights
for TG/TS people, and they are protected by
anti-discrimination legislation in many large cities now. On the other hand, there is a small
but ever-present violent element in U.S. society, and TG/TS people
here must always be on guard to avoid people and places where
they might be assaulted and hurt. Nevertheless, the U.S. is for
the most part a friendly "live and let live" society,
and transitioners are relatively free from harassment here.
- People in the U.S. tend to be more self-reliant and independently
self-supporting than those in many other countries of the world.
A big part of our freedom to "do our thing" is that
we have to be responsible for ourselves and not expect others
to take care of us. People who cannot easily manage to take care
of themselves here, and who instead expect others to take care
of them, cannot expect to transition well here. Freedom is thus
a double-edged sword: You have the freedom to try to succeed
here in the U.S., and a wonderfully open society in which to
do so, but you also have the freedom to make big mistakes and
fail - all on your own.
- Latin America:
- As we go south into the countries of Mexico, Central America
and South America, the situation of TG/TS people is very different.
In these countries most males are "macho", defining
their masculinity as "not being feminine" - and the two genders are more highly polarized than in the U.S. Any males
who are feminine in any way are subjected to extremely intense
ridicule and stigmatization. As a result, many TG/TS people in
Latin America remain in a state of fear and repression, are terrified
about showing their gender feelings, and most never even attempt
to resolve their gender conditions.
- At the same time, there is
a long tradition of "travestis" in these countries. The travestis are a large but more or less underground
community of transgender women who work predominantly in the so-called sex
industry, i.e. prostitution, strip clubs, pornography, etc.
This has long been an option for a “landing zone” for gender-variant
youngsters in Latin America who have been thrown away or run out by their families. Lacking
education, identification papers and any other form of social support – this
at least provides them with a means of economic survival.
- However, the travestis are heavily stigmatized in many of these Catholic-dominated
societies, where Church teachings and
intrigue wield so much power over society. Without any proper ID's, most have no chance of finding
regular employment and they usually remain ghettoized and in
sex work. Many of them are very pretty and womanly, as seen in
the following website of "Brazilian
Transsexuals" (Note: That site
is pornographic). These pretty she-males and trans women can easily
attract lusty male customers as prostitutes.
- The internet is now enabling many
of these women to make sexual contacts (as "escorts") and to also earn money from pornography, without having to resort to dangerous
many are harassed and terribly abused by the authorities
and the police. Even those who are transsexual and somehow manage to undergo full gender transition
are usually unable to get proper ID's, and are still considered "travestis"
and remain stigmatized in most of these countries. Many attempt
to emigrate to Europe (and some to the U.S.), where they might
have a chance to build a better life - either as she-males or
as TS transitioners.
Brazil has been an exception in Latin America
to some degree. For quite some years, beautiful and talented Brazilian
transgender women have been able to build respectable careers in
entertainment, and some became national icons, as was the case with
separate concept of transsexualism was slow to be recognized in Brazil, and
these women were almost always considered
travestis even if they fully transitioned.
Roberta Close’s eventual reassignment surgery in Europe in 1989 greatly
increased public awareness of transsexualism, especially when
arose over the government's denial of a legal change in her gender. A
government-sponsored program was finally established in Brazil in 1998 to
provide a limited number of MtF transsexuals with counseling and reassignment
surgery “on an experimental basis.” The growing number of post-op women in
Brazil then caused greater public awareness of the validity of this form of
gender variance. This government then relaxed its rigid position on changes of
name and gender on official records, and
Roberta was finally able to have her
documents legally changed in 2005.
also saw the emergence in Brazil of crossdressers as a distinct category of
gender variant people who earlier would have been automatically equated with
travestis. Some Brazilian crossdressing groups maintain an internet
presence, and organize events in the major cities there, similar in some
ways to what is done in the U.S. In addition, the various gender-variant
groups in Brazil are forming productive alliances with gay and lesbian
activist groups. There is some indication that several other Latin American
countries are beginning to evolve in these same directions.
- Western Europe:
- In contrast with most of Latin America, certain countries in Europe
are good places to transition. The Netherlands and the Scandinavian
countries are particularly accommodating and accepting of transitioners.
Spain, which recently legalized same-sex
marriage, has also become more open to gender transitions, and
publicly-funded sex reassignment surgeries (both MtF and FtM) are now
available to a moderate extent.
Some of the other European countries also provide transition medical treatment and
government health plans. However, there are often very long bureaucratic
delays in gaining access to treatment in some of those countries. Therefore, many European girls go to Thailand for their surgeries, bypassing
the government support systems. After transition, postop
women in most European countries can obtain full legal ID's and
have full legal rights as women, including the right to marry
men. However, employment opportunities are not yet
quite as wide-ranging
in Europe as they are in the U.S. For more about TS transitioning in Europe, see
the European TS website.
- The U.K. is also a good place to transition. Full support
for medical and surgical care is provided under the National
Health Plan, and U.K. society is rather accommodating of gender transitions.
However, up until 2004 an old legal precedent prevented post-op transitioners
from being legally recognized in their corrected gender. They weren't able
to get revised birth certificates, and had to "out" themselves
every time they got a new job and in other encounters with
the state bureaucracy. Worse yet, they weren't allowed to marry in their new
gender. Under pressure from U.K. trans advocacy groups (notably "Press
for Change") and pressure from the European
Union the U.K. revised its archaic laws in the
Gender Recognition Bill of
2004, and now recognizes trans people in their appropriate gender
following transition. For more about TG/TS issues in the U.K., see the
websites of the many U.K. women in
TS Successes webpage and also the
for Change website.
In Switzerland, SRS is covered by the health
insurances, as long as the person is at least 25 years old, if it takes in a
public hospital, if the person has been recommended for surgery by a
psychiatrist and if she has been examined during at least two years. Official ID
changes are made through a simplified court procedure and are accepted unless
the person is married. The most important problems are currently that is it
really difficult to find a respectful psychiatrist ready to help you, that FtM
surgeries are only practiced outside public hospitals (and health insurances
refuse to cover them) and that health insurances are likely to refuse covering
surgeries for early transitioners. Transgender people are unable to update their
official documents. The administration currently refuses to take into account
the identity changes of married people. Legal actions are likely to improve this
situation in the following years. The professional situation of people is
different from case to case. But some people have been able to keep their
position of top manager through and beyond their transition, some have been able
to get one after. The local mentality which favors the respect of the private
life is really helping the people who are able to manage their transition
successfully (Swiss information from
- Australia is increasingly accomodating gender transitioners. Many of the
people there (at least in the major cities) are friendly and have a "live
and let live" attitude much like people here in the U.S. Thus many transitioners in Australia can find reasonable employment
before and after transition, and can afford the surgeries
done in nearby Thailand. Many Australians are also well-networked
via the internet, and transitioners there benefit greatly from
this connectivity and the access to information it provides. For more about Australia, see the websites
and stories of the many Aussie girls on
TS Successes webpage.
- Russia and Eastern Europe:
- With the fall of the Soviet Union, and the emergence of open
societies in Russia and the eastern European countries, we are
now seeing quite a few successful transitions in those countries.
It is still much more difficult to transition there than
in western Europe - there is more bureaucracy to deal with and
greater difficulty qualifying for treatments. However, the treatments
are often covered by state medical systems and some women (and transmen too) are
now reporting successful transitions in those countries. This
is a very hopeful trend, and should accelerate as these countries
further "westernize". See the websites of
(Kiev, Ukraine) and
Iva (Czech Republic) for more insight
into transition in these countries.
- Asia and the Middle-East:
- There is a wide variation in the situations in the countries
of Asia. China has recently begun quietly permitting
transitions. Very few are done there compared to the size
of the population, but the women are also permitted to marry men after their
transitions. Japan is much more backward, being an intensely
conformist society that strongly rejects those "outside
the norm". However, some intensely TS women have somehow
managed to transition even there. Girls from these countries usually
go to Thailand for their surgeries, and take a chance on somehow
being able to survive back at home afterwards. Some spectacularly
successful, beautiful post-op girls are now influencing public
opinion for the better in some of these traditional societies,
a prominent example being
- a beautiful young girl from South Korea who is well known as
an actress there.
- In contrast, Thailand has a long tradition of
or "kathoey" as bar girls and entertainers. Many
TG/TS girls there manage to transition at a young age, with many
eventually undergoing SRS surgery - which is easily and inexpensively
available there. Although Thai society is accepting of these
"lady-boys", they unfortunately are not considered
women after their transitions and cannot get updated ID's and working
papers as women. Thus very large numbers of kathoey remain marginalized in jobs
as bar-girls and prostitutes in Thailand, even after becoming women. As a
result, the sex trade in Thailand is widely known around the world as having
large numbers of very beautiful "she-males" and trans women. Many post-op girls
in Thailand try to find
work or husbands in other countries, in order to escape a life
limited to sex work and entertainment. Many emigrate to countries such as Germany,
where men know they make wonderful wives and where
they are fully accepted as women.
- For more details and insights into the many variations of TG/TS
life across the Asian countries, see the
Asia website maintained by Prof. Sam Winter of the University of Hong Kong.
- India is yet another and completely different story. Indian society
has long provided a ancient form of "gender change"
as a physical escape for transsexual girls. There they can become
"Hijra" by undergoing a "sex
change" consisting of a complete emasculation as a teenager, and then joining the Hijra caste.
While not complete women (they lack vaginas and breasts), the
young Hijra escapes masculinization and can live as women for
the rest of her life. This ancient method of resolving the transsexual
condition is widely practiced in India, where there are at least
a million Hijra (one out of every 400 or so boys becomes Hijra).
In a country where many are very poor, this provides an inexpensive
means of escape for those affected by intense transsexualism.
In recent years the government has begun helping Hijra women
by providing some of them with hormones, so that they can feminize
themselves, look more like women, and hopefully be better accepted
in society. However, becoming Hijra in India exacts a high price
in terms of living forever in between the genders in group communes
in this lowly, despised caste, and mainly working as prostitutes
and beggars. Recently some Hijra have begun interacting with
western transgender and transsexual women, and are learning about
the western methods of gender transition. More Hijra will likely
seek hormone therapy and even full sex changes in the future,
if they can find ways to afford those treatments. (See
Lynn's page about Transsexualism and also
Lynn's SRS page
for more about the Hijra).
- There are also many Hijra in the secular Muslim countries
of Pakistan and Bangladesh, where the Hijra custom spread to
from India long ago. The situation of Hijra in these countries
is similar to or worse than in India, with most Hijra relegated
to a marginalized existence as street prostitutes and beggars.
- In other secular Muslim states, such as Turkey, Indonesia
and Malaysia, TG/TS women find themselves in situations similar
to those in the countries of Catholic-dominated Latin America.
In these countries many girls undertake social (TG) transitions.
However, those who do transition become identity-less and unemployable,
and are marginalized into living in urban ghettoes. There they must
usually resort to sex work or begging to survive. Although some
may manage to obtain female hormones and feminize their bodies,
few ever manage to complete a TS transition. And even if they
did, they aren't considered to be women and remain unemployable
and socially marginalized.
- The bleakest scenarios for transgender and transsexual people
exist in the strict Islamic world, where any sexual orientation
variation or gender variation is treated with the utmost ostracism
many strict muslim countries such as Saudi Arabia, gay men and
lesbians are routinely executed simply for being gay. As
you can imagine, there is no hope whatsoever for transgender
and transsexual people in such countries. It is simply inconceivable
that one could transition in such a medieval, religiously superstitious,
incredibly brutal and dangerous environment without incredible
risks to life and limb.
There are exceptions to the marginalization and persecution of trans people
in the Islamic world.
The most notable is Iran, which provides social and medical help for gender transitioners
and state recognition of their new social gender. This practice has quietly
expanded there in recent years, building on a favorable ruling years ago by the
Ayatollah Khomeini. (Note however
relationships are brutally repressed in Iran, and
many young gay people have been executed there).
- The world-wide impact of the internet:
- Fortunately the internet is helping many TG/TS people become
more aware of the situations in other countries than their own.
These contacts are helping many girls in countries where it is
difficult or impossible to transition to figure out ways to somehow
escape the trap they are in. Many other transitioners also now
take very detailed country-to-country differences into account
when seeking medical treatment, finding employment, seeking love
partners and planning their long-term futures.
- For example, many TG/TS people try to emigrate from less-tolerant
countries to more supportive ones - such as from Latin America
to Europe or the U.S. Very many TS women evaluate surgeons from
all over the world before deciding on where to go for critical
procedures such as SRS. Differences in the cost of quality medical
care, especially the costs of surgeries, leads many people in
expensive countries such as the United States to go to countries
such as Thailand for treatment. Differences in legal acceptance
of postop transsexuals leads many young TS women from countries
like Thailand and countries in Latin America to attempt to emigrate
to Europe, often by marrying European men.
- You can gain more insight into all these issues by reading
and comparing details of the individual stories on
TS Women's Successes webpage, which includes women from countries
all around the world .
- As we look around the world, we see that older, traditional,
post-colonial, third-world, and medieval societies treat overtly
TG/TS women much the same way they've always treated ANY disenfranchised
women. In traditional and medieval societies, a young woman without
any supporting family or any means of financial support becomes
a total social outcast. She then usually has only two
if she is to live: She can become a prostitute, or a beggar.
- However, as we shift our view to the more advanced countries,
we see increasingly better conditions for gender transitions
without the women being ghettoized or ostracized in the process.
In the most advanced countries, we see ever improving opportunities
for employment and even for a normal life as a woman post-transition. Hopefully
the many improvements now being made in the advanced countries
will provide models for rapid improvements in the less-developed
countries, especially under the influence of modern media and
- Links for further study:
"Links to International Support and Information Sites," LynnConway.com
"Historical and cross-cultural evidence of transsexualism," LynnConway.com.
"Vaginoplasty: Male to Female Sex Reassignment Surgery - Historical Background,"
by Sam Winter.
European Transgender Network (TGEU)
TS Information > Differences in the
situations of TG and TS people in countries around the world