Transition in SerbiaNemanja Stijak
The transition is different for all trans people who have been through it. It may include all or just some of the following steps: outing, name change, gender reassignment in ID, hormone therapy, surgeries, etc.
As we can see, some of the steps are social, some legal, some of medical nature. Ideally, all of these steps would be optional and completely independent of each other. Unfortunately, in Serbia the legal transition is still largely dependent on medical ones, namely, only the name in the documents can be changed without any medical therapies or interventions.
A person can change their name independently from the age of 15. There is an item in Family Law that indicates that a newly elected name cannot be “contrary to the customs and understandings of the environment” and it is up to the registrar to determine if the new name fulfills this condition. In practice, that most often means that the registrar will reject a name that does not match the gender mark in the documents. Therefore, many trans people who change before medical transition choose gender-neutral names. However, in the past two years, several trans people have managed to change their name even though it does not match their gender mark in the documents.
As far as medical transition is concerned, it can be done in state health institutions and is partially covered by health insurance, if the person is a Serbian citizen and insured with the Republican Health Insurance Fund.
The medical transition begins with a visit to a GP who sends a trans person to one of two psychiatrists who work with trans people. For people living in Belgrade, the procedure is quick as they immediately receive a referral to a specialist, while those from the other parts of Serbia need to obtain an additional stamp from a local specialist to be able to come to Belgrade, where both of the above psychiatrists work.
If a trans person wants to go into hormone therapy, they must get a recommendation from a psychiatrist. As a rule, psychiatrists working with trans persons in Serbia only make recommendations after a minimum of one year of regular meetings. With a recommendation for hormone therapy, the person again goes to a GP and seeks a referral to an endocrinologist who works with trans people. Unfortunately, only a few endocrinologists from the Clinical Center of Serbia work with trans persons.
Before prescribing hormone therapy, the endocrinologist will ask for a thorough blood test and various other examinations. The endocrinologist prescribes hormone therapy unless there are medical contraindications. Prescribed hormones are generally found in pharmacies. Unfortunately, some of the hormones the doctor prescribes to trans women are no longer on the market in Serbia.
Persons wishing to undergo surgery at the expense of National Health Insurance Fund must have referrals for surgery from two psychiatrists who work with trans people, as well as from endocrinologists. In addition, a person must be on hormone therapy for at least one year. The National Health Insurance Fund covers two-thirds of the cost of the operation, and the amount
a trans person has to pay out of their own pocket is about 1000 euros. In order for an operation to be approved, a person must carry out additional examinations and collect the necessary documentation that he submits to the Republic Transgender State Commission. If the commission approves the surgery, the trans person goes to the surgeon to schedule the surgery and be informed about the preparation for the surgery.
The gender mark in personal documents may change after one year of hormone therapy, based on a form signed by a specialist psychiatrist and a specialist endocrinologist. This form shall be submitted to the competent municipality, which will change the gender mark in the registry. After that, the person can change the name (if not already) and take out a new ID, passport, diplomas and other documents. This process can also be performed after surgery, in which case the surgeon signs the form.
Sasha has been active in the civil sector as a lawyer for Geten and a trans activist since 2016. In 2018 and 2019, he worked as a consultant for the United Nations and contributed to the production of various materials for the local and global Free & Equal campaign.”