Brynn Craffey

Free Sex-Change Surgery in Cuba

Filed By Brynn Craffey | July 03, 2008 4:00 PM | comments

Filed in: Marriage Equality, Politics, Transgender & Intersex
Tags: Cuba, transgender, transsexual

The first week of June saw the beginnings of a dramatic reversal of decades of oppression toward transgender people in Cuba when the government of the new president, Raúl Castro, began offering free hormone treatment and sex-change operations for transsexuals.

My first thought was, "Does that include foreigners?" I don't know the answer, but if so, they may find themselves inundated by North Americans tourists who either lack health insurance or whose policies exclude the surgeries from coverage.

The free medical treatment is the result of the passage into law on June 4 of "Resolution 126," which offers transsexuals new identification documents--no small matter!--in addition to free sex reassignment surgery and hormonal therapy. The legislation marks quite a revolutionary change for a country whose single recorded sex-change operation, according to news reports, occurred in 1988.

The policy change is part of an enormous, albeit ongoing, transformation of Cuban society brought about in no small way by Former President Fidel Castro's retirement from office in February of this year. Props should also go to Mariela Castro-Espin, daughter of current Cuban President (and Fidel's brother), Raúl Castro.

Ms. Castro-Espin heads the National Center for Sex Education (CENESEX), a government-funded body whose mission, according to Wikipedia, is to contribute to "the development of a culture of sexuality that is full, pleasurable and responsible, as well as to promote the full exercise of sexual rights." The center has played a prominent role in promoting tolerance of LGBT issues, as well as in AIDS prevention and education, and contraception.

Early news reports suggest that Resolution 126 adopts a fairly sophisticated and comprehensive approach to transsexuality, including recognition of the fact that not all of us want to have surgery. [emphasis mine]

Resolution 126, which was signed Jun. 4 by Public Health Minister José Ramón Balaguer, establishes the creation of a centre that will provide integral health care for transsexuals. It will be the only institution in Cuba authorised to carry out gender reassignment therapy.

The decision also "legitimates the work of the National Commission for Integral Care of Transsexual People," created by CENESEX in 2005 as the continuation of a multidisciplinary team that has functioned since 1979, said Castro.

"This resolution establishes all of the aspects of care for transsexuals, including the operation for those who qualify and are interested, because not all transsexuals want the surgery," said the sexologist.

The functions of the National Commission include drafting, implementing and coordinating the national policy on integral care for transsexuals, approving gender reassignment surgery on a case-by-case basis, promoting research and advising the Public Health Ministry on policy-making questions.

The new centre, meanwhile, will provide integral care, including pre and post-op interviews, diagnosis, treatment and follow-up for transsexuals undergoing sex change surgery as well as those who only receive hormonal treatment.

Let's hope that this positive development marks the beginning of a dramatic change for the Cuban LGBT community as a whole. During much of Fidel Castro's reign, which began nearly half a century ago in January, 1959, Cuba was an appallingly oppressive place for LGBT people. Condemned by a culture that glorified "machismo," effeminate gay men and transgender people were punished by being sent to rural prison farms and labor camps where they were brutally mistreated. The terrible situation may have even helped spark the North American gay rights movement according to one writer, who says that newspaper accounts of the camps triggered the first pickets in front of the White House by gays and lesbians who held up signs asking, "Cuba persecutes gays; Is the U.S. much better?"

Again according to Wikipedia, homosexuality was formally decriminalized in Cuba in 1979, yet that didn't stop hundreds (maybe thousands) of gay men (and some women) from fleeing Cuba a year later during the Mariel boat-lift, part of an estimated total of 125,000 Cubans (described at the time as "undesirables and criminals") who fled the island seeking refugee status in the United States. Many of these people set foot on our shores only to find themselves once again incarcerated for long periods of time with very slow due process--but that's another story.

While reports on the current situation differ depending on whether or not one is a Castro supporter or critic, it seems that prejudice and oppression toward the LGBT community in Cuba remain persistent. A law prohibiting hassling "others with homosexual demands" (Article 303a, Act 62 of the Penal Code of April 30, 1988) which was modified in 1997 to read, "hassling with sexual demands," continues to be disproportionately enforced against LGBT people.

LGBT organizations and publications, gay pride marches, and gay clubs are prohibited. Wikipedia says that the only gay and lesbian civil rights organization, the Cuban Association of Gays and Lesbians, formed in 1994, was disbanded in 1997 when its members were arrested. Marriage remains restricted to the union of a man and a woman, and no alternative, such as civil unions or domestic partnerships, exists.

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Glad you pointed out what the trans community has lauded since Fidel's niece made the announcement.

I'm sure a quick check will show you that tourism is prohibited to Cuba by U.S. citizens, although government-approved educational missions with clear guidelines do occur and are permitted.

Ethan St. Pierre on TransFM has talked about this on his weekly internet radio program since it was proclaimed, and it's lauded as appropriate and sound public health and general health practice.

I should point out that I don't wish ever to take lightly the awful way so many Cubans were forced from their native homeland in the late '50s. Many found refuge in the U.S., having to leave behind family members, cherished personal possessions and all proclamation of wealth or property. Diego

Hmmm, now, if only you could find a way past the illusion that such measures will actually be carried out-- and that you won't be beaten/arrested by homophobic/transphobic police/civilians in the process-- it would be a swell solution for fellow T's.

Dear, have you ever been to Cuba? Have you EXPERIENCED Cuba, not as a tourist, but as a Cuban? Please, allow me to plead for your reconsideration. Don't strengthen their economy with your tourist dollars.

Brynn Craffey Brynn Craffey | July 3, 2008 6:58 PM

a quick check will show you that tourism is prohibited to Cuba by U.S. citizens,

U.S. citizens have been getting around that ban for more than 15 years, now. One way has been to enter Cuba through Mexico.

Lucrece, I have never been to Cuba, although I know several people who have. Considering the changes occurring since Raúl assumed the presidency, I guess I'm hoping for the best and willing to adopt a "wait and see" attitude.

These changes are a smokescreen for the same old crap. We in the exile movement know this.

With that said, I share your hope for the best ;). Hopefully, there will be the best of both worlds (accommodations for T's and a less corrupt, tyrannical government).

Lucrece, I truly honor, respect and have humble quiet for the exile movement. The experience of Cuba touches my life personally.

Brynn, my sentence you called out, about the prohibition of tourism travel by U.S. citizens to Cuba, is true. People do have legal ways to visit. Tourism is not among legally allowed trip purposes for people using a U.S. passport.

I can't know how non-trans people might feel about the sanctity of their U.S. passports. I can speak only for myself. To me, it's a serious document that I treasure and value.

I hope that any trans person with a properly gender marked, legal U.S. passport (whether one-year or for the full life-span of a passport -- or anyone with HOPE to get one, would not risk losing it in an effort to bypass U.S. law. Those stamps made upon arrival and departure of non-U.S. destinations are not like temporary tatoos. They are part of the record.

Some people might exceed the speed limit in their autos, and many city and state budgets anticipate and receive revenue based on that. As a transman, I would not. Being pulled over isn't the same for me as it is for so many others, I imagine.

Each person has to assess the level of risk they wish to take or create. For me, the law saying not to be a tourist in Cuba suffices. Diego

"Dear, have you ever been to Cuba? Have you EXPERIENCED Cuba, not as a tourist, but as a Cuban? Please, allow me to plead for your reconsideration. Don't strengthen their economy with your tourist dollars."

It has been past time, for a long time now, to do away with the Cuban embargo, and I hope Obama does so. In fact, the best way to force the Castro family out of power would be for the nation to be corrupted by American money. The Russians haven't been coming since the 1980s, and the missiles were removed in 1962. This embargo is an anachronism.

Once the embargo is removed, why not allow those who desire SRS to go to Cuba? Is it really going to be worse, septically and safety-wise, than India, Thailand, or any other nation? I am sure Cubans would charge Americans for SRS, and that would force them to be competitive internationally in medical safety factors.

Is it really going to be worse, septically and safety-wise, than India, Thailand, or any other nation?

Thailand's better than the US, India not as good. But Cuba.. have you seen the pictures of some of the "hospitals" there?


The hospitals for foreigners are a lot better -

Some are better than others

And sometimes the surgical wounds, while functionally well cared for, are less than aesthetic

Compare with Thailand

I've spent some time in Aikchol hospital in Chonburi, Thailand. Less labour-saving devices and automatic monitors than in an Australian hospital, but 3 times as many nurses per patient, so the care is actually better.

You'd only ask a question like that if you'd not done much travelling outside the USA. To see how some places are slightly better, but most are an awful lot worse.

Granted, my only "experience" with Cuban health care was Michael Moore's Sicko, but it sure didn't seem too bad...

And hasn't Cuba also made great strides in LGBT equality lately?

Lucrece, If you conservatives really want to kill communism in Cuba, all you'll have to do is speak these words:

"We are announcing that the trade embargo and travel ban on cuba has been lifted."

It definitely worked in East Germany, which reunited with with its 'Wessi' cousins after the Wall fell.

After years of visits to their 'Ossi' cousins, bearing jeans, driving nice cars, wearing nice clothes and watching Wessi TV, the 'Ossis', who had the best living standard in the Eastern Bloc had a visual yardstick to compare their lives under Communism with their cousins in the West. They also in those holday gatherings got verification that what they were told in their media about their 'Wessi' cousins wasn't exactly true. All the steroid-fueled Olympic victories couldn't change that.

When the trade and travel embargo is lifted and Cubans living in south Florida and elsewhere visit their cousins on the island more frequently bearing IPods, dressed in designer clothes, wallets bulging with cash and telling their cousins about their lives in America unfettered by Communist party minders, communism in Cuba will go the way of the 8 track tape player.

"You'd only ask a question like that if you'd not done much travelling outside the USA. To see how some places are slightly better, but most are an awful lot worse."

Wow, Zoe......what a slam.......ouch! But I love you anyway. You're partially right: many Americans haven't traveled abroad, that's quite true. And we should travel more. Heck, I've never been to California, and that's in our own country. The tendency in the US is towards shorter vacations and less leisure time, which is the reverse of other nations.

There aren't many us of us from Kentucky who hold passports - I think we're second lowest in passports issued percapita in the US (I think we're still ahead of West Virginia, and have more last names to boot). I have only visited a fraction of the places I intend to go before I leave my final carbon footprints. However, my wife and I do hold them, and mine has a number of foreign stamps - some fairly surprising ones, actually. Susan's would really shock you - a big chunk of tropical and subtropical Africa and nearly every European nation west of Kiev. Be assured Australia's on our itinerary, next time we can get a couple weeks off consecutively at the same time.

I'm quite aware that medical care outside of North America and Western Europe is widely variable. I'm married to a microbiologist, and medical journals are lying around our home. But the lousy health insurance situation in the US (I have had health coverage 6 of the past 25 years) has forced many Americans to have procedures done in countries that market some of their facilities for medical tourism. We all are aware of the sizable number of US T people who travel to Thailand for SRS and other feminization and masculinization procedures. I'm also sure the facilities that do such work in Thailand, India, and such are not typical of the facilities unemployed fieldworkers receive care in.

So, Cuba gets into the medical tourism business, doing SRS. They know the internet exists. Those who take the risk of having SRS there will judge the facilities and quality of the work, and it will no doubt show up on Anne Lawrence's page for analysis. The marketplace will act accordingly. Would the money spent by US T people in Cuba possibly go to upgrade other parts of the clinics that are not seen by the medical tourists? Maybe, maybe not. But I don't believe in closed borders, for reasons Monica Roberts amply illustrates, and because I think the Cuban embargo has hurt the Cuban people a lot more than it's hurt the Castro family. And I know for damned certain that George Bush's policy of not talking to world leaders we don't like, is absolutely stupid to the extreme.

anyone want to lend me airfare to cuba? so i can get mine done?