Toprak, a 22-year-old medical faculty student, says, “I want a world where trans people are not burned to death, but a world where they are successful.”
Source: “As a trans woman and a medical student, I want to be able to easily do my job”, (Tıp Okuyan Bir Trans Kadın Olarak Mesleğimi Rahatça Yapabilmek İstiyorum), bianet.org, July 21, 2018, http://bianet.org/biamag/toplumsal-cinsiyet/199361-tip-okuyan-bir-trans-kadin-olarak-meslegimi-rahatca-yapabilmek-istiyorum
Toprak is a 22-year-old medical faculty student. She has two more years before she graduates. She is trying to obtain a new identity card as a woman before she graduates because she wants her diploma to belong to her and not to state a gender identity assigned to her at birth.
Toprak was born in Antep. She attained a high score in the university entrance exam and came to Istanbul five years ago to study at the Istanbul Faculty of Medicine.
Toprak needs financial support in order to have gender reassignment surgery. She started a crowdsourcing campaign to accomplish this.
When she becomes a doctor she wants to be able to proudly hang her diploma on her office wall. She is worried that she will not get appointed and be discriminated against as a civil servant because of the male gender identity marker on her ID card.
Toprak says: “I want to break down prejudices and show people what transwomen can achieve. Transgender people are studying in many different fields. As a transwoman, I want to easily be able to do my job. I need people’s support to be able to have this gender reassignment surgery. I want a world where trans people are not burned to death, but a world where they are successful.”
As a transwoman and medical student, Toprak spoke with Bianet about her university life, future plans and her gender transition process.
Could you tell us a little bit about yourself?
My name is Toprak and I am 22 years old. I am a fifth year medical student at Istanbul Faculty of Medicine. I am a transwoman.
Have you always lived in Istanbul?
No, I was born in Gaziantep. I passed the exam and got into a science-focused high school and studied there for four years before coming to Istanbul for university. I have been living in Istanbul for the past five years.
How is university life?
The first two years were quiet because I hadn’t started my transition process yet and I wasn’t out. I was identifying myself as gay back then. A year later, being openly gay, I started experiencing difficulties, mostly with my family. These did not have much of an impact on my university life. Because of their educational and cultural backgrounds, I did not actually receive any negative reactions from professors or fellow students.
I had only one traumatic transition process experience.
We read about this on social media. A professor at Istanbul University made transphobic statements. Where you in that class? Could you tell us what happened?
Yes. A professor was teaching hypogonadism and talking about pituitary glands, endocrine hormones, testosterone, and estrogen. The topic had nothing to do with transsexuality, but I got the feeling that it was going there.
The professor brought up the topic of transsexuality and said “Men without ovaries come and say, ‘I’m going to be a woman.’ These people are psychopaths. Upon receiving them, we refer them to psychiatry.”
He took out his ID card from his wallet and said, “Here’s a blue ID card. They work so hard to get a pink ID card. There were 250 students in the lecture hall. I was sitting at the back and the professor did not know I was trans. About 70-80 students busted into laughter together with the professor.
I stood up and said, “who are you calling a psychopath? I’m a transwoman.” He was surprised because he did not expect that there would be a transwoman in the lecture hall. He turned around and continued reading from his slides.
I said he needed to explain his statement in front of everybody since he had said this in front of everybody. He said “come and see me after class and I will explain this to you.”
This person is an endocrinologist, meaning he is working in an area that concerns trans people. It really baffles me why nobody ever complained about him because he is an extremely transphobic guy.
Did anybody in the lecture hall say anything?
No. So I shared what happened. I did not expect this to get around so quickly. I assumed people in the LGBT community would hear about it and that people would know about this person.
Things took a different turn when the Turkish Medical Association (TMA) began to support me.
How did the TMA support you?
I shared the incident on Twitter. Doctors from the TMA saw my tweet. They invited me to their board meeting and were very attentive. Their support came a few days after the incident. During those four days, I experienced some negativity at school.
What happened? I’m curious to know how the administration and students responded?
Medical students have a kind of a political stance…Actually, they don’t have a political stance, and they are apolitical. They put their careers first and ignore everything else. They treat people neither positively nor negatively. They are neutral. The university has a similar stance. They choose to remove themselves from the current affairs of the country.
That is why they tried to maintain neutrality, but the feminist club at the university showed great support. They wrote a piece, collected signatures from 11 other clubs and published the statement. I did not experience bullying or any kind of verbal violence. Apart from Twitter, I received a great amount of support.
How did the university administration deal with this?
Initially, they started an investigation against me.
Why did they start an investigation?
Because I had disclosed what the professor said.
Did they warn the professor?
No, they gave him no warning until the TMA stepped in. They treated the incident as if we were in elementary school. They called me in and asked, “Why did you do this? This should have stayed between us. Why did you have to tell everyone?” I felt terrible and I cried that day.
Later, my phone rang and the TMA invited me to their board meeting. Once the news reached the TMA, people in the medical community heard the professor’s transphobic statement. Then celebrities heard about it and they shared their reactions on social media. I never imagined so many people would hear about it.
How did these events impact the investigation started against you?
I found out that the investigation was dropped and that an investigation against the professor had opened instead.
I was a witness in the professor’s investigation and he also gave a statement. Honestly, it felt good to see that he was waiting at the door to explain himself.
Then they said he was penalized.
What was his penalty?
I’m not exactly sure, but they said that the professor was no longer authorized to give oral assessments for internal medicine. Internal medicine is a very important field and to give the oral assessment is considered a huge honor.
During this process, solidarity felt great. When I saw the power of solidarity, I decided to get funding for my surgery. A friend, studying architecture, said she started a campaign for herself and advised me to do the same. I decided to start a campaign because I urgently need to have my surgery.
Why is this so urgent for you?
Unfortunately, currently my ID card has the male gender marker. Surgery is a requirement to change your gender marker on your ID in Turkey.
Without having a female gender identity marker, I worry that I won’t be appointed. Over the past two years, there have been state security investigations against doctors. I worry that having a male gender identity marker on my ID card will impact my appointment. I am a fifth year medical student who will be graduating soon. That’s why I want to have my surgery before graduation.
The main problem for trans people regarding their diploma is the name written on it. It is necessary to change your name before graduating. If you change your name after you graduate, then there is no indication that the diploma belongs to you, making it almost null. I changed my name on my ID card recently. I started my transition a year ago and everything progressed quickly.
Which area do you want to specialize in?
Internal medicine or gynaecology. Fields such as psychiatry and surgery are important for LGBT people, but you need to have really good grades to be in these fields. We’ll see.
You spent this year working. What was your hospital experience like?
We spend many years studying, but after our third year we get to work and I like that we get to be in direct contact with patients and not spend much time at school.
Many of my professors and other students support me.
There is a certain perception of trans woman in society and when you do not fit that perception, they do not call you a trans woman. So far, I have not experienced any negative reactions from patients because they do not know that I am trans.
I used to shy away from patients having seen how patients’ relatives attack health workers.
The other day, one relative of a patient hit a doctor on the head with a brick. Imagine what a person might do to a trans woman…
This is why I do not disclose my trans identity to patients.
Could you tell us about what the transition process is like as both a medical student and as someone experiencing this?
You apply to psychiatry at a public hospital. In Istanbul you can apply to Çapa or Cerrahpaşa. They observe you for at least six months and first refer you to psychiatry and then to endocrinology. At endocrinology you get a hormone test and then you start taking hormones. This process takes about a year.
Social Security Insurance (SSI = public medical insurance) covers everything except hormone medications. Hormone medications cost about 150-200 TL a month. Doctors have now started to write medical reports for hormone medications. As a result, SSI covers hormone medications too.
What is the hormone therapy process like?
(For trans women) You take out testosterone from the body and take in estrogen. The hormones impact you. Your emotions change. The hormone perceived by the receptors change, in other words, the codes change.
For instance, when the lecture hall incident happened, I was feeling very vulnerable because it had been a few months that I had been taking hormones.
This continues for the first six months before your body starts adapting. I don’t feel like that anymore.
Does the surgery process start after that?
The most important thing is the surgery. At this point, transmen are luckier because mastectomy (removal of breasts) and hysterectomy (removal of the uterus) are operations covered by SSI. Because these operations include removing of a part, the procedure is the same for any doctor. But surgeries such as vaginoplasty are highly risky since they involve creating something out of nothing.
SSI does cover this operation but there are no doctors who perform the procedure under this insurance. Even if there is a doctor out there who performs the operation under this insurance, it is really difficult to trust that doctor.
In medical school they do not teach you anything about transgender transition processes. If the person wishes, they self educate themselves after they graduate. If that person has no training, s/he cannot do the operation.
Doctors who specialize in these surgeries must be well known in the trans community then.
Yes. Because this operation is very important, I want to go to a good doctor to have my operation. One trans woman died at an operation two years ago. She was an activist and was living in Izmir. They said she died due to a complication that had derived from her. If the doctor had made a mistake, he would have been penalized anyway.
What kinds of complications arise during an operation like this?
There are complications that are repairable and complications that are more severe. Infections and clitoris dryness are the most common complications that are repairable. One friend didn’t go to a good doctor and got infected; had the surgery again and was hospitalized for three weeks. Another friend had clitoris dryness because the nerve cells were not stitched together well; she had a second operation and was hospitalized for a month.
I do not want to go through any complications. Also, I do not want to disrupt my studies. Attendance is compulsory.
How much does gender reassignment surgery cost?
About 20-30 thousand Turkish lira(3,600-5,400 Euro).