“I don’t want to be visibly trans 24 hours a day.”

Catalonia has a health care model for transgender people that is a pioneer in Spain and Europe. Trànsit, the collective referral unit in primary care, does not ask for a psychiatric diagnosis at trans persons for access to sex confirmation surgery, which means no longer treating transsexuality as a mental illness. This is stated in instruction 14/2017 of the Servei Català de la Salut (CatSalut), which has changed the. healthcare paradigm to the most discriminated and stigmatized sector in the whole of the LGTBI collective.

However, trans people are now complaining that this model, which they themselves defend, is not being implemented. The long waiting lists for access to the surgeries (there are only three hospitals that operate: Can Ruti, Bellvitge and Clínic, and in total they perform 50 vaginoplasties per year and 15 mastectomies) leave many users without access to them. This is the story of two people who tell in EL PERIÓDICO about their journey and their years of waiting to be recognition of their rights.


Èlia Surrell: “There is no way out unless you pay the private sector”.

It has 27 years old and has been waiting since 2018 to undergo a orchiectomy (the removal of one or both testicles). Èlia Surrell complains not only that has not yet been operated on of this surgery, which is included in instruction 14/2017 of the Servei Català de la Salut (CatSalut), but rather. the system does not even perform this intervention. “In August, Trànsit called me because I had been on the waiting list for surgery since 2018 and it was my turn, but the only intervention that is being done in practice is vaginoplasty. [la reconstrucción de una vagina] and I don’t want to have it done,” says this young woman.

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Thus, when it comes down to it, the system of surgical interventions, he laments, “does not recognize the reality of trans people.” Surrell, who started trans at age 22, put herself on the waiting list for surgery years ago, despite the fact that at the time she did so without knowing full well which operation she wanted to have done. But she signed up, like many trans people, knowing that she would the waiting lists would be long. “I don’t want to have a vaginoplasty, but an orchiectomy, because the latter surgery is less invasive.” Surrell recounts.

In fact, it is an intervention “so simple”, That, referred by primary care, it is performed by urologists. “But they must certify that it is done by some kind of disease. As a trans person, I’m not in that group,” the young woman explains. She could have an orchiectomy for the private healthcare, but it would cost about 5,500 euros. “It makes me angry because there is no way out, unless you pay.”

However, such an easy intervention is for her very important. “The hormones I take now have side effects. I want to stop taking them. Also because of a physical aspect issue: I have problems with some of them. pieces of clothing I don’t want to wear,” she explains.


Àlex Bixquert: “Lometimes people’s looks are very uncomfortable”.

Five years is how long it has been Àlex Bixquert, 36, waiting for access to a mastectomy, the surgery to remove the breast. Bixquert did the social transit in 2016: from then on, they started calling him Àlex and addressing him in masculine. In 2018, he started with the physical transit.

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“Since I already knew how the story was going, I went to Trànsit in March 2018 to search hormones and to put me in waiting list for mastectomy and for thoracic masculinization surgery”. That’s how long she’s been waiting for the procedure. “A lot of people I know end up going to the private. Cost from 6,000 euros. I have thought about doing it myself as well, but it would mean asking for a loan and get into debt,” he says.

Bixquert explains that she does not experience her situation in a “particularly traumatic” way, but she does say that having a breast means she “a lot of added problems”. “For example, I don’t go to the pool. Months ago I was in a spa with my partner and things were quite conflicting: they wouldn’t let me go ‘topless’ because. I have breasts, while cisgender men did,” he says. To swim or bathe in the pool, he has to wear a binder (a kind of girdle) and, on top, a T-shirt. “It’s not comfortable.” he assures. On the beach he is freer and doesn’t use it because “there are no dress codes,” but “people’s looks are sometimes very uncomfortable”.

“Having surgery is important for live in peace, To be able to go places, to buy clothes that I can’t now. To wear more T-shirts that are not black, because this color is the one that most conceals the chest. I don’t want people to look at me in the street,” says Bixquert. “I don’t want to be visibly trans 24 hours a day.”

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