In the report: Baseline for political advocacy: Approaches to the exercise of the Right to the Family, Sexual and Reproductive Rights of Pregnant Trans Men and Registration of their Descendants in Bolivia, you say that: the lack of information and dialogue about the needs and situations experienced by the trans male population in their pregnancy practices, childbirth and including abortion, evidence, on the one hand, the lack of interest in documenting these experiences, and on the other, that precisely they are understood as an issue that only concerns cisgender women and not diversities. What are the responsibilities regarding health systems and psychological care?, among other, that a State like Bolivia must have regarding transmasculine people?
The State has a constitutional mandate of non-discrimination based on gender identity and of guaranteeing the exercise of all rights to all people and communities. (Art.14), therefore, transmasculinities should also be guaranteed access to health, sexual rights and reproductive rights, to the family, etc. Guaranteeing access to health for all people is an essential goal of the State (Art. 9). In theory, Access to any health service cannot be denied to any person.
Nevertheless, Neither the Gender Identity Law nor the Unified Health System include specific health benefits or benefits according to the needs of transmasculine people., for instance, hormone coverage, surgeries, abortions, gynecology, medical laboratories, social benefits and pre- and post-natal care for their descendants, etc. Even access to hormones is extremely expensive and sometimes there are shortages of medications.
On the other hand, there is an omission on the part of the civic registration service by not establishing a procedure to register their descendants, causing medical risks in pregnant trans parents who do not know where to go to obtain a live birth certificate in which they appear as parents respecting their gender identity, and also difficulties in accessing health care for their descendants due to lack of identity records that reflect their real affiliation with these trans men as parents..
What is demanded from Bolivian trans masculine activisms??
Knowledge by medical personnel about our health needs, specific care protocols. That the public health system cover medications and procedures related to the transition (They are considered non-essential or aesthetic services), that any care be provided regardless of whether the name change was made, although some of these benefits are considered typically feminine, for instance, gynecology, mammography and abortions.
There are no guarantees that these services will be provided to us, since it varies depending on the city or health center. Sometimes, health insurance refuses to provide them when the name change to male has already been made, with the argument that they cannot administratively justify that a female service was granted to a male.
In America the movement for the right to free and safe abortion has gained a lot of strength in recent years, although there are setbacks in some countries. However, the most generalized approach seems not to include transmasculinities.. What are the biggest problems that a transmasculine person faces once they decide to have an abortion??
Find a health center and staff willing to care for you. That health personnel apply the Constitutional Sentence 206/2014 that establishes 5 causes for IVE, since it only refers to women. That health personnel provide dignified treatment, respecting male gender identity.
The stigma and revictimization in cases of rape is highly alarming due to the lack of knowledge of our corporalities and that despite being on hormones, or name change, we can still conceive and possibly need an abortion.
What should be the civil process carried out by the State so that diverse paternities are respected?, valued and defended in Bolivia?
It depends on the particular case. Actually, It should be an administrative process in application of the Gender Identity Law and when the Civic Registry refuses to recognize it, We should go the constitutional route through an Amparo. To avoid this, It would be easier to have a clear procedure that guarantees that whatever the family configuration of that trans man, You have the possibility of registering your descendants and that your male gender identity will be respected. Without a doubt, what would also help the most is education.; make our existence visible and that trans people are also capable of parenting, be included in the ESI, eliminate myths and stigmas associated with trans reproduction. Have a law on sexual rights and reproductive rights that guarantees access to assisted reproduction methods also for diversities. Change birth registration formats by eliminating binaristic logic, etc.
