He was interested in the conditions under which hormone and drug therapy is prescribed for adults wishing to change their biological sex, how many surgical interventions for sex change are performed, under what conditions people under 18 are referred to hormone and drug therapy ( including puberty blockers) for gender reassignment and how many there are. More: ITN asks the minister about the call from Europe to legalize gender reassignment
Minister Kondeva requested opinions on the subject from the expert councils in the specialties “Endocrinology and metabolic diseases”, “Obstetrics and gynecology” and “Surgery”.
The explanation from the chief coordinator of the expert council on “Endocrinology and Exchange Diseases” is that adults wishing to change their civil gender fall into two main categories from a medical point of view: patients with intersex conditions/diseases and transgender persons. More:
In the first group are individuals with congenitally atypical or different from civil sex development of the external genitalia and/or internal genital organs with or without additional clinical symptoms and complications. They are caused most often by congenital genetic disorders and rare diseases. Due to the clinical changes in some of them, it is possible that the sex at birth was determined incorrectly. In others, the biological, clinical and mental characteristics do not correspond to the assigned civil sex. All these patients are subject to the specialty “Endocrinology and Metabolic Diseases” and are treated according to established European recommendations. More: Emily Trotinetka has received 10,000 euros for sex reassignment surgery
A large number of these patients are at risk of developing genital tumors, which require prophylactic or surgical interventions and subsequent hormone replacement therapy. In case of obvious inconsistencies between the biological characteristics of such patients and the adopted civil sex, endangering their physical and mental health, they are referred for a change of civil sex.
“The decision for such a change rests with the judicial authorities, in the presence of relevant medical documentation and expertise from appointed forensic doctors and psychologists. The number of court decisions issued in the country in this regard should be requested from the judicial administration. Medical facilities do not maintain a register of persons with intersex conditions who have changed their sex, even more so they may be treated in different medical facilities within the territory of the country or outside of it,” the minister explains. More: Up to 7 years in prison for parents in Scotland who deny their children gender reassignment
The second group of persons wishing to change their civil gender are transgender men and women. The reasons for their decision are psychological/psychiatric, not biological. They have a normally functioning endocrine and sexual system, with a normal possibility of reproduction.
Experts are adamant that they cannot start hormone therapy opposite to the biological sex. Such medicinal products are not registered either.
“It should be emphasized that many transgender Bulgarians start hormone therapy or undergo surgical interventions in countries of the European Union and beyond. Others very often undergo hormone therapy arbitrarily, based on online recommendations and online purchase of medicinal products of unknown quality and without medical control. In such cases, consultations with various medical specialists are necessary subsequently to prevent and treat side effects and complications. Therefore, it is not possible to make real statistics of how many people in our country use hormone therapy due to a desire to change sex and with what drugs,” explains Dr. Kondeva.
The main coordinator has informed that such information is provided by the medical facilities to the NHIF.
Regarding minors referred for hormone and drug therapy for gender reassignment, the answer is that it is carried out by doctors specializing in “Pediatric Endocrinology”, and the principles of treatment are similar to those for adults.
The Chief Coordinator of Surgery has stated that there are no known medical indications for gender reassignment.
The coordinator for “Obstetrics and Gynecology” has no opinion on Predov’s questions.
We remind you that in November of this year, the “There is such a people” bill for changes to the Child Protection Act was rejected.
They proposed to prohibit the distribution of propaganda materials in schools and kindergartens and the holding of events on health, gender and social topics that do not correspond to the generally accepted moral and ethical norms for the concept of “biological sex” in society and are not approved by Ministry of Education and Science (MES). More: They allowed 16-year-olds to change their gender in Sweden
The other prohibition is for the distribution of informational materials and events, but already related to propaganda or early determination of the gender identity of children, other than the biological one, as well as the provision of medical services to children, including hormone therapy or intervention that does not correspond to their biological sex. Also, the Health Act called for a ban on the direct advertising and provision of medical services involving hormonal or other medical sex reassignment therapy to persons under 18 years of age.
