Threatened trans community: Scientists criticize health care

Hundreds of international scientists have shown solidarity with the Berlin trans community. The Dolls community meeting place in the Casa Kuà health center was raided by the police on October 18th. In an open letter, the scientists call for an end to the criminalization of trans communities and needs-based health care. The more than 200 signatories include Judith Butler, Susan Stryker and Eva von Redecker.

The attack on The Dolls Casa Kuà is historic, the letter says. “The attack against the Berlin Dolls comes during a time of unprecedented rise in state fascism,” the open letter says. This is the case both in Germany, where the AfD recently won the elections in Saxony-Anhalt, as well as in neighboring European countries as well as in India, Brazil, Argentina and the United States, the authors continue.

Non-white trans women in particular are targeted by proto-fascist and authoritarian regimes: “Being trans stands out in particular as a visible violation of the cis-hetero-patriarchal norms on which fascist authority is based.” State violence in the penal system and in administration would further increase fear and mistrust towards trans people.

On October 18, 38 police officers searched the Casa Kuà health center in Berlin-Kreuzberg. At this time, the “Dolls” community meeting was taking place there, where marginalized trans women were provided with clothing and food and discussed topics related to being trans.

Reason for the search: Suspicion of illegal trafficking in prescription drugs. The public prosecutor's office seemed to suspect that hormone replacement therapy was being carried out there illegally. At the request of the taz, it was said that “suspected doping drugs” had been seized. However, hormones needed by trans women such as estrogen and progesterone have the opposite effect.

A second, previously unpublished letter from more than 120 scientists from Germany also condemns the use of the police “in a communal, self-organized protective space for people who experience structural and physical violence and danger in many ways in their everyday lives”.

The signatories also criticize the role of the legislature, which has so far failed to ensure adequate health care for trans people. They demand “needs-based, low-threshold and discrimination-sensitive health care for all trans*, inter*, non-binary and queer people”.

Trans people often wait several years for therapy places or specialized doctors. Many also report (racist) discrimination and untrained medical staff. People without health insurance or a permanent residence permit have no access to health insurance benefits anyway.

Since a landmark ruling by the Federal Social Court in October 2023, it has also been unclear which health services are covered by health insurance companies. At that time, the BSG decided that gender reassignment treatments required a new recommendation from the Federal Joint Committee. This committee determines which services health insurance companies cover. Three years later, there is still no such regulation.

From January 2027, the situation could worsen further: On the one hand, additional payments for remedies and medication will increase. On the other hand, doctors face stricter audits. Since the deadline set by the BSG (October 19, 2023), these have had to comply with significantly more restrictive guidelines for gender reassignment measures. Otherwise, they face high reimbursement of their fees.

The actions of the police and administration are already having an impact on medical treatment. “Where people used to act more empathetically within the scope of medical discretion, today fear leads to meticulous evaluation,” a doctor who wishes to remain anonymous tells the taz. This also has a negative impact on the treatment relationship between doctor and patient.

Patients feel this uncertainty directly. The taz is already aware of several cases of trans people who, after years of problem-free treatment, have now been rejected by their doctors. This is the case of an American woman. Like many trans people, she fled the transphobic regime in the USA. The diagnoses and documents from the USA had previously been sufficient in German translation, she tells the taz. But now doctors are also turning away people like them because the documents do not comply with German guidelines.