The past decade has seen an increasing number of people who identify as transgender choosing to officially transition. Today, the UK's National Health Service is asked to carry out four times as many gender reassignment surgeries a year than in 2007. Since 2011, the number of Americans who identify as transgender has doubled to 1.4 million.
Still, despite the fact that the public these days is much better informed about transgender rights in certain parts of the world, the realities of what it means to be transgender are very different depending on where you live. According to Human Rights Watch, nearly 2,000 transgender men and women were brutally murdered between 2007 and 2014 in different parts of the world.
Eight people from eight different countries open up about what it's like to transition in their own country—and how local policies affected their experience.
Kris Phillips, 19, Student
"I've never felt like I was in the wrong body, I just knew that being called 'she' didn't sound right to me. As I grew older, I began to learn about what it meant to be transgender.
My transition started mentally—I had to learn to accept myself first. I was about 16 when I first came out to my best friend, who took it really well. I then told my family, who reacted in every way you can imagine—from yelling to crying to complete silence.
In Canada, the steps you need to take towards transitioning vary, depending on the province you live in. In Ontario, where I live, you have to go to a psychologist for an evaluation before you can even apply to have your name changed. The next step for me was to go on the waiting list for Hormone Replacement Therapy (HRT). Because I'm not on testosterone yet, I still find going out in public difficult—I worry about what people think of me. But now that I am more comfortable with who I am and entering the first stages of my transition, I am extremely proud of myself for making it as far as I have."
Aale Teitto, 21, Student
"I was 16 when I realized I was a man. My family was confused at first, but when they saw how much happier I was, they swallowed their pride and supported my transition.
I received a referral from a doctor at our local healthcare center. The doctor didn't seem to entirely understand what 'trans' meant. The only thing he asked me was: 'So, do you, like, bind your chest?' I said yes, and that was it. Six months later, I started wondering why I still hadn't heard from any of Finland's trans clinics; I learned that the referral was still sitting on that doctor's desk.
That's when I decided to start taking hormones on my own—I bought them online from Finnish bodybuilders. I had no idea where those bodybuilders got them from. I knew it could be risky for my physical health, but I also felt that not taking them would have hurt my mental health more.
Finally, I got my first appointment at a local trans clinic. For the next eight months, I had to go there about once or twice a month. The official process requires that you meet with lots of people—doctors, social workers, nurses, and psychologists. I was forced to take endless tests, answer hundreds of questions about my family history, hobbies, and sex life—and I even had to take a Rorschach test.
After that, you can get your mastectomy and get on hormones. The surgery is covered by the state, but you need to pay some hospital fees—I only paid $45. Even after you've gone through all those tests, it's still recommended you see a gynecologist and take a blood test before you start taking the hormones.
If you want to legally be considered the gender you are, it takes about a year to change it on official documents. After that, you can get genital surgery if you want—but you need a recommendation from a trans clinic and a statement confirming you're infertile. That means you've either been sterilized, or have been on hormones long enough to become infertile."
Jody, 23, Model
"I was 18 when I told my parents I wanted to transition. They were completely fine with it, as long as I stopped partying so much; at the time I was going out in drag four nights a week. You can't be on hormones and get drunk all the time—you have to have a clear mind and a healthy body.
My health insurance covered most of the procedure. There are two hospitals in the Netherlands that can help you transition. Eight months after I applied to transition in Amsterdam, I started attending monthly meetings with doctors and psychologists to determine whether I qualified for the procedure.
I was able to start on my hormones three months into the meetings because I was certain I wanted to transition. If you have doubts of any kind, the process can be delayed for up to three years. Many people find the tests and questioning intrusive, which I understand. But I also understand that the medical team wants to keep the number of people who later regret their transition as low as possible. According to Dr. Martin den Heijer at the VU gender team, the number of people who regret transitioning in Amsterdam is around 1 percent because the process is so thorough and it gives people time to process. I think the Netherlands is one of the leading countries when it comes to guidance and treatment of trans people."
Teodoro, 23, Studying Philosophy at Valencia University
"As early as pre-puberty, I could sense that something about me was different. First, I considered myself a lesbian, but when I was 19 and met my first girlfriend, I realized I needed to make a change.
Beginning the transition wasn't easy. The first step you need to make is contacting your town's Gender Unit, or the one assigned to you by your general practitioner. Then—depending on where you live in Spain—you spend about four months going to therapy. After that, you are formally diagnosed with 'gender identity disorder' and referred to an endocrinologist, who will prescribe a hormone treatment. The process is fully covered by national insurance. After two years of hormone treatment, you can officially change your ID on government documents.
But of course, the process and the journey are never really finished. Before I started treatment, I was lost and I had no idea what to do with my life. Now that I own my body, I see things more clearly, and I'm not afraid to take a next step, whatever that may be."
Djura Djuricic, 29, Student and Activist
"I was 6 when I first felt I was a boy. At the time, I thought there was something wrong with me so I decided not to tell anyone. It wasn't until my second year of high school that I realized, after reading things on the internet, that there were others who felt the same way. My friends immediately accepted my decision. My parents, however, found it a lot harder to accept in the beginning, but they are progressively getting used to it.
I started the process of my transition in 2008, and by 2010 I was on hormones. Before you can receive surgery, you must get two letters of recommendation from psychiatrists, and one letter from an endocrinologist. After you pass a series of psychological and physical examinations, Serbia's national health service will cover 65 percent of the cost of the surgery.
I feel so much more confident at this stage of my transition. I'm waiting for my gender reassignment surgery at the moment, so I'm nervous, too."
Yoko Ruiz, 33, Trans Activist
"After my parents died when I was seven, I went to live with my uncles. I started discovering my true self when I wore my sister's school uniform for the first time. All my friends were girls, and I identified with the hairstyles and the dolls they had. I couldn't tell my uncles that I was gay and liked dressing as a woman because they were very religious and strict.
When I was 14, I decided to run away to another town, where I lived with someone I was in a relationship with. Later, at 17, I decided to go to Bogotá, where I got into the sex industry and befriended another trans woman. She taught me everything I know about living as a woman. Without her, I wouldn't be the person I am today.
Colombia is pretty forward thinking when it comes to protecting the rights of trans people, especially within Latin America. The Constitutional Court here has often ruled in favor of the trans community. If trans people want surgery, that's covered by the state—and although in the past you had to undergo a psychiatric evaluation before surgery, that's no longer the case. Personally, I haven't felt the need for gender reassignment surgery—at least so far. I feel like myself without having boobs or a vagina."
Fury, 30, Writer
"A little while back, I went to a Reclaim Australia counter-rally in Melbourne. Reclaim Australia is a far-right, anti-Islam protest group that vaguely attempts to project an image of respectability, while at the same time being populated by large swathes of Nazis with actual Swastika tattoos.
We did our best to stop them. After forming a human wall—we aimed to block attendees in order to dissolve the crowd—chaos broke out in pockets. At one point, an Aboriginal woman snatched the mic from the Reclaim Australia organizers and those of us nearby surrounded her like a shield while angry white men, draped in the Australian flag, lunged at us violently. When one of them heard me speak, my voice stopped him in his tracks. 'She's a woman!' he howled to one of his friends in surprise.
For trans people, seeking access to treatment in Australia can often feel like you're a dog being made to perform on an obstacle course. Every state has different regulations, and almost every doctor is unqualified. In Sydney, I've had friends get on hormones in two weeks. In Victoria, it takes upwards of six months. If you're in South Australia, you have to fly across state lines to Melbourne in order to get treatment. It is a total mess and it's reflective of what it is like to try and navigate public life in Australia as an LGBTQ person. We are a backwater of a nation that still has states where the 'Gay Panic' defense is enshrined in law. Hate crimes against trans people are not taken seriously by the justice system or the public. Finally, our program to support queer, trans, and gender diverse kids in schools got shut down by fascist members of parliament.
Everything that happened at the rally—me getting misgendered, the Islamophobia that permeated the event, the targeted violence towards the Aboriginal woman, and the Australian flag hanging over all of that—it's all interrelated, and it made it the most quintessentially Australian thing I've experienced. The experience of being trans in Australia is the experience of being 'othered.' But instead of feeling excluded, I felt love and solidarity from everyone else excluded by Australian mainstream society—Muslims, refugees, First Nations ."
Ilia Papadopoulou, 21, Model
"By the time I was four years old, I knew I was a girl. My mom knew it, too. But I was so busy with school that we just ignored it for a while until I was about 15 or 16 and started to become really aware of my identity. My entire family was very supportive—they accepted it immediately.
In Greece, It can take up to four years to transition. Fortunately for me, the process was a lot smoother—it felt like simply correcting a mistake. After a year of living as a woman, Ι started transitioning at 17 by going on hormone therapy. Outdated laws in Greece force trans people to have surgery if they want to officially change their gender in legal documents, but the government is working to correct this.
I've never had many friends, but now that I finally have the privilege of being considered the sex I feel, I'm accepted more easily by other people. I also feel more comfortable around people from my past. I recently started making real friends."