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Understanding the Needs and Challenges of Transgender People Accessing Gender-affirming Healthcare in Egypt: A Mixed Methods Study


The research investigates the challenges faced by transgender individuals when accessing gender-affirming healthcare in Egypt, utilizing a combination of quantitative and qualitative methods. The study presents the most significant sample ever collected on transgender individuals in Egypt, comprising 104 survey respondents and 30 participants in interviews and focus groups. Additionally, the research includes advocacy recommendations based on the findings and introduces a preliminary draft of a law proposal to regulate access to gender-affirming healthcare. The intention is to facilitate legal discussions regarding potential reforms that would uphold Egypt’s international and constitutional obligations concerning the right to health and equality for transgender individuals. In Egypt, the influence of Islamic Sharia, represented by Egypt’s Islamic authority, has long affected medical policies concerning transgender individuals. Al-Azhar, in particular, maintains the perspective that transgender individuals should not undergo gender-affirming healthcare as they are considered mentally ill rather than biologically ill. Accordingly, Al-Azhar suggests therapy as the preferred treatment option, discouraging surgery. This stance contradicts the opinions of Egypt’s medical experts, who advocate for transgender individuals’ access to gender-affirming healthcare. While one might assume that medical opinions would dictate medical policy, Al-Azhar’s influence has resulted in a ban on providing gender-affirming healthcare to transgender individuals. Consequently, transgender individuals have been compelled to resort to either unsupervised do-it-yourself hormonal replacement therapy or endure risky, expensive, and emotionally draining medical procedures through underground networks that lack proper equipment and training. Furthermore, even if a transgender person manages to find a willing doctor for treatment, discrimination persists within medical facilities. Moreover, the ban has made public and private health insurance coverage unavailable for gender-affirming healthcare, imposing additional financial burdens. Additionally, transgender individuals face discrimination and difficulties in obtaining valuable employment opportunities due to their identities. Regarding the quality of healthcare services, the ban, combined with the absence of comprehensive lectures on the treatment of gender-affirming healthcare in Egyptian medical schools and the lack of practical training programs, hinders transgender individuals’ ability to access appropriate care. These factors collectively impede transgender individuals’ ability to exercise their fundamental human rights to health and equality when seeking healthcare services.


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