Guide for newly immigrated and refugee trans+ people
What can you find out in this guide?
- What transsexual, transgender, trans+ and other terms mean
- That and how you as a trans+ person are protected by law in Germany
- How you can deal with discrimination
- How to change your first name and gender information
- What options are there for adapting your body to your “true” gender
- Where you can find support and help
- Where you can meet other trans* people
The text is a shortened and slightly adapted version of “Trans* Geflüchtete Willkommen – Ein Ratgeber für neu zugewanderte und geflüchtete trans* Menschen”. Our thanks go to the authors Freddie* Heithoff and Mika Schäfer as well as rubicon e.V. and Netzwerk Geschlechtliche Vielfalt Trans* NRW e.V., which developed the texts and made them available to LSVD.
- Trans+ definitions and other important definitions
It’s entirely up to you how you define yourself. It may be that one of the following terms feels appropriate for you, but it doesn’t have to be.
Transsexual/ transident/ transgender
When a child is born, the decision is made on the basis of certain sexual organs (vagina or penis) whether the child should grow up as a girl or a boy. Many trans+ people realise even as children that this doesn’t feel right for them. If a person decides that they no longer want to live in the gender that was attributed to them at birth, there are various ways to live as a member of the other gender. We explain these options in this brochure. People who (want to) live in a different gender than the one they were attributed at birth often define themselves as transsexual, transident or transgender.
A person who was defined as a boy at birth, but feels like a woman and now lives as a woman.
A person who was defined as a girl at birth, but feels like a man and now lives as a man.
Non-binary / NB / Enby
In society, the idea that there are only two genders – man and woman – prevails. In fact, there are many more than two genders. People who don’t clearly or exclusively define themselves as a man or woman are considered non-binary. People who do not clearly or exclusively define themselves as man or woman are considered non-binary. These people may define themselves as “neither nor”, “as well as”, “in between”, “without” or “with any gender”.
Trans+, trans+ person
All people who don’t feel that they belong to the gender that was determined at birth can call themselves trans+. The asterisk (*) or the plus sign (+) in German are placeholders for self-definitions such as transgender, transident, non-binary. They show that there are countless gender identities that can be found in this term. People who feel that they belong to the gender that was documented for them at birth are referred to as “cis”.
We call transition the transition to another gender, for example from man to woman, or the alignment of external characteristics with the felt gender. There are various ways of adapting to another gender. For example, you can choose a new first name that suits you well and tell other people about it. You can also have your first name and your gender entry officially changed: Your passport will show the name and gender that you’re comfortable with. You also have the option of changing your appearance to match your “real” gender. You may want to start a hormone treatment, adjust your body through surgery or wear the respective clothes. In this brochure we explain the different options available and how you can implement them. Which steps someone takes is up to each person to decide for themselves. You don’t have to take hormones or have an operation to be yourself. You decide for yourself what feels good for you!
Most people want to be recognised as the gender in which they feel comfortable. In other words, if you feel like a man (i.e. you are a man), you probably also want other people to see and address you in this way: You want to pass well. Hormone treatment and/or surgery are helpful but not necessary. Wearing the appropriate clothes also has a strong effect on how you pass. You can see if you are satisfied with the way you pass and what steps you want to take to change the way you pass.
There are two types of coming out: coming out to yourself and coming out to others. When you become aware that your gender identity doesn’t match the gender that was established at your birth, this is called “inner coming out”. Coming out to yourself can take a long time and doesn’t happen from one day to the next. If you decide to tell your family, friends, or other people about it, this is called the “external coming out”. There are many people who don’t come out to others, or only tell individual people about it, especially if being trans+ is prohibited in their country, for example. You don’t have to tell anybody about your feelings. But sometimes it helps to open up to certain people, to exchange ideas or to ask for advice.
Pronouns are elements of language that refer to people and give an indication of their gender. In German, for example, these are “er/ihn/ihm” (=he/him) or “sie/sie/ihr” (she/her). If you decide to live openly in the gender you identify with , you probably want other people to address you in this way. So most trans+ women choose the pronoun “she”, trans* men usually choose the pronoun “he”. For people who are neither woman nor man, i.e. who are not binary, there is unfortunately no official pronoun in German. Non-binary people therefore often look for other possibilities and develop their own pronouns for themselves such as “they” or “ze/hir/hirs” (pronounced “zee/here/heres”) or “ey/em/eir” (pronounced “ay/em/airs”), among others, in English or “sier”, “er*sie” or “nin” in German. Some also use their first name as a pronoun. It can be very hurtful for people if someone uses the wrong pronoun for them. We can’t know what gender people define themselves as. That’s why it’s good to ask people which pronoun they prefer.
LGBTIQ+ (LSBT*I*Q in German)
The letters stand for Lesbian, Gay (“Schwul” in German language), Bisexual, Trans+, Inter+ and Queer. These groups of people are often addressed together because there are common movements and offers. But the terms stand for different things: Lesbian, gay and bisexual are sexual orientations (so: Who do I love? Who do I like?). Inter+ people have bodies that do not exclusively correspond to the widespread idea of “female” or “male”. Trans+ people can be heterosexual, lesbian, gay or bisexual. They can also be inter+.
The term queer is often used as a collective term for people who don’t want to fit into a category or who deviate from a social norm. For example, queer can be defined as people who don’t classify themselves as either man or woman, but who don’t find the term trans* appropriate for themselves. People of different sexual orientations can also be found under this term.
Your gender identity means that you feel or identify yourself as a woman, a man or as a non-binary person. Gender identity stands for what’s going on inside you and can develop independently of how you present yourself to the outside world.
Sexual orientation describes which sex you find attractive. This can be on a romantic and/or sexual level. Your sexual orientation and your gender identity are independent of each other. So if you decide that you want to live as a man through a transition and have previously loved or desired men, you can still do so as a trans+ man. Or vice versa, if you loved or desired women before, you can still do so after the transition. Whether you’re gay, lesbian, bisexual, heterosexual or otherwise has nothing to do with your gender. Your sexual orientation does not have to change with the transition. It can change. Both are perfectly fine.
Gender roles are shaped by society. This means, for example, that a society expects a boy to play with cars and a girl with dolls. Even though this has already changed in many areas in Germany today, it still often happens that certain interests or characteristics are attributed to one gender. These often have to be fulfilled by the individual in order to be accepted by society. Gender itself – as well as gender roles – is therefore shaped by society. Children first learn that their gender must be exactly the same as that which was determined by doctors at birth. However, people can be different and behave differently than they are expected to. So the fact that a child is born with a penis doesn’t mean that they have to live as a boy, but rather that they can decide in the course of their life whether they want to live as a woman, a man or as a non-binary person and how they express their gender.
Intergender, intersexual, inter+
If a person for instance can’t be clearly classified as a girl or boy at birth because they don’t have the typical sexual characteristics, but are “between the sexes”, we speak of intersexuality. For example, a child can be born with a vagina and testicles that have grown inwards. Some inter+ people don’t notice until puberty that their body doesn’t develop in the same way as that of other children, for example when a girl develops beard growth. People can also be inter+ without ever knowing it. Like all other people, inter* people can experience and define themselves as men, as women or as non-binary. Many inter+ people are often operated on in childhood without their consent in order to create “clearly female” or “clearly male” sexual characteristics. This brochure is not specifically aimed at inter+ people. However, some topics are relevant to you and of course you can also contact the counselling centres if you have any questions (see section 4).
Discrimination means that a person is treated differently or worse than other people, for example because of the colour of their skin or their gender.
In Germany, as a transsexual/transident person, you’re protected by law against discrimination.
The Basic Law is the constitution of the Federal Republic of Germany and the most important and highest law in Germany. In the Basic Law of the Federal Republic of Germany it says that the state may not discriminate against or prefer anyone because of their gender or origin (Article 3 GG).
In addition, the General Equal Treatment Act (Allgemeines Gleichbehandlungsgesetz/AGG) applies. It prohibits discrimination against people on the following grounds:
- Religion or belief
- Disability or chronic illness
- Origin or skin colour
- Sexual orientation or identity
There are different reasons why people are discriminated against by others. For us, the points “origin and skin colour” and “gender” are particularly important in this brochure. Because the law says that people must be treated equally, regardless of whether they may for example come from Germany, Afghanistan, Bulgaria, China or another country. Likewise, trans+ people must not be treated differently or worse than other people.
The General Equal Treatment Act applies above all in working life and in various areas of everyday life. For example, a Muslim woman may not be turned away at a job interview because she wears a headscarf. It’s also forbidden not to rent an apartment to people because of their origin, or not to serve someone in a restaurant because he or she is trans+.
Here you can read in eight different languages in which areas you’re protected by law:
Transphobia (Transfeindlichkeit in German)
The term transphobia refers to prejudices, negative attitudes or aggression towards trans+ people.
Although the anti-discrimination law applies in Germany, transphobic discrimination and harassment also occurs in Germany. Unfortunately there are many people in Germany for whom transsexuality/transgender is not “normal”. A study from 2012 shows that 73 % of trans+ men and 85 % of trans+ women have been discriminated against in the last five years.
There are various forms of discrimination that trans+ people have to deal with. These include insults, (repeated) use of the wrong pronoun (misgendering), questions about intimate details, sexual assault and other forms of violence.
The procedures that people have to go through to get approval for hormones or a first name change, for example, can also be very stressful for those affected. These procedures can take a long time and cost money.
Dealing with discrimination / sources of support
You are not alone!
There are plenty of ways to get help!
If you are affected by discrimination, there are different ways to deal with it. You can try to find a way to deal with it for yourself. If something discriminatory is said to you, you can try to ignore it or turn a blind eye. If you know that there are certain places where you aren’t treated well, you can try to avoid them. You can also look for an environment where you feel comfortable and where you’re accepted just the way you are. For some people these are friends and girlfriends or relatives. For others, support groups or other groups for trans* people can be just such an environment. There are people there who have similar experiences to yours and who you can talk to about problems.
In these and other environments you can also find people who can help and support you. There are also counselling centres that you can turn to if you’ve been subjected to violence.
In section 1 we have already briefly explained which steps a transition can involve. Here we’ll describe the possible steps in more detail. However, this doesn’t mean that it always has to go this way. Sometimes procedures take longer or obstacles or problems arise. Unfortunately we can’t explain every possible step of the transition in detail here. Therefore, it’s very advisable to get support to accompany you during your transition. Both a counselling centre, which explains everything in detail, and people who accompany you emotionally on your way can be very helpful.
Legal requirements / first name and civil status changes
In Germany the Transsexual Act (Transsexuellengesetz/TSG) has been in force since 1981. This law gives trans+ people the opportunity to legally adopt the appropriate gender.
This law also applies to you as a refugee if:
- you are a “stateless foreigner” in Germany
- you have your residence in Germany as an asylum seeker or “foreign refugee”, or
- there are no regulations such as the Transsexual Act in your country of origin and you have an unlimited right of residence, or a renewable residence permit and are regularly and permanently resident in Germany.
If you have not yet completed your asylum procedure or have been rejected, you will unfortunately have to wait until you have been granted a residence permit in a (new) procedure. However, you can already start with the first steps during the waiting period (e.g. go to a counselling centre, find a therapist).
The law mainly regulates that and how you can change your first name and/or your civil status (gender entry) in your papers. So that you can do this, you must fulfill the following requirements according to §1 of the Transsexual Act:
- You must have felt you belong to the opposite gender for at least three years and have a strong inner need to live in that gender
- It must be highly probable that your affiliation to the opposite gender will not change. A court will check whether you fulfil these conditions. For this purpose the court commissions two expert opinions. This is criticised by many trans+ people. You can suggest experts to the court. For recommendations on experts, it is best to contact a local group. The experts will talk to you and write an expert opinion with their assessment, which the court will then receive. The court will decide whether your first name and/or civil status may be changed.
You also have the option of changing your first name only and changing your civil status (gender entry) later or not at all. If you want to change both, it is best to request both changes at the same time.
For assistance and more detailed information on the procedures, please contact one of the trans+ counselling centres. Self-help groups can also help you.
It is possible that the Transsexual Act will soon be amended. New regulations should make it easier for trans+ people to change their name and gender entry. For information on current developments, it’s best to contact a counselling centre or a self-help group.
Since the end of 2018, there has been a gender entry “diverse” (“divers” in German) in Germany in addition to the gender entry “male” or “female”. However, this option is not open to all people, but primarily to inter+ people. For the gender entry “diverse” you currently need a certificate from a doctor stating that you have “variants of gender development”. But this could change soon.
Good news: without an expert opinion or similar, you can get what’s referred to as an Ergänzungsausweis (complementary ID) from the Deutsche Gesellschaft für Transidentität und Intersexualität e.V. (dgti). It contains the name, gender and pronoun you have chosen for yourself. This identity card is a support in everyday life, but it is not an official identification document.
The website for this is only in German. For more information on how to get the card and what you can use it for, you can ask at a counselling centre or a self-help group.
Options for reassignment / assumption of costs
The adaptation of your body to your “true” gender and your first name and marital status changes are not interdependent. You can decide for yourself if you want to go all these ways or not. If you only want to do hormone treatment without changing your official gender, that’s perfectly fine. On the other hand, if you want to change your official gender and/or your name, no one can force you to have an operation.
There are different options for undergoing a physical transition:
- Hormone treatment (testosterone)
- Breast removal
- Removal of the uterus, ovaries and fallopian tube
- Construction of a penis
- Hormone treatment (oestrogen)
- Breast reconstruction
- Removal of the testicles and the penis
- Building a vagina
- Laryngeal reduction
- Surgical voice adaptation
- “Face feminisation”
- Facial hair removal by laser or needles
- Hair transplantation
In addition, trans+ women can change their voice through voice training. Even people who are neither men nor women can request these measures for themselves. They can get them, but often it’s more difficult for them than for trans+ women and trans+ men. It’s best to get advice and support.
Many of these measures are paid for by the health insurance company. If you have a residence permit, you are covered by state health insurance. This means that the same costs are covered for you as for German citizens. If your asylum procedure has not yet been completed or your asylum application has been rejected, you unfortunately only have a limited right to medical care. It is therefore possible that hormone treatment will not be financed. In many cases, however, hormone treatment is approved for people without full insurance cover. If you have problems, you should contact a counselling centre that can help you. Support groups can also help you with a lot of questions (see Section 4).
Hormone treatment changes your body. The process is different for every person. Mostly the body shape (fat and muscles), the face shape and the skin change. In addition, trans* men can grow beards and a deeper voice, among other things. Trans+ women often develop some breast growth and their body hair becomes less. It is very important that you consult your doctor about hormone treatment. To get hormones, you need an “indication”, i.e. a diagnosis from a doctor, psychiatrist or psychologist. The requirements for an indication aren’t fixed; sometimes a single appointment can be sufficient. You don’t have to pay for the hormones you get yourself, as they are covered by your health insurance.
The costs for psychotherapy in connection with transsexuality/transidentity are covered by the health insurance. Psychotherapy can help you on your way and is a very important basis for a transition. Therapists can also write you the report you need so that gender-reassignment surgeries are paid for by the health insurance company. If you already know that you want this, you should ask the therapist at the beginning of the therapy.
Gender reassignment surgery
Under certain conditions, many of the gender reassignment surgeries we’ve listed above can be covered by health insurance. Unfortunately, operations that are described by the health insurance as “cosmetic” (especially face feminisation, larynx reduction and hair transplantation) are not financed by the health insurance. Whether breast reconstruction is paid depends on how large the breasts have become as a result of hormone treatment.
In order for the health insurance to pay for gender-reassignment surgery, you must meet several requirements: You must have been taking hormones for at least 6 to 12 months, have had psychiatric-psychological support for at least 18 to 24 months and have been living in your “true” sex for 12 to 18 months (“everyday life test”). A therapist writes a detailed statement about this, known as an “indication report”. This document is sent to the health insurance company together with other documents. A competent body, the Medical Service of the Health Insurance Funds (MDK), usually issues an expert opinion on whether the measure should be paid for by the health insurance fund. The health insurance companies then decide on the basis of this appraisal.
It’s essential that you seek assistance from a counselling centre. There you will find important information and support. Self-help groups can also help you with many questions.
- Contact points for trans+ people
Under Organizations you can find a map with all specialised counselling centres and group services for LGBTI+ refugees.
There are many different services for trans+ people: Trans+ counseling centers with professional counselors, voluntary trans+ counselling and trans+ groups. The people there don’t all have detailed knowledge about refuge and asylum, but can help you with a variety of questions about trans identity and trans sexuality, for example: How do I know that I am trans+? How can I get hormones? What kind of operations are there and what do I have to do? What can I do if I am discriminated against? You can also talk about your wishes and fears in peace. And in trans* groups you can meet other trans* people in peace and quiet.
If you can’t or don’t want to be counselled in German, you can bring someone along to interpret for you. If you don’t know who you can bring along, ask at a counselling centre.
Unfortunately the following websites are mainly in German. If you don’t speak German very well yet, you can ask a person you trust to help you with the translation.
On the dgti website you can find nationwide support services that have special expertise in the field of transsexuality and transidentity under Beratungsstellen (counselling centres). The Regenbogenportal also gives a good overview of nationwide services. A list of contact points for trans+ people in North Rhine-Westphalia (counselling centres and groups) can be found on the website of the Netzwerk Geschlechtliche Vielfalt Trans* NRW e.V..
Other interesting websites, forums and Facebook groups for trans+ people
TransMann e.V. (for trans+ men)
In these forums you can exchange ideas with other trans+ people and find lots of information.
FTM-Portal (Forum for trans+ men)
NBForum (Forum for non-binary people)
You can also exchange information with other trans+ people in closed Facebook groups.
Deutschsprachige Enby / Non-Binary Menschen (for non-binary trans+ people)
Transgender Support Circle (in English)
All transmen know each other (for trans+ men, in English)
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