It was another long and desperate night for Lendi Mustafa somewhere back in 2011. His mother found him once again crying at the same spot at the kitchen table.

“And now, what happened?” his mother asked tenderly.

Just a year earlier, they had had a heartfelt conversation right there at the kitchen table, when Lendi had told his mother that he likes girls. This time around, Lendi wanted to further explain to her that he was a trans man — biologically born female but identifying as a man. He didn’t want to risk her rejection, as he thought it could be complicated for his mother to understand. In fact, it had been a long emotional struggle of self-discovery for Lendi as well — a long process of frustration and self-restraint before coming out as trans man.

“As a kid, when I thought that there was something wrong with my physical appearance, my imagination would come into play and I’d think, ‘When I grow up, I will look like a man physically,’” Lendi says. “I used to read a lot on the internet at that time, in order to understand what [a transgender person] is. There were moments when I was determined to live as myself. But then there were moments when people would call me with the long name [Lendita], and I would remember that [biologically] I am female.”

Lendi Mustafa is the first transgender person to come out publically in Kosovo, where there is a huge amount of misunderstanding about transgender issues.

In his early teens, nights out with three friends in downtown Prishtina provided Lendi with the only space for understanding, escapism and comfort. Born female and having to socially conform to gendered-identities as women, the four friends would share similar struggles relating to their identities.

“We were four persons and would have discussions such as, ‘What if we’re not lesbians but we’re something else?’” Lendi recalls. “And then we would say, ‘We can’t be lesbians because lesbians don’t feel like men, and we feel like men.’”

Today, Lendi is 20 years old and is the first transgender person to have come out publicly in Kosovo. The fact that no other person has felt comfortable enough to publicly come out as transgender demonstrates not only the personal struggle of individuals not feeling comfortable in their own bodies; it also reflects Kosovar society, in which transgender issues are highly misunderstood and expressing a different gender identity different to that assigned strictly in line with biological sex at birth remains a major cause of prejudice.

Apart from a small circle of LGBTI activists and sociologists, discussions on transgender persons remain almost invisible in Kosovo at the institutional level, in schools and in the media. With the terms ‘sex’ and ‘gender’ often used interchangeably, it only adds even more to the general public’s confusion and misunderstanding. For instance, Kosovar identification documentation have the word ‘gender’ instead of ‘sex,’ contributing to the lack of awareness and knowledge.

Transgender persons, together with gay, lesbian and bisexual persons are exposed to violence and discrimination, bullying and harassment, hate speech in the media and on social networks, and poor or inadequate access to health services. Transgender persons are particularly misunderstood, at both a societal and institutional level.

Blert Morina, an LGBTI rights activist and program manager at Center for Equal Rights (CEL), says that accepting somebody as ‘different’ remains an issue for Kosovar society, which also displays its own particular prejudices: “For example, in society [compared to a trans woman] one is more accepted as a trans man, when somebody is born female but feels and lives as a man,” Morina says. “It is a huge problem for somebody born male to come out as a woman. Here [in Kosovo], the power of the family is measured in men — the more men in the household the more powerful that house will be considered, and obviously it would be a shock to have a male declaring that they want to become a woman.”

Kosovo’s constitution provides equality before the law, where everyone enjoys the right to legal protection without discrimination. But only at the end of 2015 were amendments made to the Law on Protection against Discrimination in order to recognize gender identity.

For LGBTI activists, the law still fails to address other important issues. “For example, trans persons don’t know if they have the right to change their name, or change the sex in their documents, because we have the word ‘gender’ in our personal documentation,” Morina says. “So many gaps remain to be filled, as is the case with same-sex marriage, which is unclear if two gay persons can get married or not.”

While the Family Law of Kosovo defines marriage as between a man and a woman, the Constitution says that it is a union between two persons. As such, many have come to interpret that same-sex marriage is allowed, however to date it has yet to be tested.

Lack of professional understanding

Over the past few years, LGBTI activism has been on the rise in Kosovo, with LGBTI marches marking the International Day against Homophobia, Transphobia and Biphobia having now been held three years in a row. However, while this has increased the visibility of the country’s LGBTI activism, it has not necessarily increased visibility or acceptance of the LGBTI population in the public domain.

For example in October the government of Kosovo and the LGBTI Equal Rights Association for Western Balkans and Turkey (ERA), organized the first regional conference of its kind on LGBTI rights. Kosovo was selected as the host country due to the fact that it has the highest level of discrimination against LGBTI persons in the region.

This was borne out by a 2015 research report by France-based polling company IPSOS, that looked into perceptions of LGBTI issues in society and the level of non-acceptance and discrimination felt by LGBTI persons. The research also highlighted that the highest level of discrimination and non-acceptance from Kosovar families and society is experienced by transgender persons.

Despite this, Morina says that until recently, Kosovo’s LGBTI organizations didn’t prioritize transgender issues.

“The LGBTI movement [has] had a higher visibility, but the transgender community hasn’t been very much in the focus,” Morina says. “One of the reasons is that initially organizations themselves didn’t have the capacity to cover the concerns of transgender persons and [the other reason] is that the needs of the transgender community are different from those of lesbians, gay persons and bisexuals.”

Blert Morina says that while the LGBTI movement has increased its visibility and activism in recent years, it has taken longer for transgender issues to be focussed on.

This month marks the first ever research in Kosovo into solely transgender issues, as two LGBTI-rights organizations published a report focusing on the limited access of transgender persons to social protection and the health system. It also highlights the specific needs of the transgender community that remain completely unaddressed by any Kosovar institution.

According to the report, regardless of the readiness of some health professionals to help transgender persons, their knowledge and understanding remains very limited, including in relation to basic terminology.

When asked how they would define the term “transgender,” answers provided by some of the 25 health professionals interviewed for the report included: “I don’t know,” “Mental deviation,” “Relationship with both genders” and “Bisexual.”

According to the report, the majority of health professionals didn’t recognize that they have a role in supporting transgender persons, including in assisting them to express their self-identity; many even expressed a belief that trans persons should have no right to express their gender identity.

The approach of some health professionals in this regard was apparent in answers such as, “We don’t need to provide support, we can ignore them because they are repellent people, they need to be seen by psychiatrists.” When asked if health professionals should have a role in supporting transgender people, another replied, “Not at all. Who would support them? [Only] abnormal people.”

Meanwhile, the report found that social workers had limited experience in providing support to transgender persons, but those interviewed displayed a willingness to offer their help, many citing their official duty to do so. Still, as with health professionals, they largely lacked a clear understanding of terminology, indicating a lack of awareness on transgender issues.

When asked their understanding of the term ‘transgender,’ some of their answers included, “Persons who do not belong to one gender, male or female,” “Affinity to both genders,” “Homosexual persons — same sex marriage:  Is that what it refers to?” and “Maybe bisexual preferences.”

According to Morina, the role of health care professionals and social workers is crucial in helping transgender persons on their journey to discovering their gender identity. “The transgender community has specific needs because they want to express a different gender identity, which opposes their biological sex,” says Morina, comparing the needs of trans people to those who are lesbian, gay or bisexual. “In this context, transition is a priority and not sexual orientation.”

One of the transgender persons interviewed in the report expressed how their feelings of not being accepted had at times led to suicidal thoughts and that they had even attempted to take their own life.

“It is very painful when somebody wakes up every morning and doesn’t feel comfortable with their own body,” Morina says. “In Kosovo we aren’t very open to talking about our bodies, our needs or sexuality and when you first begin to accumulate all of these emotions and feelings, it tends to be be followed by anxiety and depression.”

Costly transition

Back in 2011 at the kitchen table, Lendi had reached a point of frustration and despair. He had been researching hormone replacement therapy and sex reassignment surgery, however, he soon realized that Kosovo lacks any kind of infrastructure that would support transgender persons who choose such options and he would instead need to seek costly interventions abroad.

When his mother approached him as he sat there in tears, he had explained what it means to be a trans person, and that he was interested in undergoing the full transition process. His mother immediately tried to be supportive and scheduled Lendi an appointment with a psychologist at Prishtina’s public hospital for the next day.

Therapies with psychologists and psychiatrists have the biggest role in assessing that a transgender person is ready to start with hormone replacement therapy and sex reassignment surgery but Lendi found himself having to explain transgender terminology and issues to the psychologist so that they could in turn explain to his mother. The same issue arose when he later met with the hospital’s psychiatrist. While, the psychologist was curious to learn more about transgender issues as Lendi introduced her to different data, she had no idea about what it is to be transgender. Lendi claims that the psychiatrist failed to keep a professional detachment and instead treated him with pity.

Without even the basic provisions of support available in Kosovo for transgender people, an already difficult process puts even more strain on those going through it. “Starting from the basics, such as psychologists and psychiatrists [that] aren’t available [with appropriate support] in Kosovo,” Morina says. “Then, [there is] hormonal therapy — the process is not only costly, but painful as well. Regardless of somebody’s desire to change their sex so that it aligns with their gender identity, it will still be a shock until one gets adapted with [their] new body parts.”

Morina also points to the environment in Kosovo and the worries for trans people undergoing full transition about how they will be accepted. “One can be surrounded by open minded people, but still it will be a shock when you see somebody for 20 years and then somebody new appears in front of you,” he says. “It is a shock for all sides, and Kosovo, unfortunately doesn’t provide any [appropriate] conditions for the transgender community. The concept of ‘[good] conditions’ doesn’t [even] exist.”

Lendi however, has finally found a psychologist that he feels comfortable with and is waiting for the green light to start other procedures. He accepts that he will need to travel abroad in order to start with the surgery processes, but right now he at least knows that he is one of the lucky few trans people in Kosovo to have his family’s full support.K

Photos: Majlinda Hoxha / K2.0.