World
Philadelphia health providers bring trans-affirming surgery to Argentina
Temple University Hospital doctors recently traveled to Buenos Aires
BY LAUREN ROWELLO | Argentina is known for implementing some of the most comprehensive federal laws to protect and affirm transgender people. In 2012, the country became the first to pass legislation that gives its trans citizens the right to be recognized and treated in accordance with their gender identities — and the right to develop a sense of personhood associated with this experience.
This law gave Argentines the right to change their legal documents to display accurate gender markers and updated names — something many trans people in the U.S. are still unable to pursue because of differences in state laws regarding the matter. Among various other rights — including confidentiality — the legislation also grants trans people in Argentina the right to access comprehensive hormone therapies and gender-affirming surgeries.
But the right to pursue authenticity doesn’t mean trans-competent care is readily available. That’s why Dr. Alireza Hamidian Jahromi, MD, director of the gender affirmation surgery program at Temple University Hospital, is passionate about collaborating with providers across borders.
He recently traveled to Buenos Aires with Dr. Michael Metro, MD, director of reconstructive urology at Temple University Hospital, to jointly perform the first-ever penile inversion vaginoplasty in Argentina.
“A lot of teaching and training has to happen before you can perform a surgery,” Hamidian Jahromi underlined, noting that resources — including access to trans-specific training — can be limited in some areas, especially for genital reconstructions or “bottom” surgeries.
For instance, in 2012 — the year Argentina’s trans-affirming legislation was passed — the U.S. had only six surgeons performing genital reconstruction surgeries. A lack of surgeons greatly limits a surgery’s availability. Today, more doctors are starting to learn about and perform these procedures in the U.S. — but insurance does not always cover them and some state laws are attempting to further limit people’s ability to pursue them.
To overcome the unique hurdles and barriers that each country faces, Hamidian Jahromi — who is on the central committee for certification and mentorship at WPATH (World Professional Association for Transgender Health) — urged advocates to not only raise awareness of trans people and their needs but also to push for stronger and more accessible training and education for healthcare providers.
“[Surgeons] specifically have to go through a special training in order to know how to bring their skills together to be able to align them with the patient’s specific need,” Hamidian Jahromi said, adding that a specialization in gender-affirming surgery requires many years of training to develop expertise.
Exposure to and experience in a variety of related fields — such studying and collaborating closely with both urology and plastics — is necessary, and finding programs and professionals to study under can be an additional challenge.
The first trans-specific surgical fellowship in the U.S. didn’t open until 2017. It took more than nine years of education — along with additional surgical experience completed in Europe — for Hamidian Jahromi to become fellowship trained and specialized in trans-specific surgical interventions.
It takes a lot of time and intentional effort to build a comprehensive program that can competently and efficiently meet the needs of its patients. A lack of appropriate training can and has led to botched procedures, infections, and other disastrous outcomes.
Fortunately, there are more resources for learning and honing these skills across the United States than there were in the past. Hamidian Jahromi, who is the assistant professor of Plastic and Reconstructive and Gender Affirming Surgery at the Lewis Katz School of Medicine at Temple University, often trains surgeons, fellows and residents here in Philadelphia today.
Continued learning is not only key to the development of trans-specific programs and new providers. Trans-competent experts rely on information-sharing between professionals to constantly challenge themselves in new ways with the hope of improving their skills, advancing their understanding of best practices, and implementing new techniques in how to better care for trans people.
Because of this desire and ability to share and exchange skills, Hamidian Jahromi was able to observe the surgeries and study with colleagues at NYU — who pioneered a robotics-assisted peritoneal flap vaginoplasty, which is more minimally invasive than traditional methods. Temple is now one of just a handful of programs to offer surgeries using this technique.
It’s just one of various modalities used to help Hamidian Jahromi’s patients achieve their goals.
“A lot of [needs] could be different in every patient,” Hamidian Jahromi explained about the differing challenges, unique experiences and individual perspectives of each patient — who all have a different idea about what a positive outcome will look like for them. “And that’s actually a welcome part of these kinds of surgeries for me — because you have to see the patient, you have to see the world through their eyes, you have to try to understand.”
“I also have to mention that a lot of these surgeries need more than one surgeon at the time of the surgery. It’s multi-speciality,” he added, explaining that teams of experts in those related fields often work together to achieve the best outcomes. “So when I’m standing here in front of you, I’m standing on a pillar of different members of my team that all work together very closely in order to create a success story for each individual patient. It’s a whole team’s work.”
Hamidian Jahromi, who is cisgender, was drawn to trans healthcare because he appreciated the opportunity to make such a positive difference in the lives of patients and to develop longer relationships with each person he supports.
“When you put together the happiness and the help you’re providing for the patients, I’m very well-rewarded every day,” he added.
Colombia
Colombia anunció la inclusión de las categorías ‘trans’ y ‘no binario’ en los documentos de identidad
Registraduría Nacional anunció el cambio el 28 de noviembre
Ahora los ciudadanos colombianos podrán seleccionar las categorías ‘trans’ y ‘no binario’ en los documentos de identidad del país.
Este viernes la Registraduría Nacional del Estado Civil anunció que añadió las categorías ‘no binario’ y ‘trans’ en los distintos documentos de identidad con el fin de garantizar los derechos de las personas con identidad diversa.
El registrador nacional, Hernán Penagos, informó que hizo la inclusión de estas dos categorías en los documentos de: registro civil, tarjeta de identidad y cédula de ciudadanía.
Según la registraduría: “La inclusión de estas categorías representa un importante avance en materia de garantía de derechos de las personas con identidad de género diversa”.
Estas categorías estarán en el campo de ‘sexo’ en el que están normalmente las clasificaciones de ‘femenino’ y ‘masculino’ en los documentos de identidad.
En 2024 se inició la ejecución de diferentes acciones orientadas implementar componentes “‘NB’ y ‘T’ en el campo ‘sexo’ de los registros civiles y los documentos de identidad”.
Las personas trans existen y su identidad de género es un aspecto fundamental de su humanidad, reconocido por la Corte Constitucional de Colombia en sentencias como T-236/2023 y T-188/2024, que protegen sus derechos a la identidad y no discriminación. La actualización de la Registraduría implementa estos fallos que ya habían ordenado esos cambios en documentos de identidad.
Por su parte, el registrador nacional, Penagos, comentó que: “se trata del cumplimiento de unas órdenes por parte de la Corte Constitucional y, en segundo lugar, de una iniciativa en la que la Registraduría ha estado absolutamente comprometida”. Y explicó que en cada “una de las estaciones integradas de servicio de las más de 1.200 oficinas que tiene la Registraduría Nacional se va a incluir todo este proceso”.
Japan
Tokyo court upholds Japan’s same-sex marriage ban
Country is only G7 nation without legal recognition of same-sex couples
The Tokyo High Court on Nov. 28 ruled the lack of marriage rights for same-sex couples in Japan is constitutional.
The Associated Press notes Judge Ayumi Higashi upheld the legal definition of a family in Japan as a man and a woman and their children. The court also dismissed the eight plaintiffs’ demand for 1 million yen ($6,406.85) in damages.
Hiromi Hatogai, one of the plaintiffs, told reporters after the court ruled that she is “so disappointed.”
“Rather than sorrow, I’m outraged and appalled by the decision,” said Hatogai, according to the AP. “Were the judges listening to us?”
Japan remains the only G7 country without legal recognition of same-sex couples, even though several courts in recent years have ruled in favor of it.
The Sapporo District Court in 2021 ruled the denial of marriage benefits to same-sex couples violates the constitution’s equality clause. The Nagoya District Court in 2023 issued a similar ruling. The Fukuoka District Court in a separate decision said Japan’s current legal framework is unconstitutional. The Tokyo High Court in 2024 came to the same conclusion.
The Washington Blade last month noted Prime Minister Sanae Takaichi, who is Japan’s first female head of government, opposes marriage equality and has reiterated the constitution’s assertion the family is an institution based around “the equal rights of husband and wife.”
India
India’s Jharkhand state works to improve trans people’s access to health care
People for Change working with local officials to address disparities
The transgender community has been part of India’s social fabric for centuries, but decades of policy neglect pushed many into poverty and inadequate health care.
The Supreme Court formally recognized trans people as a third gender in 2014, yet state-level services developed slowly. Telangana opened India’s first dedicated trans clinic, the Mitr Clinic, in 2021 with support from the U.S. Agency for International Development and Johns Hopkins University. Jharkhand State has now ordered all government hospitals and medical colleges to establish dedicated outpatient units for transgender patients.
People for Change, an LGBTQ organization, spent the past year mapping gaps in trans health care across Jharkhand. Its surveys of 100 trans residents in five districts found limited access to gender-affirming care, hormone therapy, dermatology, and mental-health services. The group followed this survey with a May 2025 consultation in Jamshedpur, an industrial town in Jharkhand, that brought together clinicians and community leaders to outline a feasible outpatient model.
Those findings were presented to Health Minister Irfan Ansari in June, backed by input from allied organizations and more than 50 trans leaders. The process helped inform the state’s decision to introduce dedicated trans outpatient departments in all government hospitals and medical colleges.
People for Change, which played a central role in shaping the policy, noted that government hospitals in Jharkhand still face infrastructure and resource gaps. Even so, the group said the order reflects a clear policy commitment to creating dedicated trans health services.
If Jharkhand’s trans outpatient departments system functions as planned, it could become a regional model for states with comparable gaps in public health access.
Government data from the 2011 Census — the latest official count to identify an “other” gender category — lists 13,463 trans residents in Jharkhand, alongside sizable populations in neighboring states: 40,827 in Bihar, 30,349 in West Bengal, 22,364 in Odisha, 18,489 in Chhattisgarh, and 137,465 in Uttar Pradesh. Though likely underreported, these figures underscore the scale of need across eastern and central India.
“The decision to start dedicated transgender OPDs (outpatient departments) is not just an administrative step — it is a statement of inclusion, a recognition that the transgender community deserves discrimination-free, dignified, and responsive healthcare. When the government takes such a deliberate step, it sets a tone for systemic change,” said Souvik Saha, founder of People for Change. “It creates an official entry point for transgender healthcare.”
“For the first time, transgender persons will have a recognized and respectful space within the public health system,” added Saha. “That itself is a major shift. It signals to doctors, nurses, and administrators that transgender health is a priority. This leads to sensitization, accountability, and the gradual improvement of attitudes within hospitals.”
Saha told the Washington Blade the policy is likely to trigger broader improvements, noting that once a service is formally notified, budget allocations, training, infrastructure, and staffing typically follow. He said the move could strengthen the system gradually, “step by step.”
“We are realistic: we know improvements won’t happen overnight. But we are also optimistic because the state has already shown genuine leadership and empathy by issuing this order,” said Saha. “And since Jharkhand is celebrating its 25th year of formation, this decision reflects the state’s intention to move towards greater equality and social justice.”
“For the transgender community, this is not just a service — it is dignity. It is visibility. It is inclusion,” he added. “And with the government, civil society, and community working together, we believe this will lead to meaningful and lasting change in the years ahead.”
Saha told the Blade that the dedicated transgender outpatient will operate within existing government medical colleges and hospitals in Jharkhand and will be staffed by current medical and paramedical teams, with no separate funding required at this stage. He said the policy does not call for separate wards or beds, but for clearly designated outpatient spaces for trans patients. The service, he added, will be run by existing staff who will receive training and orientation as needed.
“At this moment, the specific operational details are still being discussed with the government of Jharkhand. However, what is clear is: the OPD will function as a dedicated space within the hospital, not limited to a specific day,” said Saha. “Transgender individuals will have access to focused, discrimination-free services through this dedicated space. The clinic will run through existing hospital systems, with linkages to psychiatry, dermatology, endocrinology, and other departments when required.”
“This structure allows the government to start services immediately without needing new construction, new staff positions, or separate budget lines,” he added. “It is a practical and efficient first step, making the service accessible while keeping the doors open for: future budget allocations, specialized staffing, expansions into gender-affirming services, and strengthened infrastructure. The government’s intent is very clear: to ensure dignified, equitable, and discrimination-free healthcare for the transgender community. This order is a strong beginning, and operational details will continue to evolve through collaborative discussions between the government, hospitals, and People for Change.”
Saha acknowledged that taboos, misinformation, and stereotypes about the trans community persist in Jharkhand and in many other states. However, Saha said there are encouraging models at which to look.
He pointed to Kerala and Chhattisgarh, which have introduced sensitization programs and begun integrating trans-inclusive practices into their public health systems. These examples, he noted, show that when health departments invest in training and awareness, attitudes shift and services become more respectful and accessible.
“In Jharkhand, People for Change has proposed a similar approach. We have formally recommended to the government that civil surgeons, chief medical officer, doctors, nurses, and other hospital staff be trained on gender sensitization and transgender health challenges. This includes understanding gender identity, psychological needs, respectful communication, medical protocols, and ways to ensure discrimination-free services,” said Saha. “The encouraging part is that these proposals are already being discussed in detail with the government of Jharkhand. The government has shown strong intent through the issuance of the transgender OPD order, and training health professionals is naturally the next crucial step.”
Saha noted that it remains unclear whether trans people will be recruited into government health roles, saying it is too early to make any definitive statement. He explained that recruitment requires separate processes, policies, and approvals, and the current order does not address new staffing or the creation of government positions.
A recent performance audit by the Comptroller and Auditor General of India, the constitutional authority responsible for auditing government spending and administration, outlined severe human-resource and medicine shortages across Jharkhand’s public health system.
Tabled in the state assembly in February, the report found that about 61 percent of sanctioned posts for medical officers and specialists were vacant, along with more than half of all staff-nurse positions and roughly four-fifths of paramedic posts. The audit also documented acute shortages of essential drugs in the hospitals it reviewed, with stock gaps ranging from 65 to 95 percent during the 2020-2022 period. The findings highlight the systemic constraints that the new trans outpatients will have to navigate.
Saha acknowledged that drug shortages remain a serious issue in government hospitals and said the concern is valid. Even so, he added that he is approaching the new outpatient policy with hope and confidence.
“The government of Jharkhand has made a historic and intentional decision by opening dedicated transgender OPDs,” said Saha. “When a government takes such a strong step of recognition and inclusion, it also shows the readiness to understand the specific health challenges and medication needs of the transgender community.”
“As more transgender persons start coming to the OPDs and their health requirements become clearer through proper documentation and reporting, we are confident that the state will make every effort to ensure that essential medicines are available for them,” he added.
Saha said People for Change is also seeking support outside the public system. The organization has begun briefing civic service groups — including Lions Club, Rotary Club and Inner Wheel, international volunteer organizations that run local welfare and health projects — on the outpatient order and the community’s needs. According to Saha, several of these groups have indicated they may help trans patients with medicines and other essentials when prescribed by a doctor.
“So the effort is two-fold: the government is creating an inclusive health system and will be informed of the community’s specific medicinal needs through the OPDs. People for Change and partners are strengthening the safety net to ensure that transgender persons are never left unsupported,” said Saha. “We truly believe that this collaborative approach will ensure that transgender individuals receive the medication and care they deserve — with dignity, consistency, and compassion.”
“Every hospital may take a slightly different amount of time depending on internal readiness, but overall: The foundational work is already underway, Hospitals have started preparing their designated OPD spaces, And coordination is happening at the level of civil surgeons, medical superintendents, and hospital management teams,” he added.
