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Philadelphia health providers bring trans-affirming surgery to Argentina

Temple University Hospital doctors recently traveled to Buenos Aires

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Buenos Aires, Argentina (Bigstock photo)

Philadelphia Gay News published this article on July 18. The Washington Blade is publishing it with permission.

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.

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Ecuador

Justicia reconoce delito de odio en caso de bullying en Instituto Nacional Mejía de Ecuador

Johana B se suicidó el 11 de abril de 2023

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(Imagen de cortesía)

Edición Cientonce es el socio mediático del Washington Blade en Ecuador. Esta nota salió en su sitio web el 9 de febrero.

A casi tres años del suicidio de Johana B., quien estudió en el Instituto Nacional Mejía, colegio emblemático de Quito, el Tribunal de la Corte Nacional de Justicia ratificó la condena para el alumno responsable del acoso escolar que la llevó a quitarse la vida.

Según información de la Fiscalía, el fallo de última instancia deja en firme la condena de cuatro años de internamiento en un centro para adolescentes infractores, en una audiencia de casación pedida por la defensa del agresor, tres meses antes de que prescriba el caso. 

Con la sentencia, este caso es uno de los primeros en el país en reconocer actos de odio por violencia de género, delito tipificado en el artículo 177 del Código Orgánico Penal Integral (COIP).

El suicidio de Johana B. ocurrió el 11 abril de 2023 y fue consecuencia del acoso escolar por estereotipos de género que enfrentó la estudiante por parte de su agresor, quien constantemente la insultaba y agredía por su forma de vestir, llevar el cabello corto o practicar actividades que hace años se consideraban exclusivamente para hombres, como ser mando de la Banda de Paz en el Instituto Nacional Mejía.

Desde la muerte de Johana, su familia buscaba justicia. Su padre, José, en una entrevista concedida a edición cientonce para la investigación periodística Los suicidios que quedan en el clóset a causa de la omisión estatal afirmó que su hija era acosada por su compañero y otres estudiantes con apodos como “marimacha”, lo que también fue corroborado en  los testimonios recogidos por la Unidad de Justicia Juvenil No. 4 de la Fiscalía. 

Los resultados de la autopsia psicológica y del examen antropológico realizados tras la muerte de Johana confirmaron las versiones de sus compañeras y docentes: que su agresor la acosó de manera sistemática durante dos años. Los empujones, jalones de cabello o burlas, incluso por su situación económica, eran constantes en el aula de clase. 

La violencia que recibió Johana escaló cuando su compañero le dio un codazo en la espalda ocasionándole una lesión que le imposibilitó caminar y asistir a clases.

Días después del hecho, la adolescente se quitó la vida en su casa, tras escuchar que la madre del agresor se negó a pagar la mitad del valor de una tomografía para determinar la lesión en su espalda, tal como lo había acordado previamente con sus padres y frente al personal del DECE (Departamento de Consejería Estudiantil del colegio), según versiones de su familia y la Fiscalía.

“Era una chica linda, fuerte, alegre. Siempre nos llevamos muy bien, hemos compartido todo. Nos dejó muchos recuerdos y todos nos sentimos tristes; siempre estamos pensando en ella. Es un vacío tan grande aquí, en este lugar”, expresó José a Edición Cientonce el año pasado. 

Para la fiscal del caso y de la Unidad de Justicia Juvenil de la Fiscalía, Martha Reino, el suicidio de la adolescente fue un agravante que se contempló durante la audiencia de juzgamiento de marzo de 2024, según explicó a este medio el año pasado. Desde entonces, la familia del agresor presentó un recurso de casación en la Corte Nacional de Justicia, que provocó la dilatación del proceso. 

En el fallo de última instancia, el Tribunal también dispuso que el agresor pague $3.000 a la familia de Johana B. como reparación integral. Además, el adolescente deberá recibir medidas socioeducativas, de acuerdo al artículo 385 del Código Orgánico de la Niñez y Adolescencia, señala la Fiscalía.

El caso de Johana también destapó las omisiones y negligencias del personal del DECE y docentes del Instituto Nacional Mejía. En la etapa de instrucción fiscal se comprobó que no se aplicaron los protocolos respectivos para proteger a la víctima.

De hecho, la Fiscalía conoció el caso a raíz de la denuncia que presentó su padre, José, y no por el DECE, aseguró la fiscal el año pasado a Edición Cientonce.

Pese a estas omisiones presentadas en el proceso, el fallo de última instancia sólo ratificó la condena para el estudiante.

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Africa

LGBTQ groups question US health agreements with African countries

Community could face further exclusion, government-sanctioned discrimination

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The White House commemorates World AIDS Day in 2023. Health agreements the U.S. has signed with Uganda, Kenya, and other countries have sparked concern among queer rights groups. (Washington Blade photo by Michael Key)

Some queer rights organizations have expressed concern that health agreements between the U.S. and more than a dozen African countries will open the door to further exclusion and government-sanctioned discrimination.

The Trump-Vance administration since December has signed five-year agreements with Kenya, Uganda, and other nations that are worth a total of $1.6 billion. 

Kenyan and Ugandan advocacy groups note the U.S. funding shift from NGO-led to a government-to-government model poses serious risks to LGBTQ people and other vulnerable populations in accessing healthcare due to existing discrimination based on sexual orientation.

Uganda Minority Shelters Consortium, Let’s Walk Uganda, the Kenya Human Rights Commission, and the Center for Minority Rights and Strategic Litigation note the agreements’ silence on vulnerable populations in accessing health care threatens their safety, privacy, and confidentiality.

“Many LGBTQ persons previously accessed HIV prevention and treatment, sexual and reproductive health services, mental health support, and psychosocial care through specialized clinics supported by NGOs and partners such as USAID (the U.S. Agency for International Development) or PEPFAR,” Let’s Walk Uganda Executive Director Edward Mutebi told Washington Blade.

He noted such specialized clinics, including the Let’s Walk Medical Center, are trusted facilities for providing stigma-free services by health workers who are sensitized to queer issues.    

“Under this new model that sidelines NGOs and Drop-in Centers (DICs), there is a high-risk of these populations being forced into public health facilities where stigma, discrimination, and fear of exposure are prevalent to discourage our community members from seeking care altogether, leading to late testing and treatment,” Mutebi said. “For LGBTQ persons already living under criminalization and heightened surveillance, the loss of community-based service delivery is not just an access issue; it is a full-blown safety issue.”

Uganda Minority Shelters Consortium Coordinator John Grace said it is “deeply troubling” for the Trump-Vance administration to sideline NGOs, which he maintains have been “critical lifelines” for marginalized communities through their specialized clinics funded by donors like the Global Fund and USAID. 

USAID officially shut down on July 1, 2025, after the White House dismantled it.

Grace notes the government-to-government funding framework will impact clinics that specifically serve the LGBTQ community, noting their patients will have to turn to public systems that remain inaccessible or hostile to them.

“UMSC is concerned that the Ugandan government, under this new arrangement, may lack both the political will and institutional safeguards to equitably serve these populations,” Grace said. “Without civil society participation, there is a real danger of invisibility and neglect.” 

Grace also said the absence of accountability mechanisms or civil society oversight in the U.S. agreement, which Uganda signed on Dec. 10, would increase state-led discrimination in allocating health resources.

Center for Minority Rights and Strategic Litigation Legal Manager Michael Kioko notes the U.S. agreement with Kenya, signed on Dec. 4, will help sustain the country’s health sector, but it has a non-binding provision that allows Washington to withdraw or withhold the funding at any time without legal consequences. He said it could affect key health institutions’ long-term planning for specialized facilities for targeted populations whose independent operations are at stake from NGOS the new agreement sidelines.

“The agreement does not provide any assurance that so-called non-core services, such as PrEP, PEP, condoms, lubricants, targeted HIV testing, and STI prevention will be funded, especially given the Trump administration’s known opposition to funding these services for key populations,” Kioko said.

He adds the agreement’s exclusionary structure could further impact NGO-run clinics for key populations that have already closed or scaled down due to loss of the U.S. funding last year, thus reversing hard-won gains in HIV prevention and treatment.  

“The socio-political implications are also dire,” Kioko said. “The agreement could be weaponized to incite discrimination and other LGBTQ-related health issues by anti-LGBTQ voices in the parliament who had called for the re-authorization of the U.S. funding (PEPFAR) funding in 2024, as a political mileage in the campaign trail.”

Even as the agreement fails to safeguard specialized facilities for key populations, the Kenya Human Rights Commission states continued access to healthcare services in public facilities will depend on the government’s commitment to maintain confidentiality, stigma-sensitive care, and targeted outreach mechanisms.

“The agreement requires compliance with applicable U.S. laws and foreign assistance policies, including restrictions such as the Helms Amendment on abortion funding,” the Kenya Human Rights Commission said in response to the Blade. “More broadly, funded activities must align with U.S. executive policy directives in force at the time. In the current U.S. context, where executive actions have narrowed gender recognition and reduced certain transgender protections, there is a foreseeable risk that funding priorities may shift.”

Just seven days after Kenya and the U.S. signed the agreement, the country’s High Court on Dec. 11 suspended its implementation after two petitioners challenged its legality on grounds that it was negotiated in secrecy, lacks proper parliamentary approval, and violates Kenyans’ data privacy when their medical information is shared with America. 

The agreement the U.S. and Uganda signed has not been challenged.

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European Union

European Parliament resolution backs ‘full recognition of trans women as women’

Non-binding document outlines UN Commission on the Status of Women priorities

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(Photo by nito/Bigstock)

The European Parliament on Feb. 11 adopted a transgender-inclusive resolution ahead of next month’s U.N. Commission on the Status of Women meeting.

The resolution, which details the European Union’s priorities ahead of the meeting, specifically calls for “the full recognition of trans women as women.”

“Their inclusion is essential for the effectiveness of any gender-equality and anti-violence policies; call for recognition of and equal access for trans women to protection and support services,” reads the resolution that Erin in the Morning details.

The resolution, which is non-binding, passed by a 340-141 vote margin. Sixty-eight MPs abstained.

The commission will meet in New York from March 10-21.

A sweeping executive order that President Donald Trump signed shortly after he took office for a second time on Jan. 20, 2025, said the federal government’s “official policy” is “there are only two genders, male and female.” The Trump-Vance administration has withdrawn the U.S. from the U.N. LGBTI Core Group, a group of U.N. member states that have pledged to support LGBTQ and intersex rights, and dozens of other U.N. entities.

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