Con­ser­va­tive Ser­bia be­comes un­likely sex change cen­ter

Kuwait Times - - HEALTH & SCIENCE -

In a coun­try where Gay Pride pa­rades re­quire mas­sive se­cu­rity and al­most half the cit­i­zens think ho­mo­sex­u­al­ity is a dis­ease, Ser­bia is draw­ing pa­tients from around the world seek­ing sex change op­er­a­tions to be­come men.

Of­fer­ing ex­perts in the field for a frac­tion of the cost in western Europe and Amer­ica, Belgrade has be­come a sur­pris­ing cen­tre for the com­plex gen­der re­as­sign­ment surgery. One Ital­ian pa­tient be­gan the transition to be­come a man 14 years ago and vis­ited Bel­gium, Bri­tain and Ger­many look­ing for the best clinic to com­plete the pro­ce­dure.

In the end the 38-year-old anes­thetist chose the Belgrade Cen­tre for Gen­i­tal Re­con­struc­tive Surgery, led by Miroslav Djord­je­vic, a pro­fes­sor of urol­ogy and surgery in the Ser­bian cap­i­tal. “I did a lot of re­search and con­tacted many cen­ters and I found that al­most every­one was a stu­dent of Pro­fes­sor Djord­je­vic, so I wanted to go to the source of this knowl­edge,” said the bearded and softly-spo­ken pa­tient, speak­ing to AFP a few days af­ter surgery.

He asked to be iden­ti­fied only by the ini­tials A.T. Djord­je­vic op­er­ates on about 100 in­ter­na­tional sex change pa­tients each year from coun­tries in­clud­ing Ja­pan, Brazil, South Africa, Aus­tralia and the United States. An­other 20 or so come from around the for­mer Yu­goslavia. Eighty-five per­cent of his pa­tients are seek­ing fe­male-to-male op­er­a­tions, a rarer and more com­pli­cated pro­ce­dure than the re­verse.

For gen­eral health­care Ser­bia is not widely con­sid­ered a med­i­cal tourism des­ti­na­tion, al­though it does draw some for­eign­ers seek­ing cheap den­tistry. Take, for ex­am­ple, gall­stone treat­ment in Ser­bia, which “is five times cheaper than in Ger­many, but no­body comes here for gall­stone treat­ment,” said 51-year-old Djord­je­vic. He said pa­tients come to his cen­tre, which opened in 2006, be­cause it’s one of fewer than 20 around the world that can per­form the full fe­male-to-male surgeryand it’s unique be­cause “we per­form ev­ery­thing in one stage”. “We do, at the same stage, the re­moval of the breasts, re­moval of fe­male in­ter­nal gen­i­talia... and then we fin­ish our surgery with the cre­ation of a neophal­lus,” he ex­plained.

This med­i­cal spe­cialty started in Ser­bia in the late 1980s un­der Djord­je­vic’s men­tor Sava Perovic, a sur­geon who pi­o­neered de­vel­op­ments in treat­ment for trans­gen­ders. An­other cen­tre in his name, the Sava Perovic Foun­da­tion, also per­forms fe­maleto-male sex changes in Belgrade.

Me­dia-savvy Djord­je­vic de­nies that value-for­money is the main rea­son for Ser­bia’s pop­u­lar­ity, al­though A.T. paid 15,000 Eu­ros ($16,000) in Ser­bia for surgery that would have cost 60,000 eu­ros in Bri­tain. The Ital­ian pa­tient said he could have had his op­er­a­tion for free at home but he be­lieved the sur­geons there lacked enough ex­pe­ri­ence.

David Ralph, a Lon­don-based con­sul­tant urol­o­gist who spe­cial­izes in pe­nile con­struc­tion, said lower hos­pi­tal costs rather than sur­gi­cal ex­penses ap­peared to be what drove down prices in Ser­bia. “At the end of the day the pa­tients get the same,” Ralph told AFP, al­though he said he pre­ferred to do fe­male-to-male surgery in a series of smaller op­er­a­tions to re­duce the chance of com­pli­ca­tions. In any case the pre-sur­gi­cal pro­ce­dure is lengthy: a pa­tient should un­dergo a thor­ough psy­chi­atric eval­u­a­tion and hor­mone treat­ment to­tal­ing up to two years.

‘Vi­o­lence, bul­ly­ing, re­jec­tion’

Ser­bia’s suc­cess in this spe­cial strand of med­i­cal tourism is in­con­gru­ous with the wide­spread at­ti­tudes to­wards gays and trans­gen­ders in the pa­tri­ar­chal coun­try of seven mil­lion peo­ple. At Belgrade’s Gay Pride march in 2010, hard­line na­tion­al­ists at­tacked par­tic­i­pants and clashed with po­lice, wound­ing 150 peo­ple and prompt­ing of­fi­cials to ban the pa­rade for the next three years.

Thou­sands of riot po­lice are now de­ployed for the an­nual event and the city cen­tre is locked down. A UN-backed sur­vey on dis­crim­i­na­tion in late 2013 showed that 49 per­cent of Ser­bians be­lieved ho­mo­sex­u­al­ity was a dis­ease that should be treated. — AFP


BELGRADE: An anony­mous Ital­ian anes­thetist (R) speaks with the Pro­fes­sor Miroslav Djord­je­vic (L), af­ter his sex change op­er­a­tions at a spe­cial­ized clinic on Oc­to­ber 11, 2016.

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