In a documentary that premiered in mid-August, a transexual who was the first to undergo gender reassignment surgery in Cuba in 1988, highlights how, more than 20 years later and after a lot of struggle, there has been a positive change for trans people in the country but how she now feels trapped and must battle against the ingrained sexism that still lurks in Cuban society, thus providing a rare glimpse into the problems of gender inequality.

Confined by the Gender She Transitioned To
Mavi Susel, the transwoman in question, is the subject of “En el cuerpo equivocado” or “In the Wrong Body” a documentary by the once actress and now filmmaker Marilyn Solayas.

From IPS:

The story of Susel, who underwent gender reassignment surgery on May 22, 1988, goes beyond the “complex and, above all, necessary” issue of transsexualism, to explore “the construction of gender” and the prevalence of the traditional role of women in Cuba, Solaya said.

“After Mavi showed herself so capable of standing up to society, she ran up against her limits. She became the woman she always wanted to be, that she learned to be, that society has taught her to be: traditional and domestic,” Danae Diéguez, an expert on gender and filmmaking, told IPS.

At the age of 49, Susel, a homemaker who is dedicated to caring for her elderly mother and her husband, decided to start breaking out of her private realm: in place of her dream of becoming a nurse, she began to provide assistance at a health centre, and she joined an amateur singing group.

“I fought for all of this, not only to be a housewife; I had dreams. I said to myself: I’m going to have my marriage, my house, but I’ll also be useful to society, I’m going to fulfill my aims, but I wasn’t able to…,” Susel says with regret in the documentary, which touches on two sensitive issues: the traditional role assigned to women, and the social integration of transsexuals.

Women in Cuba have the same constitutional rights as their male counterparts, with guarantees of equality in the workplace and political spheres. However, what is guaranteed constitutionally and what is expressed in the attitudes of the society under that constitution are two different things, and while women are not legally restricted to gender binary roles, many women in Cuba still suffer due to an ingrained sexism that has resisted change. The documentary aims to both highlight this issue and to raise awareness of the problems that persist for both women and trans people.

As such, “In the Wrong Body” has seen a mostly positive reaction from theater-goers. It has, however, met opposition elsewhere and despite this project having been created by people from various mediums including television, Cuban television companies have so far declined to air the documentary.

While social stigma surrounding LGBT topics still exists in Cuba and strains of the institutionalized homophobia of former years still persists, the push for trans and LGB inclusion, rights and the quest to fulfill their needs continues at a pace.

State Subsidized Gender Reassignment Surgery 
Interestingly, it is the controversy surrounding Susel’s gender reassignment surgery that is said to have precipitated what was in effect an all-out ban on gender reassignment surgery in Cuba after 1988.

In 2007, however, the procedure was once again legalized and earlier this year it was revealed by Mariela Castro, the daughter of President Raul Castro and one of the main driving forces for policy change, that gender reassignments had once again been carried out and that they were being subsidized under Cuba’s much lauded national health care system.

Signed June 4, 2008, Resolution 126 created a center for transexual health care, designating it an institution within Cuba that is specifically authorized to carry out gender reassignment, both the operations themselves and the therapeutic care that runs alongside gender reassignment, including diagnosis, treatment and follow-up, as well as facilities for trans patients who wish to solely receive hormonal treatments.

Of course, the announcement met opposition from some quarters. Questions were raised as to whether the state should be funding procedures with such a high cost, but advocates deflected this criticism, pointing to the necessity of gender reassignment for trans patients that require it (not all do) and saying that the procedures are in fact strictly scheduled and budgeted for, therefore only a certain number would be carried out each year to spread the burden and only Cuban citizens would be allowed to benefit from the facility.

To date, uptake remains relatively low and while exact figures have not been produced this Associated Press report puts the prospective total of surgeries currently on the books at 30, though a majority of these have yet to be performed.

Legislation and Conversation
While one can not legislate to change people’s attitudes, as has been shown to be the case with women’s rights in Cuba, with regards to LGBT rights, removing legal barriers could be a first step to invoking change.

The hope is that in facilitating legal equality and support there will be a trickle-down effect that creates discussion and debate among the people and a chance to educate and inform, something which is the focus of Mariela Castro’s work at the National Centre for Sex Education (CENESEX):

“We see transsexualism as a special reality that requires a special response from society,” said Castro, who pointed out that many transsexuals drop out of school because of rejection by society and the incomprehension they face in the classroom, from other students and their families, and from teachers as well.

Stepped-up efforts to train teachers and to promote awareness-raising strategies on sexual diversity in the media are among CENESEX’s current priorities, as it awaits passage of a proposed reform of Cuba’s Family Code.

The reformed Family Code would stipulate that the family has the responsibility and duty to accept and care for all of its members, regardless of their gender identity or sexual orientation. It would also recognize the same civil, patrimonial, inheritance and housing rights for homosexual and heterosexual couples, while opening the door for legal recognition of same-sex civil unions.

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“We have also presented the arguments for a decree law on gender identity that would legally establish that a sex reassignment operation is not necessary for obtaining a change of identity, in the case of diagnosed transsexuals. That would basically amount to social recognition of their identity,” said Castro.

But Mavi Susel’s story, as the first MTF (male-to-female) trans person to undergo sex reassignment surgery in the country, starkly illustrates the barriers that have already fallen for trans people in Cuba – perhaps notable the world over in regards to state subsidized reassignment – and those that have still yet to fall, and how they, in turn, are linked to other societal restrictions, whether it be notions of gay and lesbian life and how same-sex couples should be treated, or to underlying concepts of male and female roles and how women are regarded in Cuba despite the constitutional guarantees of equality that are in place.

It also illustrates how, whatever the country or setting, while gender reassignment surgery is often the focus of discussion when issues surrounding trans life are broached,  there are a myriad of other hurdles that trans people must face, many of which are shared among each one of us, be it because of our sex or sexuality, but of which an undue proportion can be seen to burden trans people whether they ultimately choose to have surgery or not.