Based on the recent study Healthcare rights of transgender people and gender affirmation practices in Armenia, we share key insights into how trans people navigate hormone therapy, surgery, and support systems in a context shaped by legal gaps, discrimination, and fragile access to care.
The study was conducted by Socioscope with financial support from Pink Armenia and the New Democracy Fund.
Hormone therapy: self-treatment by necessity
For many trans people in Armenia, hormone therapy begins without doctors. A chronic shortage of trained endocrinologists, combined with fear of discrimination and mistrust of institutions, has made self-administered hormone therapy the most common path. People learn from each other, search online, and copy regimens from peers, often without understanding how differently bodies respond to hormones.
This produces serious health risks. Regular medical monitoring, which is essential during hormone therapy, is largely absent. Access to safer medication has worsened after the war in Ukraine: sanctions and disrupted supply chains reduced imports from Russia (previously a common informal route). Gels and patches are often unavailable or too expensive, forcing people to rely on riskier pills and injections.
Hormones also reshape emotional life. Some people stop hormones abruptly during crises, because their bodies or minds cannot cope with unsupported treatment.
Surgery: limited choice, fragile care
Gender-affirming surgeries in Armenia take place in a narrow and uncertain medical landscape. Historically, many procedures were organised through visiting surgeons from abroad. Today, some Armenian surgeons perform these operations, but the field remains small and opaque.
Trans people have little real choice of doctors. Decisions are often based on community word-of-mouth rather than informed selection.
Post-surgical care is one of the most fragile parts of the process. After major surgeries, trans people often receive little follow-up or supervision. Doctors are perceived as disappearing after the operation, leaving patients to manage recovery on their own.
Some doctors refuse to treat trans people after learning their gender identity. Even when surgery eventually happens, it often requires calming doctors and adapting one’s behavior to avoid rejection.
Networks of support: survival through community
In the absence of a reliable healthcare and legal framework, trans people in Armenia rely heavily on community networks. Friends, activists, and informal groups help locate safer doctors, import hormones, share information about surgeries, and provide emotional and material support.
Families play an ambivalent role. Some parents offer support, often quietly and with difficulty. Others react with rejection.
The state appears mostly as an obstacle. Without legal gender recognition, daily life becomes constant negotiation. Changing a passport photo can help temporarily, but mismatched documents still lead to questioning, humiliation and exclusion.
Alongside medical needs, trans people describe everyday necessities that are rarely discussed: binders, prosthetics, appropriate underwear, clothing that allows them to move through public space without fear.
