Gender affirming process/ Proces prilagođavanja pola

Thinking about the gender affirming process? Want to know more about this procedure in Montenegro? We provide you text which will explain what are your rights in the health care system of Montenegro, what is the procedure, and what steps are necessary for you to undertake the process of transition.

Based on the Law on Health Insurance (Article 16b), Montenegro covers 80% of the cost of „changing sex for medical reasons“. It is also in Art. 16b, para. 5 stipulates that „the criteria for determining medical reasons for changing sex shall be prescribed by the state administration body competent for health matters (hereinafter: the Ministry).“ The Ministry adopted the Rulebook on the Establishment of Medical Reasons for Sex Change (Official Gazette of Montenegro, number 47/2014 ) which defines 7 opinions of experts (psychiatrist, psychologist, endocrinologist, internist, gynecologist, urologist, social worker) on the basis of which a positive opinion is made to cover the costs of transition from health insurance.

If you want to access hormone replacement therapy, a few steps are necessary before your doctor prescribes the necessary therapy:

• Psychological assessment from psychologist and report
  (Center for Mental Health in Block 5. Contact phone for scheduling 020 / 481-928)
• Blood tests: Complete blood count, biochemical findings (glucose, urea, creatinine, bilirubin, cholesterol, triglycerides, sodium, potassium, chlorides)
  (These can be taken at the Health Center from 7:00 to 9:00 in the morning)
• Hormone findings: TSH, free T4, prolactin, estradiol, progesterone, free, total and biodegradable testosterone, DHEAS, FSH, LH, korizol.
  (These findings are at the KBC Laboratory from 7:00 to 8:30 in the morning)
  
• Scheduling appointment for endocrinologist
  
• For the collecting of the findings, you should first take a referral from your chosen general practitioner in the Health Center.
  (Instructions for hormonal findings, blood finds and instructions for endocrinologists)

To obtain the findings, you must first obtain a referral from your chosen general practitioner at the Health Center: a refferal to hormonal findings, blood tests and an endocrinologist.

After your endocrinologist prescribes hormone therapy, you should bring his report to your chosen doctor to open an injection order at the Health Center.

If you want to undergo surgery, a mastectomy (breast removal) is available in Montenegro. Genital reconstructive surgery is still performed abroad, in collaboration with the Health Insurance Fund. You need to gather the recommendations prescribed by the Protocol (psychiatrist, psychologist, endocrinologist, internist, gynecologist, urologist, social worker). Then, with all these recommendations, the prophylactic from the clinic where you are planning the surgery, as well as the referral to the Urology Consulate, you go to the Urology Consulate, who will give you a recommendation for a referral abroad. The recommendation of the Consilium, together with the documentation, is submitted to the Health Insurance Fund of Montenegro in order to obtain a decision on sending abroad for the purpose of performing surgical procedures.

Tips:

* It would be good to refer your chosen GP to your identity. Your chosen GP will be the point of contact throughout the process, giving you directions, scheduling check-ups, and is therefore useful in getting you into your situation so that he can adequately provide you with health care services.

Pursuant to the Law on the Protection of Patients’ Rights, you have the right to choose a medical doctor, to be informed and informed, to make a self-determination (free choice), to access medical records, to refuse to be subject to scientific examination and research, to obtain a second expert opinion. to privacy and confidentiality, to timely health care, to objection, to compensation for damages and to the arbitrary departure of a healthcare facility.

If you have any of these rights violated, have a problem with your doctor, or experience discrimination within a healthcare facility, you can contact a patient rights advocate.

Also, our friends from the NGO Center for Research and Monitoring have created a Healthy Healthcare application through which you can anonymously report unprofessional and inadequate treatment of health care workers.

Of course, in any situation, you can also contact us. If you need advice on any of these steps or assistance in accessing healthcare facilities, we encourage you to contact us.