Activist’s mission to eliminate a legal need for sexual reassignment surgery led from Montreal to the UN


MicahMONTREAL – Human-rights expert Micah Grzywnowicz came to Montreal with an admittedly crazy objective: “To change the world.” The trajectory to accomplish this lofty goal unexpectedly went all the way to the UN.
Dedicated to advancing the rights of trans people, the Polish-born activist finds the gender binary of male and female stifling and identifies as transgender. (Grzywnowicz has requested the use of gender-neutral pronouns, accepted within the trans community: “hir” for her/him and her/his, and “zie” for she/he.)

Grzywnowicz, 30, is a recent graduate of the prestigious Sauvé Scholars Program in Montreal, which was created by former governor general Jeanne Sauvé and brings young people from around the world together with a goal to “enable and empower a new generation of global leaders.” Grzywnowicz’s participation from August 2012 to April marked the first time the Sauvé House had a project on trans issues under its tutelage since the program’s inception in 2003.

Originally, hir project was to develop a tool kit for activists to fight laws that oblige trans people to submit to sexual reassignment surgery in order to have their gender marker changed on legal documents. When the surgery is not desired by those who want to change their gender marker on those documents, Grzywnowicz says, it is tantamount to forced sterilization — the procedure not only structurally modifies the body, but removes the reproductive organs.
“Forced sterilization is a form of social control against stigmatized bodies and identities,” Grzywnowicz says. “Many of my friends have undergone forced sterilization in order to have their gender changed on their legal documents. This issue is not only about having kids, it’s about what their bodies were forced to endure.”
With a spectrum of gender identities, the path of a trans person is a highly individual one. Many are eager to have sexual reassignment surgery, to complete their identification as the opposite of their birth gender. But not all trans people feel the need for medical transition; some are perfectly content presenting themselves as the gender to which they identify via their clothing, hairstyle, mannerisms — the social cues that mainstream society uses to interpret gender.
Currently, all provinces except Ontario require sexual reassignment surgery in order to change the “M” to “F” or vice versa. Elsewhere, a high number of countries and territories also mandate the surgery as a prerequisite for legal gender recognition: 24 countries in Europe, 14 in Latin America, 19 states in the U.S.
In Quebec, Article 71 of the civil code states: “Every person who has successfully undergone medical treatments and surgical operations involving a structural modification of the sexual organs intended to change his secondary sexual characteristics may have the designation of sex which appears on his act of birth and, if necessary, his given names changed.”
All of this because of one letter recorded at the time of birth, strung along on a plethora of documents: a passport, a job application, a university transcript, a loan application. Most people don’t give it much thought; they reflexively tick the little box that applies. But for trans people, it can be offensive, painful — a constant reminder of who they are not. They do not fit neatly and exclusively into a box and are regularly challenged, particularly if their presentation matches neither their photo ID nor their gender marker.
Grzywnowicz’s gender identity developed in tandem with hir activism in lesbian, gay, bisexual, transgender and queer (LGBTQ) organizations in Europe. (Grzywnowicz is now based in Sweden, where zie feels it’s possible to have a stronger impact on trans issues than in Poland.)
“I learned language to connect my feelings with my identity,” zie says. “It broadened my understanding that one doesn’t have to be defined as woman or man — a body doesn’t have to be connected to the gender on documents.”
This realization empowered Grzywnowicz to assert hir crystallized identity. With courage, and a rebellious tinge, zie transgressed gender norms by pushing the limits of what people expected to see on the outside and who they thought zie was on the inside — a gender bender. Due to differences in cultural norms, Grzywnowicz has typically been perceived as male in Europe and was usually perceived as female in Montreal.
“I played with gender — it’s not always ‘what you see is what you get.’ I loved confusing people. It felt good to do that,” zie says and chuckles.
But some people are not amused; these transgressions have occasionally elicited violent reactions. And navigating the world with a non-conforming presentation can be challenging; Grzywnowicz knows all too well how the letter that denotes gender can spark a barrage of questions when the person flashing the ID does not physically match the gender indicated on it.
“People freak out when they can’t put you into a box,” Grzywnowicz says. “It’s exhausting to constantly justify yourself. The passport is supposed to be sufficient, but they’d look at it and see it didn’t match what I looked like and I was often asked to show another ID. It was a lot of stress to be questioned each time I checked in, or boarded a plane, or crossed passport control.”

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“We’re structurally marginalizing trans people by forcing one and only one possible path for legal recognition — a path that ends with the removal of reproductive organs,” says Gabrielle Bouchard, peer support and trans advocacy coordinator at Concordia University’s Centre for Gender Advocacy.
Bouchard believes Quebec is the most “gendered” province in Canada and supports the abolishment of the legal requirement for surgery, in order to open the possibilities for trans people to choose what they do with their bodies and when. Transitioning to the opposite sex can take several years. During that period, the trans person lives in legal limbo, because the gender to which they are transitioning is not legally recognized.
“Our government is doing what we see as horrible when done in other countries,” Bouchard says.
She wishes gender markers would be made irrelevant and eliminated from all documents, but admits it is a divisive issue within the trans community — particularly for some trans women. The “F” reaffirms their gender identity and is a tool to prevent being marginalized.
“When you’re trans, it’s in your face every single day. You have to ‘out’ yourself every time. Having this legal recognition when you’re a 6-foot-4 trans woman can save you a whole bunch of problems,” Bouchard says.
While in Montreal, Grzywnowicz gathered information on jurisprudence and best practices from around the globe, adding to the arsenal to combat compulsory surgeries. Zie was paired with an academic adviser, Prof. Colleen Sheppard, director of the Centre for Human Rights and Legal Pluralism at McGill University.
“My work with Micah focused on the importance of equality of rights, and specifically protections against discrimination on the basis of sex and gender identity,” Sheppard says. “Litigation in Canada regarding the rights of trans persons has raised issues of discrimination in the workplace and in relation to government services.”
She points to a landmark decision in 2012 by the Human Rights Tribunal of Ontario, which ruled that requiring sexual reassignment surgery as a precondition of changing the gender marker on an individual’s birth certificate is discriminatory.
Sheppard adds: “The traditional grounds of discrimination, such as sex, disability and sexual orientation, do not resonate well with the experiences of trans individuals, which may be more aptly described as gender identity discrimination.”

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An unexpected break came for Grzywnowicz in mid-December. A colleague was in Washington, D.C. for a consultative meeting with the UN’s Special Rapporteur on torture (SRT), Juan Mendez, who was collecting information for a report on abuses within health care settings that may amount to torture. She said she would bring up the issue of forced sterilization; shortly thereafter, the SRT’s office requested that Grzywnowicz write a submission on the issue. The brief was presented to the SRT at a meeting of experts in Washington, D.C.; Grzywnowicz had no idea if the submission would be included in the SRT’s final report.
When asked what zie thought the outcome might have been, Grzywnowicz recalls thinking: “Worst-case scenario, Mr. Mendez doesn’t include forced sterilization of trans people in his mandate, but at least it’s on his radar, and he’s now aware of it. Best-case scenario, he includes it — which would be groundbreaking.”
A nail-biting six weeks passed and the decision was announced: It would be included in the final report, marking a pivotal point for trans rights. “My brain was on fire,” says Grzywnowicz.
In March, the report was presented to the UN Human Rights Council and its contributors were invited to a panel discussion with the SRT in Geneva. Grzywnowicz addressed a session about the potential of the report to bring change to the lives of trans people worldwide and the responsibility of the states to change abusive laws.
In the SRT’s final report, Paragraph 88 specifies: “The Special Rapporteur calls upon all States to repeal any law allowing intrusive and irreversible treatments, including forced genital-normalizing surgery, involuntary sterilization, unethical experimentation, medical display, ‘reparative therapies’ or ‘conversion therapies,’ when enforced or administered without the free and informed consent of the person concerned. He also calls upon them to outlaw forced or coerced sterilization in all circumstances and provide special protection to individuals belonging to marginalized groups.”
Elated at having direct access to the authorities and mechanisms to help trans people, Grzywnowicz says: “It’s the highest you can go to claim change. I would never have thought that at the end of my eight-month program, my work would have such an impact.”

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Legal gender recognition in Quebec and beyond:
It can take several years for a trans person to legally change their name in Quebec. They must obtain letters from psychiatrists or mental health professionals attesting that they have “gender identity disorder” (now called gender dysphoria by the DSM-5, the American Psychiatric Association’s bible of mental health disorders) and begin medical transition to the opposite sex.
The Quebec Civil Code stipulates a person who wishes to have their gender marker changed in the province must be at least 18 years of age, must have undergone “medical treatment and structural modification of the sexual organs” and must be a Canadian citizen.
Bill 35 sought to amend and repeal parts of the Quebec Civil Code regarding civil status, successions and the publication of rights. Trans advocacy groups and health care professionals who are experts in trans issues proposed amendments to the bill in order to remove the obstacles to legal gender recognition. The bill was presented and discussed at the Committee on Institutions until June, but no final decision was made.
In 2010, the World Professional Association for Transgender Health stated: “No person should have to undergo surgery or accept sterilization as a condition of identity recognition. If a sex marker is required on an identity document, that marker could recognize the person’s lived gender, regardless of reproductive capacity. The WPATH Board of Directors urges governments and other authoritative bodies to move to eliminate requirements for identity recognition that require surgical procedures.” This position has since been supported by the World Health Organization and the UN.

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