Dmitri Isaev is exploiting a legal loophole to help the transgender community from a secret location in St Petersburg
You wont find any mention of Dr Dmitri Isaevs clinic online, and patients cant look up the number in a phone book. Both name and address are kept secret, and those who would like an appointment with Isaev, a leading gender identity expert, must discover the location of his St Petersburg clinic by word of mouth.
The doctor has been working undercover after conservative activists led a campaign of intimidation against his clinic for transgender patients at Saint Petersburg State Paediatric Medical University.
Isaev, a 60-year-old psychiatrist, led a team of doctors at the university for nine years, issuing official permission for gender reassignment surgery and for changes to identity documents.
It was the countrys largest trans clinic, granting authorisation documents for up to half of the reassignment procedures that take place in Russia each year, according to Isaev. Costs for the permits were kept at a relatively modest 10,000-15,000 roubles (135-200).
But in 2014, the publics attitude to his work changed. A year after the passage of a controversial federal law banning anything perceived to be gay propaganda, a self-styled anti-gay hunter named Timur Bulatov spearheaded a campaign against Isaev.
When interviewed in Aprilabout the psychiatrists work, Bulatov claimed the doctor had created an entire army of gender perverts and described him as Dr Frankenstein.
The campaign against Isaev lasted for months. First came abusive text messages, then a social media campaign, with his phone number and photograph posted on dozens of homophobic social media pages, some with hundreds of members.
Isaev said he was forced to leave his position at the university after complaints about his work reached the district attorneys office.The university denied that he had been forced to resign and said he had left of his own accord to focus on his research.
Not long after his departure, trans people were banned from driving in Russia as part of a legal amendment limiting people with physical and mental disabilities from driving. A move widely condemned by human rights groups.
Undeterred by the escalating climate of intolerance, Isaev decided to reopen his clinic, but this time covertly.
Wary of public pressure, several clinics turned down Isaevs request for treatment rooms, but after 11 months of searching he found his new location in St Petersburg traditionally considered Russias most liberal city.
Though most such consultations take place at medical universities, the psychiatrist found a legal loophole that allowed him to set up privately under the proviso that all of the staff responsible for authorising surgery were certified to practice medicine.
From the undisclosed location, he is once again able to issue the legal permits needed for a person to change their gender identity. The practice is thriving.
Since the late 1990s, Russia has followed a system modelled on many European countries, whereby anyone wishing to change their gender identity must undergo a psychiatric evaluation before receiving the permit needed to change their documents and have surgery.
Certified psychiatrists such as Isaev and his team evaluate candidates based on whether they have fully formed their gender identity and are ready for the repercussions that may come with changing gender in Russia.
Isaev said the witchhunt over the past three years reminded him of the 1980s, when gender and identity research was still based on Soviet academic papers.At least in those days, he said, the rules of the game were clear. Its incredibly complicated to predict what can happen now.
After the collapse of the Soviet Union, Isaev dedicated his research to transgenderism, and has since published more than 120 academic articles and his advocacy has earned him respect among Russias trans community.
Things moved from a dead stop thanks to Isaev, said Anastasia Gerasimova, who received permission for a sex-change from him. People would come to his consultations from across the country.
A local trans activist, Igor Burtsyev, said there had been some advantages in Isaevs forced change of location, since the secret clinic was now enjoying greater independence from the university, a government institution.
Part of us want the government to actually change something, but those of us quite close to the situation understand that until the government changes things, we actually have it much better, Burtsyev said.
A version of this article first appeared on Coda Story
Read more: https://www.theguardian.com/society/2017/feb/01/russian-doctor-defies-intimidation-to-authorise-gender-reassignment-surgery