With that particular anecdote, Jess begins her comedy stand-up titled “Trans ovaries.” In just 45 minutes, with lots of good humor and a tiny bit of pain, Jess explains to the public what it feels like to be a transgender man in Costa Rica. “Being a transgender man in Costa Rica involves educating people on a regular basis. Being a trans man, with a masculine aspect such as mine, but who still has a vulva and a vagina, and ovaries as well... you go through life like a Jehovah Witness, but the other way around: You have to go and explain to each and every person what it means to be a transgender man, plus a lot of stuff that people don’t care about.”

Through comedy, Jess brings the transgender reality closer to the public. Jess’s audience is diverse: transgender, cisgender (people whose gender identity matches the biological sex they were assigned when they were born), homosexual, heterosexual... in the end, just people. The money raised from Jess’s stand-up will go to Colectivo Trascendentes, an organization led by Jess and founded in 2018 aimed at providing accompaniment and support for trans people while fighting for recognition, visibility, and full enjoyment of non-cisgender people. Colectivo Trascendentes is also a substitute family for those who have left without one while going through their gender identity journey.

No tools to undergo transition

Jess’s story begins in Caracas, Venezuela, where he was born back in 1989. “Gender identity was quite confusing for me. For as long as I can remember, I have always been sure I am male. […] My older brother says that I started talking at two and when I was two and a half years old I began to say that I was a boy, and each and every time my mom heard me saying that she gave me a slap in the face.”

Jess was allowed to use male clothing and play soccer in his neighborhood, however when he had to go out in public to attend familiar gatherings, the problems began: Jess’s mother insisted that he should wear puffy dresses and patent leather shoes. When he was six, he asked for an Aladdin birthday party and what he got instead was a Princess Jasmine birthday party, costume and all. He spent almost his entire birthday party crying in a corner.

Jess’s story is not the only one. His story is repeated over and over again in the transgender community. “Trans people know it since they are very little, I’ve heard it again and again. Either they don’t have the tools or their context is not helpful. They know something is off, that something is different, but they don’t know; they can’t grasp it; they don’t have someone who can guide them, which frequently results in a truth discovered later in their life,” explains María José Longhi, Prevention Officer of the HIV/AIDS Costa Rica Project at the Humanistisch Instituut voor Ontwikkelingssamenwerking (Hivos). Longhi has been working closely with the transgender community, trans women in particular, the population group with the highest HIV prevalence rate (24.6%) in the country.

Coming out twice

College was a major break for Jess. As a Communication student at the Central University of Venezuela, he joined an LGBT+ group, he fell in love—with a woman—for the first time, and he came out as a lesbian. But family issues were not far behind: After several incidents of both physical and psychological abuse and a handful of conversion therapy sessions, his mother kicked him out of his house.

Although it was difficult, Jess already had a professional career and he could move forward with his life—an unusual situation among the transgender community in Costa Rica. A study on HIV and sexually transmitted diseases conducted in 2018 includes a chapter on the trans women population in the country. The study showed that only 14% of the 259 trans women surveyed had completed college studies.

Jess arrived in Costa Rica as a Tal Cual daily correspondent to cover the 2014 presidential elections and since then he has been in the Central American country, the place where he discovered his gender identity thoroughly. The first chapter took place when Jess worked for El Venezolano newspaper. His contract required him to follow specific standards of appearance and so he went to a beauty salon, yet right after he left he had a crisis. At that moment, Jess finally understood that he was not the person he saw in front of the mirror. He ran to the bathroom to undo his hairdo, he wiped the nail polish off his nails, and decided that on his 27 birthday he would present himself to the world with a masculine appearance.

The masculine demeanor was followed by a second coming out boosted by an episode of the TV series The L world. “At the start of the third season, there's a character that identifies as female, but later on he comes out as a trans man adopting the name Max. Over the course of the episode, I identified with Max’s situation. It was about 2 a.m. and I got up, took my clothes off, ran into the bathroom, and began to stare at myself. I looked at my body with no tits, without feminine hips, and a penis. In that moment, I said to myself ‘Well, now you've gone completely nuts.’ From then on I couldn't sleep and at 6 a.m. I phoned my therapist and booked an appointment at 7 a.m.

As my therapist sipped his coffee, he stared at me with his tired-looking eyes and said: ‘Well, you are dealing with a gender identity crisis. We are going to follow some steps and let's see where they take you.’ To identify as a transgender man was like opening the Pandora's Box of all the violence I had been suffering by repressing my masculine self. It was a hard time. Even though I had the support of my therapist, I lost my job, my partner left me, and I even attempted suicide.”

The next step was to begin a masculinizing hormone therapy. "A hormonal therapy is aimed at reaching similar cisgender—people whose gender identity is congruent with their sex assigned at birth—hormonal levels,” explained the Head of the Endocrinology Department at San Juan de Dios Hospital, Alejandro Cob, who has recently treated over 60 patients in his private practice.

However, Jess had to save enough money to undergo transition. He was able to start transitioning in January 2018 and since then he has been under treatment with the male hormone testosterone. A year and a half later, Jess is able to grow facial and body hair, his back has widened, and his hips have narrowed. Luckily for Jess, his menstruation has stopped completely.

Hiding your identity in exchange of health care

But not every transgender person can have access to a private treatment. "You hear trans women talk about birth control pills, about self-medication with hormones," Longhi says. Doctor Cob is aware of the situation. "I think that transgender people are a population group that had been left on their own, self-medicating with treatments that are potentially dangerous,” he says.

Legal actions had unprecedented results in the issue. After writs of amparo were filed at the Constitutional Chamber against the Costa Rican Social Security Fund (CCSS) demanding attention to this population, the institution decided to implement a treatment protocol for trans people which came into action this year.

The protocol exclusively comprises hormone therapy and psychological or psychiatric accompaniment of the patient. It does not cover surgeries. Even though the protocol is already available, the Endocrinology Department at San Juan de Dios Hospital has not experienced patient overflow. It is possible that those who need the treatment do not know about the protocol nor that they have the right to its access.

More often that not, access to healthcare is denied to transgender people, assures Cob and Longhi agrees. Longhi has worked with several trans women that feel—or rather they are made feel—that they live in a sub-society, that they do not have rights, that they cannot lease a house, or that they cannot go to a public institution, for instance a hospital. 26% of the trans women surveyed in the study conducted in 2018 said they had to hid their gender identity in order to receive healthcare. Transgender people often have to disclose their birth name and attend their appointments matching the sex they were assigned at birth.

But law has changed. Today, trans people can change their legal name to match the gender with which they self-identify. In compliance with a resolution of the Inter-American Court of Human Rights, since May 2018, the procedure can be carried out for free in the Civil Registry. To date, 450 people have already changed their name.

The law applies to foreigners as well. In April, Jess Márquez Gaspar became the first foreigner to obtain the Costa Rica Foreign Resident Card (DIMEX) matching the gender with which he self-identifies: male.

The privilege of growing old

It is Wednesday night. The Teoré/tica’s small room is crowded. About 50 people are in the cultural spot that probably used to be the living room of a private house decades ago. The audience is diverse: cisgender people, homosexual, heterosexual, but mainly trans women.

The neighborhood is not a stranger to them. Some of them spend their nights in the street corners looking for clients, but this particular night they have gathered to share their stories. It is the launch party for the book Atrevidas, relatos polifónicos de mujeres trans (Bold, Polyphonic Narratives by Transgender Women) written by Camila Schumacher comprising the stories of about 30 trans women who are members of the Transvida organization.

While the stories were published anonymously, with each identity hidden behind the author’s pen, tonight the stories return to their protagonists, such as Cassandra. She goes to the front of the room. She has short hair and she is wearing jeans, white shirt and white sneakers too. She sits in the couch, crosses her legs, and reads.

“I don’t cross dress anymore. I don't wear wigs and I wouldn’t wear high heels again. Not anymore. But don’t get confused, I’m a woman. I feel like a woman and I’m sure about it, in my heart and in my mind. Where it matters, right?”

In Latin America, transgender people have an average life expectancy of 35 years, however, in Transvida there is a group of trans women over 50 who call themselves ‘elderly women.’ Cassandra is one of those ‘elderly women’ who had to live in a Costa Rica more hostile towards trans women. Being arrested for being on the streets was common and once a restaurant denied her service, even when she had the money to pay. A Costa Rica where a book about transgender women would hardly be published.

“Growing old is not easy for anyone, not everyone ages well. For us, trans women, it’s harder. For us, growing old is a privilege denied to many. This is to survive, to endure.”

Context hostility

That night, Cassandra is convinced she is a survivor. Despite the joy that the published book brings to the Transvida gals, they are sad too. One is missing. Alondra is gone.

Alondra passed away over a month ago. She was the head and mentor in Transvida, the trans woman who represented them at the 22nd International AIDS Conference (AIDS2018) that took place in the Netherlands. Alondra is gone now.

“She was a woman with HIV who had began her treatment, stabilizing her condition, who had also joined a Central American HIV organization,” says Longhi. “She created a trans women group in Guanacaste (a North Pacific province in Costa Rica). She was devoted to her job, she even did the follow up of HIV-positive people,” Longhi adds.

But one day, Alondra decided to return to Guanacaste. She quit her job at Transvida and she left. There, says Longhi, Alondra spiraled into a cycle of drug abuse, returned to sex trade, abandoned her treatment and rejected all help. After a while, we were able to bring her back to San José, where a couple of days later, on June 9, 2019, she died in the hospital. She was 38.

“Alondra’s story is proof that for a trans woman, even if she has accompaniment, even if she is empowered, even if she has information, even if she has been a supporter for others, the context is so hostile that trans women won't recover altogether. There are trans women who make it, but not all trans women do,” says Longhi.

While society and laws change, trans women and trans men, such as Cassandra and Jess, must find the strength to live and survive. Strength to change their current situation for them and for future generations. The resilience and support they give to each other are their main tools.