“I felt like the whole world was trying to break me once more, like it was against me again,” says Polina Skvortsova, about the moment Russia launched its full-scale invasion of Ukraine last February.

Skvortsova, a 36-year-old trans woman living in Kyiv, says that before 24 February she’d only just started to emerge from a period of financial struggles, worsened by poor mental health. The invasion crushed her hopes for the future: in the past year she has had to move from one unstable housing situation to another, been unable to work and partially lost access to hormone therapy.

“I had a bad financial situation even before 24 February,” says Skvortsova, a self-taught and self-employed computer technician, who takes orders for repairs via Facebook. “But I had a clear plan for how to get out of it, and it was working. Because of the war, I fell backwards again.”

Although there’s no official statistical data on the number of trans people in Ukraine, 7,000 Ukrainians received a permit for a transition between 2016 and 2019, according to an analytical report by the Center of Social Expertise.

For many trans people in Ukraine, including Skvortsova, the war has aggravated already precarious living situations. Since a row with her transphobic father in 2010, Skvortsova has lived in Kyiv, hundreds of miles away from her family home in the Kherson region. She has experienced persistent financial hardship and suffers from depression.

As well as the rising inflation and deteriorating economic situation facing all Ukrainians, trans people have additional obstacles to deal with. Medical treatment has become patchy – the price of hormone therapy drugs, for instance, has shot up by 20% – and changing one’s official documents is even more difficult than it used to be.

People’s need to complete their legal transition has also become more urgent, so they can flee the country or avoid trouble with Ukraine’s conscription office. And every encounter with officials and the police brings a risk of being harassed and humiliated.

‘A vulnerable position’

“The war left the country unprepared in many respects,” says Yana Lys, Volyn regional coordinator for Insight, a Ukrainian LGBTQ+ NGO. “It hurts me as a transgender woman because for too long the state has delayed the implementation of Western standards of inclusion and assistance. As a result, transgender people are in a vulnerable position.”

Like in the United Kingdom, Ukraine currently requires trans people to receive a medical diagnosis of gender dysphoria to undergo gender-affirming hormone therapy or alter their identity documents. In the 2021 rating of The International Lesbian, Gay, Bisexual, Trans and Intersex Association (ILGA), Ukraine came 39th out of 49 European countries as anti-LGBT hate speech and hate crime continued to be a severe issue.

With Ukraine under martial law, the question of documents has become particularly important for Ukrainian trans people. Men aged 18 to 60 are subject to conscription and forbidden from leaving the country, and trans people can face harassment and intimidation from border guards and other law enforcement officials as a result.

In late January, for example, the western regional office of Ukraine’s State Border Service shared a Facebook post titled: ‘Border guards detained a draft dodger pretending to be a woman’. The post, which was picked up by Ukrainian media outlets, included several photographs of the detainee (although their face had been pixelated), who had been apprehended at the Hungarian border. It claimed they had at first “tried to pretend to be a woman” but then “finally confessed to fraud”.

At the time of publishing, Ukraine’s State Border Service had not replied to openDemocracy’s request for comment.

While trans women can technically leave Ukraine even if their documents list them as male, to do so they need an official letter from the conscription office saying they are unfit for military service due to gender dysphoria. That requires a medical diagnosis, which in turn requires several meetings with doctors and substantial paperwork. And even with the diagnosis, the conscription office still might not issue a letter.

“Currently military commissariats are working solely on the registration of conscripts. Everything else is on hold,” Skvortsova says.

Skvotrsova started her transition in 2016, undergoing what she describes as a traumatising psychological evaluation, but hasn’t yet completed the legal process. She still needs to visit several doctors, including an endocrinologist, to get the necessary documents. Only once she has a new passport listing her correct gender can she visit the conscription office to be deregistered.

For trans people who want to join the military meanwhile, delays in updating documents might mean they are blocked from signing up.

Grassroots support

Even in peacetime, it wasn’t easy for trans people in Ukraine to get a diagnosis. They had to seek out doctors who had been appropriately trained or at least had experience in working with trans people.

“The first concern is finding friendly doctors to go to. And there is a big gap here,” Lys says.

Before 2022, Ukrainian LGBTQ+ organisations had been filling in gaps left by the state, training sympathetic doctors and lawyers and helping people to access them.

But with the invasion, this support system has disappeared. Some LGBTQ+ organisations have relocated abroad, as have some doctors, while others have joined the military. The shortage of drugs makes it hard for people to maintain their courses of hormone therapy.

At the same time, the demand for treatment is higher than ever because of martial law. Trans people have mapped out the remaining points of assistance and share contacts among themselves. Even before the war, most of the doctors were based in Kyiv, and the situation has worsened since Russia’s invasion, making life increasingly difficult for people living elsewhere.

Like with other aspects of life in Ukraine, grassroots organisations are doing their best to provide help. Skvortsova and Lys both receive their hormone therapy drugs from support groups, Trans*generation and Insight respectively. Other groups, like Kohorta and Gay Alliance, help people with medication and basic food products.

Insight has also helped around 7,000 LGBT+ people with legal and psychological assistance, hormonal therapy and relocating, while Trans*generation has provided long-term help to 93 trans people who are still in Ukraine.

Lys says that despite these efforts, the government needs to step in. “It’s important that the state deals with this systematically – educating people and helping vulnerable members of society.” At the time of writing, the Ukrainian government had not replied to openDemocracy’s request for comment.

Some trans people, like many other Ukrainians, want to leave the country because of the widening socio-economic crisis.

Ania, a 29-year-old trans woman from the western Ukrainian city of Rivne, who started her transition at the end of 2019, needs the details on her passport changed so she can move to Canada under that country’s emergency travel scheme. But at the moment, she says, the conscription office isn’t removing anyone from the register.

The Defence Ministry, which oversees the conscription office, did not respond to openDemocracy’s request for comment.

“There won’t be normal life in Ukraine,” says Ania, who currently works in quality control at a factory. “Corruption is high, the judicial system doesn’t work, there are a lot of taxes for everyone. I want to go to Canada to earn enough money for housing. Costs in Ukraine are very high and it’s impossible to make enough money in wages.”

Skvortsova is hoping that Ukraine’s economy will pick up soon. She recently started treating her depression with medication donated by support groups, and says she has been feeling better and now has enough strength to finish her transition. She plans to buy broken laptops online, repair them and sell them on. If the plan works, it might bring her some financial stability.

“Lately, I have been in a positive mood, because I see that we are starting to climb out of this hole a little bit,” she said, explaining that it feels like people are returning to Ukraine and there’s a bit more money around. “More people can pay me for my services,” she says.

“I didn’t want to leave Ukraine at the beginning of the war. I want to go to Europe as a visitor, not as a refugee. It is a matter of principle, the Russians should leave Ukraine, not us,” she says.