The free medical treatment is the result of the passage into law on June 4 of "Resolution 126," which offers transsexuals new identification documents--no small matter!--in addition to free sex reassignment surgery and hormonal therapy. The legislation marks quite a revolutionary change for a country whose single recorded sex-change operation, according to news reports, occurred in 1988.

My first thought was, "Does that include foreigners?" I don't know the answer, but if so, they may find themselves inundated by North Americans tourists who either lack health insurance or whose policies exclude the surgeries from coverage.

The first week of June saw the beginnings of a dramatic reversal of decades of oppression toward transgender people in Cuba when the government of the new president, Raúl Castro, began offering free hormone treatment and sex-change operations for transsexuals .

The policy change is part of an enormous, albeit ongoing, transformation of Cuban society brought about in no small way by Former President Fidel Castro's retirement from office in February of this year. Props should also go to Mariela Castro-Espin, daughter of current Cuban President (and Fidel's brother), Raúl Castro.

Ms. Castro-Espin heads the National Center for Sex Education (CENESEX), a government-funded body whose mission, according to Wikipedia, is to contribute to "the development of a culture of sexuality that is full, pleasurable and responsible, as well as to promote the full exercise of sexual rights." The center has played a prominent role in promoting tolerance of LGBT issues, as well as in AIDS prevention and education, and contraception.

Early news reports suggest that Resolution 126 adopts a fairly sophisticated and comprehensive approach to transsexuality, including recognition of the fact that not all of us want to have surgery. [emphasis mine]

Resolution 126, which was signed Jun. 4 by Public Health Minister José Ramón Balaguer, establishes the creation of a centre that will provide integral health care for transsexuals. It will be the only institution in Cuba authorised to carry out gender reassignment therapy. The decision also "legitimates the work of the National Commission for Integral Care of Transsexual People," created by CENESEX in 2005 as the continuation of a multidisciplinary team that has functioned since 1979, said Castro. "This resolution establishes all of the aspects of care for transsexuals, including the operation for those who qualify and are interested, because not all transsexuals want the surgery," said the sexologist. The functions of the National Commission include drafting, implementing and coordinating the national policy on integral care for transsexuals, approving gender reassignment surgery on a case-by-case basis, promoting research and advising the Public Health Ministry on policy-making questions. The new centre, meanwhile, will provide integral care, including pre and post-op interviews, diagnosis, treatment and follow-up for transsexuals undergoing sex change surgery as well as those who only receive hormonal treatment.

Let's hope that this positive development marks the beginning of a dramatic change for the Cuban LGBT community as a whole. During much of Fidel Castro's reign, which began nearly half a century ago in January, 1959, Cuba was an appallingly oppressive place for LGBT people. Condemned by a culture that glorified "machismo," effeminate gay men and transgender people were punished by being sent to rural prison farms and labor camps where they were brutally mistreated. The terrible situation may have even helped spark the North American gay rights movement according to one writer, who says that newspaper accounts of the camps triggered the first pickets in front of the White House by gays and lesbians who held up signs asking, "Cuba persecutes gays; Is the U.S. much better?"

Again according to Wikipedia, homosexuality was formally decriminalized in Cuba in 1979, yet that didn't stop hundreds (maybe thousands) of gay men (and some women) from fleeing Cuba a year later during the Mariel boat-lift, part of an estimated total of 125,000 Cubans (described at the time as "undesirables and criminals") who fled the island seeking refugee status in the United States. Many of these people set foot on our shores only to find themselves once again incarcerated for long periods of time with very slow due process--but that's another story.

While reports on the current situation differ depending on whether or not one is a Castro supporter or critic, it seems that prejudice and oppression toward the LGBT community in Cuba remain persistent. A law prohibiting hassling "others with homosexual demands" (Article 303a, Act 62 of the Penal Code of April 30, 1988) which was modified in 1997 to read, "hassling with sexual demands," continues to be disproportionately enforced against LGBT people.

LGBT organizations and publications, gay pride marches, and gay clubs are prohibited. Wikipedia says that the only gay and lesbian civil rights organization, the Cuban Association of Gays and Lesbians, formed in 1994, was disbanded in 1997 when its members were arrested. Marriage remains restricted to the union of a man and a woman, and no alternative, such as civil unions or domestic partnerships, exists.