LAUSR

Lebanon is considered liberal and democratic in comparison with Arab countries; but when it comes to transgender people, many legal and social challenges are present. In the penal code, article 534 identifies “Any sexual intercourse contrary to the order of nature is punished by imprisonment for up to 1 year” [1,2]. In Lebanon, transgender people are frequently victims of a transphobic culture, which originates from a lack of understanding in society. They are often erroneously conflated with the gay community, who are also victims of systemic prejudice [3] . As medical doctors, we find ourselves responsible for providing medical care to this community despite all the social, legal and religious challenges, based on ethical principles. Of concern, we are writing this letter to share our experience with transgender patients since 2004 in our Obstetrics and Gynecology department in a tertiary referral hospital in Beirut, Hotel Dieu de France. The start of our experience was tragic. In 2004, a trans woman who underwent successful gender affirming surgery in our clinic was killed by her children. This crime was enough to lead us to reconsider the strategies adopted in our institution to provide a plan of care for transgender patients. Multiple ethical problems are assumed in the face of every transgender patient: