How the War in Ukraine Upended Trans Lives

Last winter, Alexa Crystal was sitting in her kitchen with her friend Julie in Kyiv, Ukraine, when she asked her where she got hormone replacement therapy (HRT). Julie’s answer was simple: “From the pharmacy.” For Crystal, that moment was pivotal: “I had no idea it was that easy,” she says. Later, Julie gave her a wig and as the long hair fell down her back, Crystal looked at herself in the mirror. “I realized this was it.”

On January 17, 2025, despite the ongoing upheaval of Russia’s full-scale invasion of Ukraine, which today is entering its fifth year, Crystal took the first steps towards transitioning, texting her doctor to begin hormone therapy. 

When we met a year later in a polished, vast cafe in Kyiv, its walls hued pale-blue, Crystal, who is 23, wore no make up, and possessed a serene, confident energy. “I finally realized that I don’t want to live my life as a boy, as a gay man,” Crystal says on discovering easy access to HRT. “I’m not wearing much makeup because I want to see how I’m changing naturally. 

“Now I know what dysphoria is,” she continues. “But when I was a child and looked at my body, I didn’t understand why I looked that way.” Some people within her LGBTQ+ community questioned her transition. She remembers being asked whether she was “really trans” or just wanted to wear women’s clothes. Others insinuated she had found a way around conscription. In 2024, the age limit for conscripts eligible for mobilization was lowered from 27 to 25, meaning she could soon be affected.

Since 2022, all Ukrainian men aged 18–60 have been unable to leave the country. Over half a million Ukrainian men are estimated to be in hiding, trying to avoid the draft. The term “Tetseka” which refers to the Territorial Recruitment Center, has entered the daily vocabulary, as officers stop men in public spaces, check documents and quickly send those deemed fit into training—sometimes within days. As society has reorganized around the war, absorbing the conflict, some men describe finding stability in military service and relief in no longer having to avoid conscription.

Crystal recalls an incident that took place near where she lives in Obolon, a large residential district in northern Kyiv on the banks of the Dnipro river. “I was walking to the supermarket, and in front of me was a man heading the same way.” An unmarked car pulled up on the street and, seconds later, a policeman and a military officer got out, approached the man and asked for his documents. “What’s happening with mobilization is intense,” she says.

The decisive factor for mobilization is the sex marker in the person’s passport, leaving many Ukrainian transgender women, whose documents do not reflect their gender identity, in fear of mobilization. 

The pressures of paperwork and passports have shaped decisions for others as well. A day after Alexa’s visit, Toma Boldarieva arrived at the same Kyiv café with her boyfriend, Victor. Boldarieva, who is striking, tall and poised, sat with her hands gently crossed, wearing a purple dress with a chainlink motif. “I thought about my passport at the last moment,” she says softly. If not for the war, she probably wouldn’t have changed her sex marker, but she was invited to another city and, needing to travel, thought: “Okay, I need to deal with this.” In the end, the process was easy for Boldarieva, despite taking place during the war, in January 2025. “I didn’t stay long in the hospital, they gave me a diagnosis, and I received the certificate.” 

Before 2016, in order for a Ukrainian to change their sex marker, applicants had to be diagnosed with “gender dysphoria,” spend 30–45 days in a psychiatric hospital and obtain approval from a state commission to begin the process, effectively pathologizing gender identity as a psychiatric condition. In 2016, Ukrainian lawmakers overhauled the legal gender recognition process, ending mandatory surgery and long psychiatric hospitalizations. But the process, which was already difficult before the war, has become a major obstacle for most trans people in Ukraine. 

Anastasiia Yeva Domani, a trans woman who serves as the executive director of Cohort, an NGO supporting the transgender community in Ukraine, tells me that, in order for cisgender men to avoid conscription, “Many doctors abused their duties and engaged in fraudulent practices by issuing false diagnoses for men.” This led to fear among doctors, including some trans allies, who told Domani they were afraid of investigation by security and law enforcement agencies. As a result of this heightened scrutiny, many transgender people were unable to obtain gender reassignment certificates at a crucial moment.

Asked her opinion on mobilization, Boldarieva is straightforward: “I would like to say that we should have a choice. But we don’t have a choice.” Ukraine finds itself in a position with few real alternatives. Simply put, if it stops fighting, it falls to Russia. Mobilization is something of a false choice for many Ukrainians – a notion familiar to trans people. “I love when people say being trans or gay is a choice,” says Crystal, laughing. 

Boldarieva recalls that she knew she was a woman from birth: “I already understood myself in childhood,” she says. Acting on this knowledge, Boldarieva began a HRT regimen at 28, following advice that she found on the internet due to a lack of access to health resources at the time. Interruptions to hormone therapy can lead to “spikes in blood pressure and dizziness. If stopped suddenly, the body may react strongly and, in some cases, revert. People can feel very unwell” explains Domani. “You can’t just stop.” As access worsened after Russia’s full-scale invasion, some people switched to cheaper medications, often with significant side effects.

LGBTQ+ groups expanded humanitarian efforts, distributing hormones through international programs funded by the Global Fund and coordinated by the Alliance for Public Health. Still, outreach was limited. “We can’t reach everyone, especially those in small towns,” she said. “Most likely, people had to manage on their own.” Domani recalls carrying bulk supplies from abroad in suitcases, but that has become more difficult. Hormones are expensive and are paid for out of pocket, not covered by insurance, which forces those transitioning to make difficult choices, balancing medication fees with rent and food.

Despite the strain, many transgender Ukrainians have reorganized their lives to continue treatment. Crystal had previously planned to begin hormones only after leaving the country. “I thought I’d start hormones when I go abroad, after the war ends and I have the chance to leave,” she says. But waiting for the “perfect” circumstances no longer felt realistic. “The right time is now.”

Boldarieva reached a similar conclusion, undergoing breast surgery during the war, deciding “there was no point in postponing it.” These times, she says with a faint smile, “force you to realize you have to live in the present.”

Both women also describe what they have seen as a gradual change in public attitude. Notably, Gen Z has been markedly more tolerant toward transgender people than previous generations. “My sister accepted me from the very first moment that I told her,” recalls Crystal. Her sister changed her name on Telegram from brother to sister immediately. For Boldarieva, who has been a pharmacist for 10 years, there has been a lot of improvement in how she is treated daily: “I work with people, up to 100-150 people per day. I’m happy to see that young people are much more tolerant of us.”

That shift, according to Boldarieva, was undermined by Trump’s return to power in 2024, which she argues has set back trans rights in Ukraine more than the war itself. “Before Trump came, there was some progress. There was hope that we would eventually achieve equal rights.” Today, Boldarieva argues that because Ukraine depends so heavily on the U.S., it has in some ways mirrored the MAGA agenda, avoiding issues that might be seen as too progressive. 

Even as she describes a broader rollback in reform, individual legal victories have continued to surface. Days before our interview, a court in Ukraine’s Kharkiv region ruled in favor of a transgender woman who sought removal from military registration after legally changing her gender in 2025. She challenged the refusal in court, presenting updated civil records and registry confirmation identifying her as female. The court ordered her exclusion from the draft registry. 

Boldarieva acknowledges it was a significant victory, and the trans community celebrated, but as the news spread, online comments were often derogatory and misinformed, tainting what she saw as progress. “Of course, I want to see a flourishing present-day Ukraine. I hope for that, which is why I’m staying here, even though I could have left many times,” she says. 

Despite the war now entering its fifth year and the impact of political shifts abroad – both of which have complicated what once seemed a steady path toward progress on trans rights – Crystal and Boldarieva have long settled into their identities. On the day she began transitioning, Crystal looked in the mirror and thought, “This is who I’ve been.” After a year on hormones, the physical changes have only strengthened her self-image. “When my hair started growing and I felt more feminine, I was really satisfied… I started to feel more aligned with my inner self, like Alexa’s inner self finally matched her outer expression.”