MOSCOW – Alexei, a transgender man, had always planned to someday change the gender marker on his Russian passport — but time is now running out. “I’m in a panic.

The process of my gender transition had been delayed because I have been living on my own since I was 18 and I didn’t have enough money.

Now I have to start it urgently,” Alexei, 23, told The Moscow Times.“It's hell,” he said, sitting at a cafe in central Moscow.Alexei is one of the thousands of transgender people in Russia who have been affected by new legislation which, once signed into law, will ban them from accessing gender-affirming health services — and deprive them of the right to determine their own identity and future.Russia’s lower-house State Duma swiftly approved the bill in its second and third readings this week.

It is expected to undergo a vote in the upper-house Federation Council on July 19, after which President Vladimir Putin will likely sign it into law.Activists and transgender people say the bill, which was first introduced in May, has spurred numerous individuals to hastily start the gender reassignment process out of fears that this opportunity will soon be stripped away.They warn that the legislation could increase already high rates of suicide and suicide attempts among transgender people and encourage an underground market for surgeries and medications.“The way how these people see their future is collapsing.

We are getting a lot of suicidal messages,” said Yan Dvorkin, the head of Center-T, a group that helps transgender and non-binary people in Russia.According to Dvorkin, who remains one of the few prominent LGBT activists still inside Russia, Center-T has already seen a three-to-fourfold increase in requests for assistance in the weeks since the bill was introduced.If passed, the bill will ban gender reassignment surgeries and treatments such as hormone replacement therapy.

It will no longer be possible to change one’s gender marker on their legal documents.According to the State Duma website, the government will establish a list of permissible interventions "related to the treatment of congenital physiological anomalies in children."The bill will also ban those who have already transitioned from adopting children — and annul their marriages."This decision will protect our citizens and our children," State Duma Speaker Vyacheslav Volodin said as the bill passed its third reading, describing gender reassignment as “the path leading to the degeneration of the nation.”The legislation comes amid the country’s wider crackdown on LGBT people, minorities and dissenters that has gained momentum since the invasion of Ukraine.Russian officials, including President Vladimir Putin, frequently slam liberal Western values, particularly those concerning gender and sexual freedoms, as a foreign ideology that threatens Russian society.Lawmakers were also concerned about an “increasing number of cases” where Russian men “used gender reassignment certificates to avoid being drafted into the military” and being sent to Ukraine, the Kommersant business daily reported in May, citing a source in the State Duma.Russia ranked 46th out of 49 European countries in Rainbow Europe's annual LGBT rights rankings.According to Human Rights Watch, Russian politicians “are harming transgender and intersex people by continuing to deploy cynical ‘family values’.”  “The hypocrisy of not allowing adults to make decisions about their bodies … is not unique to Russia but rather part of a cynical and exploitative anti-rights tilt politicians around the world are taking,” Kyle Knight, a senior researcher on health and LGBT rights at Human Rights Watch, said last month.Currently, those hoping to change their gender marker and seek gender-affirming surgeries and treatments must first undergo a challenging process involving a specialized medical commission only available in major cities like Moscow.Many transgender people also face financial difficulties due to discrimination and transphobia in the workplace, which in turn exacerbate their financial struggles during their gender reassignment process.Some transgender people, like Alexei, have been forced to seek financial assistance from LGBT aid organizations.

Others have resorted to taking out loans.“I launched a fundraiser and also had to take out a loan in order to do my surgeries.

The situation is very alarming — it’s not clear how much time is left,” Danil, a transgender man from Siberia, told The Moscow Times. “Taking away the right to dispose of one's own body is inhumane.”Along with legal and financial difficulties, rights activists warn that banning gender reassignment would also lead to the emergence of a black market for surgeries and hormones.“It was one of the biggest parts of our work — we tried to make medical care available to people so that they did not prescribe drugs to themselves [and] so that they took tests and doctors could adjust their treatment — this way, hormone therapy is safe,” Dvorkin said.“Now it feels like our work is dying,” he added.According to Dvorkin, endocrinologists have already started turning away transgender patients, fearing they may be accused of promoting “LGBT propaganda” or could face attacks from patients' relatives.LGBT organizations such as Center-T have also experienced problems with sponsors as many organizations hesitate to collaborate with LGBT activists.Russia last year imposed steep fines for LGBT “propaganda” toward both minors and adults, which includes public displays and media portrayals of non-heterosexual identities.Authorities have already filed at least 19 misdemeanor lawsuits against the country’s major streaming platforms over films and television shows depicting "non-traditional sexual relations." Dvorkin, who himself was fined 100,000 rubles ($1,100) in May on "LGBT propaganda" charges, had been the caretaker of a child with a disability for six years until he was reported to the authorities earlier this year, a move he linked to his activism.For now, Dvorkin has no plans to change his gender on his documents, meaning the legislation banning access to gender-affirming services, if signed into law, would restrict his rights in the future.“This moment of taking away our rights is very hard to experience.

When I discuss this legislation, I feel like my head is being cut off,” Dvorkin told The Moscow Times.Until recently, some transgender people had postponed their transitions because of Russia’s military mobilization for the war in Ukraine, unwilling to take part in the war or subject themselves to the widespread transphobia in Russia’s army.Yet the number of Russians who received a new passport after receiving gender-affirming care almost doubled last year — at least 936 people changed their gender marker, independent news outlet Mediazona reported, citing Russia’s Interior Ministry.Transgender people have been among the hundreds of thousands of Russians who have fled the country since the start of the war in Ukraine and worsening domestic repressions, but going abroad is costly and can carry its own risks. For LGBT activists like Dvorkin, staying in Russia is also the only way to support the country’s transgender community despite the risks of being fined or physically attacked.“Around 90% of the people I work with have no privilege to leave the country.

I want to stay here to support them,” Dvorkin said.

“I can’t imagine myself leaving the country.”Other transgender people who spoke to The Moscow Times echoed this thought.“I love my country.

My close friends and family are here,” Alexei told The Moscow Times.“Even the idea of leaving hurts me.”