The “persons with special needs” category includes “unaccompanied minors, handicapped persons, elderly, pregnant women, single parents with minor children, victims of torture, rape and other forms of psychological, physical or sexual violence”.[1]
In addition to the measures set out in Identification, the LFIP makes a number of special provisions regarding the reception services to be extended to “persons with special needs” including unaccompanied children. However, the additional reception measures prescribed by the law are far from sufficient.
Reception of unaccompanied children
When it comes to unaccompanied children, Article 66 LFIP orders that the principle of “best interests of the child” shall be observed in all decisions concerning unaccompanied minor applicants. According to the new Article 66(B) LFIP, all children younger than 18 shall be placed in children’s shelters or other premises under the authority of the Ministry of Family and Social Services.[2]
Unaccompanied male children may face difficulties in accessing protection. If the child does not have an identity card, the Child Support Centres (ÇODEM) will help to obtain one. If the child goes directly to a PDMM, he will not obtain an ID card as he must receive a guardianship decision from a court first. However, when children go to court for the appointment of a guardian, judges say that they cannot appoint a guardian because the child is not registered and, therefore, legally does not exist. This creates a vicious circle where children remain in a prolonged state of limbo and further hinders their access to the international protection procedure. Children staying in dormitories get a foreign identification number, not an ID card to access basic services such as education. When they leave the dormitory and reach the age of 18, they can apply for an ID.
There is no clarity in Child Protection Law and its regulation. The law concerning exit procedures for refugee children staying in dormitories remained unclear in 2022. Children’s settlement is also problematic, and it is traumatizing because they are placed in dormitories by the juvenile police. Police officers often do not know what to do and how to treat children. Practices change from district to district. Protection measures are taken when a child is placed in an orphanage, but a guardian is not appointed directly, which is problematic. Since the child does not have a legal representative, permission to leave cannot be obtained, even if all the other steps of family reunification are completed. PMM requires a legal representative for the child to leave the orphanage, but it is unclear who will handle the child’s exit process as no guardian has been appointed. In some institutions, this problem is solved by assigning an internal officer for the signature.[3] The cases of unaccompanied children were not thoroughly examined in Agri. They are frequently detained in removal centres, where the administration of the removal centre appoints a detainee as the child’s representative. Two siblings, for instance, were detained in a removal centre, and a detained family was appointed as their legal representative. They were required to be deported along with their designated representatives were deported.[4] It is reported as a general problem that allocation of responsibility for unaccompanied minors is not clear, which causes conflicts between the provincial units of the Ministry of Family, Labour and Social Policies, children’s police and PMM and results in protection gaps.[5]
Undocumented migrants are not permitted to travel within the country. They are unable to purchase a bus ticket, even if they have been sent to another city or are staying in a hotel. When they are apprehended, they are sent to removal centres and then pushed back towards the borders. In 2022, various stakeholders continued to state that unaccompanied adolescents aged 15-16 had been determined to be 18 on paper, while other unaccompanied children aged 12-13 were determined to be relatives of these older children and were released from child-care institutions.[6]
Stakeholders reported unaccompanied minors entered Türkiye. A Ukrainian businessman welcomed unaccompanied children into his hotel in Antalya. A second one is located in Eryaman, Ankara. In the one in Eryaman, minors aging from 3 to 15 have resided while children older than 15 have placed in Antalya. The accommodations operated in close collaboration with the Ministry of Family and Social Services.[7]
Reception of survivors of torture or violence
Victims of gender-based violence are referred to Centres for the Elimination and Monitoring of Violence (Şiddet Önleme ve İzleme Merkezi, ŞÖNİM) which are run by the Ministry of Family and Social Services. There are other shelters managed by municipalities or NGOs.[8] In 2019 there were reports of 145 shelters with a capacity of 3,482 places.[9] Figures for 2022 were not made pubic.
There are now two dedicated facilities for victims of human trafficking: one operated by PMM for women in Kırıkkale with 12 places, and another shelter for women operated by the municipality of Ankara with 30 places.[10] LGBTIQ+ victims can also access to these facilities. [11]
Some NGOs, municipalities provide places for short stays in case of emergency (see also Temporary Protection: Vulnerable Groups).
In most cases, the criteria for renewal of residence permits and financial support, long waiting times, and lack of interpreters can leave women and children victims of gender-based violence unregistered. Refugees and returnee women and girls have a right to documentation, including identity papers and travel documents issued in their own names, but this is often not the case in practice since the PMM requires women to produce a certificate proving their status as married/divorced or widowed. Another approach that does not adopt gender sensitivity is that divorced or widowed women must prove that they are divorced or widowed to receive the Türk Kızılay Card.
Due to language barriers, access to justice can be particularly challenging for women. They receive legal notifications in Turkish, not in their native languages Additionally, women may fear the justice system and the loss of their status and rights. The cancellation of social support and social cohesion programmes increased refugee women’s social isolation and exposed them to domestic violence. Even greater obstacles exist for women refugees from vulnerable groups, such as sex workers, to access health services. They lack access to sexual health information, health care facilities, HIV testing centres, and counselling services.[12]
Asylum-seeking women may be exposed to discrimination on the grounds of gender, especially in terms of benefiting from services. Single refugee women face difficulties in finding a rental house and taking part in social life. At the same time, refugee women may be discriminated against in accessing services and benefiting equally.
ASAM-SGDD provided counselling to Ukrainian and Russian victims of gender-based violence in their access to health care or permit processes.[13]
Reception of LGBTQI+ persons
LGBTQI+ persons are not mentioned as a category of “persons with special needs” in the LFIP. Prior to the termination of the “joint registration” system in September 2018, UNHCR / SGDD-ASAM mainly referred LGBTQI+ persons to specific provinces, where communities were known to be more open and sensitive to this population.
In 2022, LGBTQI+ refugees were still being referred to Eskişehir, Denizli and Yalova, but not to Ankara as in previous years. In addition, stakeholders indicated that LGBTQI+ individuals could be referred to Corum, Elazig, Erzurum, Yozgat, and Kayseri, where the refugee population is smaller. Vulnerability was not taken into consideration during the referral process.[14]
In addition, transgender persons who start or are undergoing gender reassignment process may face obstacles in securing treatment due to hospitals’ limited familiarity with this field, as well as restricted financial capacity to afford hormones which are not covered by social security. In general, they consult the nearest research and training public hospitals with medical councils responsible for deciding on medico- legal processes. Under the management of Pozitif Living Association and with the financial support of UNFPA, a new project enabling the purchase of prescribed hormones from pharmacies for up to three months began in 2022. In addition, the project provides a one-time payment for a doctor’s appointment for GSS recipients whose GSS got deactivated due to the one-year rule, if the applicant encounters difficulties in accessing an appointment due to language barriers or gender-based discrimination.[18] In 2022, Izmir courts reportedly issued rulings in favor of transgender persons’ transition processes, access to hormone therapy, and name-changing procedures.[19] In Mersin, however, the courts issued two negative interim decisions regarding the transgender reassignment process: in one interim decision, the court ruled that the applicant would not receive legal aid and granted the applicant additional time to pay the court fees. The applicant could only continue with IOM’s financial support. In a separate instance, the court demanded the applicant to pay for a deposit fee which is an unusual practice in this type of cases.[20]
For transgender people in the transition process who reside in small cities, obtaining travel permits to receive treatment at hospitals specialising in this field, which are primarily located in Izmir, Ankara, Istanbul, Adana, and Mersin, remains quite difficult. For instance, transgender residents of Denizli are required to obtain a travel permit to attend the hospital regularly in Izmir.[21] Medical records from hospitals need to be used to obtain travel permit via E-Devlet (an online platform to access public services).[22]
In 2022, refugees and especially LGBTQI+ refugees continue to experience problems accessing health services, including:
- Language barriers, lack of translators;
- Bureaucracy, complex healthcare system and hospital layouts;
- Behaviour of healthcare professionals, LGBTQI+ phobia, discrimination, and racism;
- Insufficient education about LGBTQI+ issues, ignorance of healthcare professionals in the institutions where services are provided;
- Irregularities in the follow-up of pregnancies, child vaccinations and chronically ill patients;
- Problems in accessing treatment;
- High fees demanded of refugee women before and after childbirth;
- Requiring a pre-intervention fee, not starting the treatment, delaying the treatment;
- Difficulties in making an appointment during the pandemic process;
- HIV phobia and stigmatization experienced by refugees living with HIV;
- Refusals from family health centres (non-admission of unregistered patients in primary care).[23]
Refugees living in Türkiye have the right to gender/sex-reassignment surgery, just like every citizen living in the Republic of Türkiye but must be legally resident under Temporary Protection or International Protection. In the absence of these, the person can start the process with a passport, and if there is no proof of legal stay in Türkiye, the person can start the process with a passport and an official document proving that they are staying in Türkiye legally. In addition to this, the person must be 18 years old and unmarried, either single or divorced.[24] Refugees experience several barriers to accessing this type of service. There is a language barrier if a lawsuit needs to be filed for access. In the absence of an interpreter, the process takes longer and difficulties arise. Secondly, as the process goes forward, the person is transferred to training and research hospitals in big cities. There are travel and accommodation expenses due to traveling to and from these big cities, and these expenses are not covered. During the psychiatric observation period that lasts for six months to two years, there are language barriers and translator difficulties. When hormone therapy starts, unfortunately, the medications costs are not met. The person can be exposed to ill-treatment due to the inexperience of courthouse staff, and unfortunately, the court decision is not positive in many courthouses. Unfortunately, surgeries are very expensive. In public hospitals, the GSS covers the cost of certain surgeries, such as vaginoplasty and testicle removal, but applicants must pay for the remainder. The cost of the surgeries ranges between 60,000 and 80,000 TRY.[25] The United Nations High Commissioner for Refugees provides monthly financial assistance of 2,300 TRY for transgender and intersex refugees.[26]
Reception of persons living with HIV
People living with HIV are not explicitly identified as a group having special needs in the LFIP. However, PMM has classified individuals living with HIV as chronic disease holders, and as a consequence, international protection holders can receive the necessary medical services one year after registering. Few NGOs deal with the needs of this group such as Poziif Yasam Association in İstanbul (Anatolian / European sides), Yalova, Denizli, Mersin, Eskisehir and Kirmizi Semsiye Cinsel Saglik ve Insan Haklari Association in Ankara. In 2022, in a case involving an applicant with HIV, an Istanbul court ruled that the applicant’s GSS registration must be reactivated due to the applicant’s special needs. Since 2021, Pozitif Yasam and Kirmizi Semsiye Cinsel Saglik ve Insan Haklari Association have provided prescription assistance to HIV+ individuals for up to three months, or six months in exceptional circumstances. The reason behind the need for assistance is the significant delay in reactivating the health coverage of international protection applicants after a year. This process was normally straightforward prior to COVID-19 and took a couple of days if the applicant could demonstrate that they were informed of their HIV+ status in Türkiye and continue to receive treatment there, but after 2021, this process could take months. Since there should be no interruption in this form of treatment, these two organisations, with UNFPA funding, started providing assistance to the applicants. In addition, the stigma against refugees living with HIV is quite persistent and they are blamed for the rising number of HIV cases in Türkiye. Lack of access to contraceptives is a further obstacle to their sexual safety. To combat this issue, the Poztif Yasam and Kirmizi Semsiye Cinsel Saglik ve Insan Haklari Associations have been distributing condoms and conducting trainings on sexual health and safety. Furthermore, they refer some applicants to testing centres because they believe the number of refugees living with HIV to be higher than the actual figure.[29]
NGOs also helped Ukrainians living with HIV present in Türkiye. They primarily provided services in Istanbul and Antalya, but as of late 2022, they started to leave Türkiye. The majority of this profile legally resides in Türkiye on a temporary or permanent residency basis.[30] ASAM provided translation assistance to vulnerable Ukrainians, such as persons living with HIV, LGBTIQ+ and the elderly.
[1] Article 3(1)(l) LFIP.
[2] Law No 7196 amending several acts, 6 December 2019, in Turkish at: http://bit.ly/2TSm0zU.
[3] Information provided by various stakeholders, May-June 2023.
[4] Information provided by a stakeholder, May 2023.
[5] Information provided by various stakeholders, June 2023.
[6] Information provided by various stakeholders, May 2023.
[7] Information provided by a stakeholder, March 2023.
[8] Ministry of Family, Labour and Social Services, Şiddet Önleme ve İzleme Merkezi, available in Turkish at: https://bit.ly/2HLo6fm.
[9] See BBC Türkiye, 25 Kasım Kadına Yönelik Şiddetle Mücadele Günü – Kadınların ağzından sığınma evleri: ‘Sanki suç işlemişiz gibi davranıyorlar’, 25 November 2019, available in Turkish at: https://bbc.in/33S3g7j; See also, NPR, ‘We Don’t Want To Die’: Women In Türkiye Decry Rise In Violence And Killings, 15 September 2019, at: https://n.pr/2WZtP8T.
[10] PMM, Victims of human trafficking, available at: https://bit.ly/43jw6uf.
[11] Information provded by s stakeholder, June 2023.
[12] Information provided by various stakeholders, May-June 2023.
[13] Information provided by a stakeholder, March 2023.
[14] Information provided by a stakeholder, June 2023.
[16] Information provided by a stakeholder, June 2023.
[17] Information provided by a stakeholder, June 2023.
[18] Information provided by a stakeholder, June 2023.
[19] Information provided by a stakeholder, June 2023.
[20] Information provided by a stekholder, June 2023.
[21] Information provided by a stakeholder, June 2023.
[22] Information provided by a stakeholder, June 2023.
[23] Kirikci, A., Aydın, E., Celik, S., Sayar, S., Arac, M from Hevi LGBTI, “Right to Health of LGBTI+ Refugees and Discrimination”, April 2021, available at: https://bit.ly/3CsgvOI, 4-5.
[24] Ibid, 20.
[25] Information provided by a stakeholder, June 2023.
[26] Information provided by a stakeholder, June 2023.
[28] Information provided by a stakeholder, June 2023.
[29] Information provided by a stakeholder, June 2023.
[30] Information provided by a stakeholder, June 2023.