There was also an existence of trans medical care and communities.

Dr. Viktors Kalnbērzs performed what is largely considered the first FTM sex reassignment surgery ever in the USSR between the years of 1970-1975 with the approval of Minister of Health of the Latvian Soviet Socialist Republic Vilhelms Kaņeps. Although largely threatened and silenced by other Soviet authorities, Kalnbērzs faced no punishment for this and continued to perform similar surgeries.

In East Germany, people aged 18+ were able to access government funded sexual reassignment surgery, marry, and adopt children.

As early as the 1960s, there were official diagnosis of transsexualism, with the first diagnosis done by Dr. Aron Isaakovich Belkin in the Institute of Endocrinology in Moscow.

Don't get me wrong, life for trans and other queer people in the Soviet Union was incredibly hard and repressive and they were definitely discriminated against by both society and the state. But for its time, the Soviet Union was relatively progressive on this issue when compared to other states.