ABCDEFGHIJKLMNOPQRSTUVWXYZAAABACADAEAFAGAHAIAJAKALAMANAOAPAQ
1
Country(Q.12) Type of transgender healthcare and coverage available in my country Score (/15)Points (/2)(Q.16) Psychiatric diagnosis like ‘Transsexualism’ or ‘Gender Dysphoria’ required forPoints (/2)(Q.18) How long from first request to receive an initial appointment with a trans health professional?Points (/2)(Q.21) Are these groups excluded from or made to wait longer before receiving trans health? Score (/8)Points (/2)(Q.24) Youngest age for puberty blockersOtherPoints (/2)(Q.25) Youngest age for hormonesPoints (/2)Total points for Analysis (/12)
2
Breast augmentationElectrolysisFFSHRT (Estrogen)HRT (Testosterone)HystorectomyMastectomyMetoidioplastyOrchiectomyOvariectomy (aka oopherectomy)PhalloplastyPuberty blockersTracheal shaveVaginoplastyVocal trainingOtherHRTSurgeryNot requiredNeurodiverse (esp autism)DisabledNon-heterosexualNBGNCAsylum seekersRefugeesHigh BMI/ OverweightPrisoners/in jailOther (please specify)
3
Austria
4
TGEU Confirmation (sources)-Could not find any confirmation that is was covered, with a lot of references suggesting it wasn'tNEI(2019) Gender incongruity in Austria. p. 34. https://www.sozialversicherung.at/cdscontent/load?contentid=10008.718421&version=1568796537
-8 FFS related procedures performed		-Type not specified
(n.d.) TransX factsheet - https://www.transx.at/Dokumente/FactSheet_TS.pdf (p. 2)
(2022) Note on a doctor's experience at a public hospital - https://www.medinlive.at/gesellschaft/trans-people-are-underrepresented-and-overlooked		-Type not specified
(2022) https://www.medinlive.at/gesellschaft/trans-people-are-underrepresented-and-overlooked
(n.d.) https://www.transx.at/Dokumente/FactSheet_TS.pdf		-Also that it must be abdominal
(n.d.) https://www.transx.at/Dokumente/FactSheet_TS.pdf		(2019) https://www.sozialversicherung.at/cdscontent/load?contentid=10008.718421&version=1568796537-This is not completely confirmed, but seems likely, though uncommon, given available information.
-"The Austrian health insurance fund operations abroad, where there are doctors with significantly more experience and better results, only if no doctor in Austria claims to be able to perform these operations."
-There do appear to be surgeons in Austria who sporadically do.
(circa 10 yrs ago) (n.d.) Transmale genital adaptation. https://www.transx.at/Pub/OP_Genital_FM.php		-Contrary to respondent`, this was explicitly covered as per the following report.
(2019) Gender incongruity in Austria. https://www.sozialversicherung.at/cdscontent/load?contentid=10008.718421&version=1568796537		-No specific evidence, but this seems highly likely given the circumstances identified for Orchiectomy. In this case, however, the respondent agrees.(n.d.) Fact sheet sex change in Austria. https://www.transx.at/Dokumente/FactSheet_TS.pdf
(2019) Gender incongruity in Austria. https://www.sozialversicherung.at/cdscontent/load?contentid=10008.718421&version=1568796537		-No direct statement of coverage, but given that HRT is covered and provisions exist for PB in Austria this seems likely. Also the respondent has indicated that this is covered.
(2017) Recommendations for the treatment process for gender dysphoria in children and young people according to the classification in the currently valid DSM or ICD version. p.8. https://www.sozialministerium.at/dam/jcr:61c72a41-24e1-49c0-8bda-7669c68cdf4f/Transgender_Empfehlungen_KJ_Stand_14.12.2017_final%20mit%20neuer%20ICD-10-Verlinkung.pdf		-Possible, given mention of "operations on the larynx... [and] head and neck" in following report, but not clear enough.
(2019) Association of Austrian Social Insurance Carriers. p.31. https://www.sozialversicherung.at/cdscontent/load?contentid=10008.718421&version=1568796537		(2019) Gender incongruity in Austria. https://www.sozialversicherung.at/cdscontent/load?contentid=10008.718421&version=1568796537
(n.d.) Tranx factsheet. https://www.transx.at/Dokumente/FactSheet_TS.pdf		-Requires a referral from an ENT specialist with gender identity disorder not accepted as a reason
(n.d.) Voice. https://www.transx.at/Pub/Stimme.php		"Yes access to GCT and GCT funding, but with conditions.
(2018) Trans and intersex equality in Europe: A comparative analysis. p. 78. https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf
-Note that mandatory psychotherapy is not or only partially covered
(2018) Intersexuality and transidentity. https://www.bundeskanzleramt.gv.at/dam/jcr:e31962af-4646-4897-abc2-151ba7514426/Intersexuality_Transidentity.pdf
"Most of the costs for psychotherapy have to be met by the patient"
(n.d.) https://www.transx.at/Dokumente/FactSheet_TS.pdf
"phalloplasty is only possible with high risks and many complications in Austria"
(n.d.) https://www.transx.at/Dokumente/FactSheet_TS.pdf		(2021) Experiences and Interactions with the Healthcare System in Transgender and Non-Binary Patients in Austria: An Exploratory Cross-Sectional Study. p.3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8297154/
(n.d.) Fact Sheet: Sex change in Austria. p.2. https://www.transx.at/Dokumente/FactSheet_TS.pdf
-As per Vinnese medical student (EPATH Summer School) letter from a mental health worker required for hormones.		(2021) Experiences and Interactions with the Healthcare System in Transgender and Non-Binary Patients in Austria: An Exploratory Cross-Sectional Study. p.3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8297154/
(n.d.) Fact Sheet: Sex change in Austria. p.2. https://www.transx.at/Dokumente/FactSheet_TS.pdf
-As per Vinnese medical student (EPATH Summer School) letter from a mental health worker required for hormones.		(2021) Experiences and Interactions with the Healthcare System in Transgender and Non-Binary Patients in Austria: An Exploratory Cross-Sectional Study. p.3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8297154/
(n.d.) Fact Sheet: Sex change in Austria. p.2. https://www.transx.at/Dokumente/FactSheet_TS.pdf
-As per Vinnese medical student (EPATH Summer School) letter from a mental health worker required for hormones.		As per respondentIt seems likely that there is some hesitancy or greater gatekeeping around autistic people, especially children and adolescents, based on their guidelines. But no firmer evidence.
(2017) https://www.sozialministerium.at/Themen/Gesundheit/Nicht-uebertragbare-Krankheiten/Psychische-Gesundheit/Transsexualismus-Geschlechtsdysphorie.html		-As w/ autism, it seems likely that there is some hesitancy or greater gatekeeping around autistic people, especially children and adolescents, based on their guidelines. But no firmer evidence.
(2017) https://www.sozialministerium.at/Themen/Gesundheit/Nicht-uebertragbare-Krankheiten/Psychische-Gesundheit/Transsexualismus-Geschlechtsdysphorie.html		NEI-A diagnosis of transsexuali`sm is required to access care. The following article reports on higher rates of dissatisfaction by NB folks,
(2021) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8297154/
(2020) Associations between patient-doctor relationship and healthcare utilization with quality of life in trans-identifying people in Austria: a pilot project. https://repositorium.meduniwien.ac.at/obvumwhs/content/titleinfo/5554293/full.pdf (this also looks like a good source here and in other places.		0
No proof one way or another		-Only documented/accepted refugees are covered and only if you can prove prior access to HRT.
(2017) Current migration situation in the EU. p. 14. https://fra.europa.eu/en/publication/2017/current-migration-situation-eu-lesbian-gay-bisexual-transgender-and-intersex
(n.d.) https://www.transx.at/Dokumente/FactSheet_TS.pdf		-Recognised refugees
(n.d.) https://www.transx.at/Dokumente/FactSheet_TS.pdf		-No evidence one way or another. Put yes because respondent indicated it was and because BMI limits for trans surgeries exist widely.-There have been some positive developments here (p. 60).
(2019) Combating discrimination on grounds of sexual orientation and gender identity. p. 60. https://rm.coe.int/combating-discrimination-on-grounds-of-sexual-orientation-and-gender-i/16809fb2b8
One report (2015) indicates that it's theoretically accessible, but that one might need to take legal action to attain it. 2017 report states that "regional criminal court of vienna ruled that prisoners have the right to access hormone treatment and reassignment surgery while serving their sentence (p. 47)."
(2017) https://ilga-europe.org/files/uploads/2022/04/annual-review-2017.pdf
(2015) https://tgeu.org/anti-torture-committee-scolds-austria-over-treatment-of-trans-inmates/"		(2016) Recommendations for the treatment process for gender dysphoria in children and young people according to the classification in the currently valid DSM or ICD version - https://www.sozialministerium.at/dam/jcr:61c72a41-24e1-49c0-8bda-7669c68cdf4f/Transgender_Empfehlungen_KJ_Stand_14.12.2017_final%20mit%20neuer%20ICD-10-Verlinkung.pdf (p.8)Translation is unclear. "Up to the age of 14, the consent of the legal guardian is absolutely necessary, for measures that have a lasting effect, such as partially reversible hormone treatment, also up to the age of 18."
Appears to be saying that <14 parental consent required for puberty blockers/just therapeutic treatment? Any other treatment (hormones/surgery) requires parental consent <18? Verify.
(2017) https://www.sozialministerium.at/dam/jcr:61c72a41-24e1-49c0-8bda-7669c68cdf4f/Transgender_Empfehlungen_KJ_Stand_14.12.2017_final%20mit%20neuer%20ICD-10-Verlinkung.pdf		-"This treatment is usually recommended from the age of 16, if possible with the consent of the legal guardian". Categorized as partially reversible and includes PBs? This is a stronger source, since it's from the Austrian health ministry, but need to verify translation.
(2016) https://www.sozialministerium.at/dam/jcr:61c72a41-24e1-49c0-8bda-7669c68cdf4f/Transgender_Empfehlungen_KJ_Stand_14.12.2017_final%20mit%20neuer%20ICD-10-Verlinkung.pdf (p.8)
Or
-18 (w/o parental consent)
(2017) https://fra.europa.eu/de/publication/2017/mapping-minimum-age-requirements-concerning-rights-child-eu/access-transgender-hormone-therapy
5
TGEU Confirmation (score)NEI
Could not find any confirmation that is was covered, with a lot of references suggesting it wasn't		NEI11111NEI
-This is not completely confirmed, but seems likely, though uncommon, given available information.
-"The Austrian health insurance fund operations abroad, where there are doctors with significantly more experience and better results, only if no doctor in Austria claims to be able to perform these operations."
-There do appear to be surgeons in Austria who sporadically do.
(circa 10 yrs ago) (n.d.) Transmale genital adaptation. https://www.transx.at/Pub/OP_Genital_FM.php		111101111211
-As w/ autism, it seems likely that there is some hesitancy or greater gatekeeping around autistic people, especially children and adolescents, based on their guidelines. But no firmer evidence.
(2017).p. 3. https://www.sozialministerium.at/dam/jcr:61c72a41-24e1-49c0-8bda-7669c68cdf4f/Transgender_Empfehlungen_KJ_Stand_14.12.2017_final%20mit%20neuer%20ICD-10-Verlinkung.pdf		003-6 months20NEINEI
No proof one way or another		11NEI1NEI31Tanner 2-321618
6
Belgium
7
TGEU Confirmation (sources)-It appears that the breast implants are covered but not the surgery.
(n.d.) Access to trans healthcare: The situation in Europe. https://www.thenewfederalist.eu/access-to-trans-healthcare-the-situation-in-europe?lang=fr
-It is specified that "breast prosthesis (product and procedure) is covered, but then that "breast augmentation" is not
(n.d.) Interventions. https://transgenderinfo.be/m/zorg/kostprijs/ingrepen/		(n.d.) Hair removal. https://transgenderinfo.be/m/zorg/vervrouwelijking/epilatie/
(n.d.) Electrolysis refund Germany. https://2pass.clinic/en/hair-removal/costs/electrolysis-refund-germany		(n.d.) Interventions. https://transgenderinfo.be/m/zorg/kostprijs/ingrepen/-"For persons who take hormones for feminization ,a distinction must be made between anti-androgens and oestrogens. With the anti-androgens, there is only one product for which a reduced cost price can apply. The pharmacy price for Androcur without reimbursement is 23.87 euros. If the person has been prescribed this and can submit a certificate from an endocrinologist, the pharmacy price is 6.53 euros. For estrogens, the (reduced) cost price varies depending on the product"
(2022) Medication. https://transgenderinfo.be/m/zorg/kostprijs/medicatie/		-Only sustanon and only w/ special application.
(2022) Medication. https://transgenderinfo.be/m/zorg/kostprijs/medicatie/
(2017) https://igvm-iefh.belgium.be/sites/default/files/118_-_being_transgender_in_belgium.pdf"		(2022) Interventions. https://transgenderinfo.be/m/zorg/kostprijs/ingrepen/-But not chest masculinization
(2022) Interventions. https://transgenderinfo.be/m/zorg/kostprijs/ingrepen/		-"Penileplasty"
-It appears that some parts of the operation, but not "surgery in total" are covered.
(2022) Interventions. https://transgenderinfo.be/m/zorg/kostprijs/ingrepen/		-"Castration"
(2022) Interventions. https://transgenderinfo.be/m/zorg/kostprijs/ingrepen/		-Not specifically, but documentation specifies hysterectomy and respondent, who is highly knowledgeable, indicates that this is covered.
(2022) Interventions. https://transgenderinfo.be/m/zorg/kostprijs/ingrepen/		-"Penileplasty"
-It appears that some parts of the operation, but not "surgery in total" are covered.
(2022) Interventions. https://transgenderinfo.be/m/zorg/kostprijs/ingrepen/		-Only partially reimbursed till 21 under the Transgender Care Convention (1500-2000 Euros/year co-pay in some circumstances).
(2022) Hormones. https://transgenderinfo.be/m/zorg/kinderen/hormonen/
(2022) Medication. https://transgenderinfo.be/m/zorg/kostprijs/medicatie/		(2022) Interventions. https://transgenderinfo.be/m/zorg/kostprijs/ingrepen/-It appears that some parts of the operation, but not "surgery in total" are covered.
(2022) Interventions. https://transgenderinfo.be/m/zorg/kostprijs/ingrepen/		-Reimbursement
(2022) Consultations. https://transgenderinfo.be/m/zorg/kostprijs/consulten/		-Co pays typical and can be fairly high without supplemental insurance (e.g. 3500 Euro for phalloplasty). As a result, total costs may likely be higher than in countries with a similar number of covered procedures.
(2022) Interventions. https://transgenderinfo.be/m/zorg/kostprijs/ingrepen/
-Various private insurances (increased coverage and hospitalization) are available and common in Belgium. Exclusions specific to trans people are seemingly illegal, but companies can and will try anyway. Beyond mandatory basic insurance (identified here) all have to pay.
(2022) Insurances. https://transgenderinfo.be/m/zorg/kostprijs/verzekering/
-Yes access to GCT and GCT funding partial, but only at specific hospitals (this has certainly been superceeded by new coverage).
(2018) Trans and intersex equality rights in Europe. p. 78. https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf		(2018) The state decides who I am. p.80. https://www.amnesty.eu/wp-content/uploads/2018/10/the_state_decides_who_I_am.pdf(2018) The state decides who I am. p.80. https://www.amnesty.eu/wp-content/uploads/2018/10/the_state_decides_who_I_am.pdf(2018) The state decides who I am. p.80. https://www.amnesty.eu/wp-content/uploads/2018/10/the_state_decides_who_I_am.pdfAs per respondent
-Whole process can take 3+ yrs
-Establishing psychiatric diagnosis takes approx 6-12 mths @ Ghent
New clinics have opened since 2021
(2022) ILGA annual report. https://ilga-europe.org/files/uploads/2022/04/annual-review-2022.pdf, p. 41
1.5-2 yrs
(2021) Record number of trans people registring for treatment. https://www.hetrozehuis.be/nl/pers/recordaantal-trans-personen-meldt-zich-aan-voor-behandeling/
(2018) https://www.amnesty.eu/wp-content/uploads/2018/10/the_state_decides_who_I_am.pdf, p. 80		NEINEI
(2017) Being transgender in Belgium: 10 years later. https://igvm-iefh.belgium.be/sites/default/files/118_-_being_transgender_in_belgium.pdf		NEI-Certain prescriptions/care gender specific
(2020) Legal gender recognition in the EU. p. 185. https://ec.europa.eu/info/sites/default/files/legal_gender_recognition_in_the_eu_the_journeys_of_trans_people_towards_full_equality_sept_en.pdf		0-No intervention for people who are not affiliated with a Belgian health insurance company (eg people who live abroad or have an asylum application pending).
-As per respondent, those already on HRT can continue this as an asylum seeker (likely to be difficulties associated with legitimacy of existing access and proof).
(2022) Convention. https://transgenderinfo.be/m/zorg/kostprijs/conventie/
(2022) Insurances. https://transgenderinfo.be/m/zorg/kostprijs/verzekering/		NEINEI-"No transgender participant [transgender prisoner in this study] had ever had contact with the transgender infopunt to collect more information about the subject (p. 22)."
(2021) Gender binary bars-A qualitative exploratory study of the experiences and challenges of transgender persons in detention. p. 22-23. https://www.ugent.be/nl/univgent/missie/diversiteit-en-inclusie/voor-studenten/inclu-scriptieprijs/scripties-2021/davo-maras-transgender-personen-achter-gender-binaire-tralies-een-exploratief-onderzoek-naar-de-ervaringen-van-ex-gedetineerde-transgender-personen-in-belgische-gevangenissen
-Limited knowledge from officals about health care options. Care often frozen on prison intake. There have been cases where folks have pursued care from prison and prison authorities made this impossible.
-However, there is a lot of work going into improving care for trans prisoners in Belgium right now and the situation is vastly better than other states. This is a case where it looks worse because there is information.
(2022) New project September 2022: Beyond binary bars. https://transgenderinfo.be/nieuw-project-september-2022-beyond-binary-bars/
(2019) Combating discrimination on grounds of sexual orientation and gender identity. p. 60. https://rm.coe.int/combating-discrimination-on-grounds-of-sexual-orientation-and-gender-i/16809fb2b8		-Suggests this happens between 8 and 14.5
(2022) Hormones. https://transgenderinfo.be/m/zorg/kinderen/hormonen/		-Onset of puberty or 15-16 ("if they have known the practitioner long enough")
(2022) Hormones. https://transgenderinfo.be/m/zorg/kinderen/hormonen/
-16
(2021) Hormones. https://transgenderinfo.be/m/zorg/vermannelijking/hormonen/
8
TGEU Confirmation (score)10011111111111113211001-2 years0NEINEINEI11NEINEI131Tanner 221527
9
Bulgaria
10
TGEU Confirmation (sources)-Most recent information
-No HRT or surgery covered by National Health Insurance Fund.
(2020) National report-Bulgaria. p. 7. https://bilitis.org/wp-content/uploads/2021/08/OpenDoors-National-Report-Bulgaria-FINAL_EN.pdf
(2020) Open it-The doors. p. 22. https://bilitis.org/wp-content/uploads/2022/03/opendoors_guide_bg.pdf		-Most recent information
-No HRT or surgery covered by National Health Insurance Fund.
(2020) National report-Bulgaria. p. 7. https://bilitis.org/wp-content/uploads/2021/08/OpenDoors-National-Report-Bulgaria-FINAL_EN.pdf
(2020) Open it-The doors. p. 22. https://bilitis.org/wp-content/uploads/2022/03/opendoors_guide_bg.pdf		-Most recent information
-No HRT or surgery covered by National Health Insurance Fund.
(2020) National report-Bulgaria. p. 7. https://bilitis.org/wp-content/uploads/2021/08/OpenDoors-National-Report-Bulgaria-FINAL_EN.pdf
(2020) Open it-The doors. p. 22. https://bilitis.org/wp-content/uploads/2022/03/opendoors_guide_bg.pdf		-Most recent information
-No HRT or surgery covered by National Health Insurance Fund.
(2020) National report-Bulgaria. p. 7. https://bilitis.org/wp-content/uploads/2021/08/OpenDoors-National-Report-Bulgaria-FINAL_EN.pdf
(2020) Open it-The doors. p. 22. https://bilitis.org/wp-content/uploads/2022/03/opendoors_guide_bg.pdf		-Most recent information
-No HRT or surgery covered by National Health Insurance Fund.
(2020) National report-Bulgaria. p. 7. https://bilitis.org/wp-content/uploads/2021/08/OpenDoors-National-Report-Bulgaria-FINAL_EN.pdf
(2020) Open it-The doors. p. 22. https://bilitis.org/wp-content/uploads/2022/03/opendoors_guide_bg.pdf		-Most recent information
-No HRT or surgery covered by National Health Insurance Fund.
(2020) National report-Bulgaria. p. 7. https://bilitis.org/wp-content/uploads/2021/08/OpenDoors-National-Report-Bulgaria-FINAL_EN.pdf
(2020) Open it-The doors. p. 22. https://bilitis.org/wp-content/uploads/2022/03/opendoors_guide_bg.pdf		-Most recent information
-No HRT or surgery covered by National Health Insurance Fund.
(2020) National report-Bulgaria. p. 7. https://bilitis.org/wp-content/uploads/2021/08/OpenDoors-National-Report-Bulgaria-FINAL_EN.pdf
(2020) Open it-The doors. p. 22. https://bilitis.org/wp-content/uploads/2022/03/opendoors_guide_bg.pdf		-Most recent information
-No HRT or surgery covered by National Health Insurance Fund.
(2020) National report-Bulgaria. p. 7. https://bilitis.org/wp-content/uploads/2021/08/OpenDoors-National-Report-Bulgaria-FINAL_EN.pdf
(2020) Open it-The doors. p. 22. https://bilitis.org/wp-content/uploads/2022/03/opendoors_guide_bg.pdf		-Most recent information
-No HRT or surgery covered by National Health Insurance Fund.
(2020) National report-Bulgaria. p. 7. https://bilitis.org/wp-content/uploads/2021/08/OpenDoors-National-Report-Bulgaria-FINAL_EN.pdf
(2020) Open it-The doors. p. 22. https://bilitis.org/wp-content/uploads/2022/03/opendoors_guide_bg.pdf		-Most recent information
-No HRT or surgery covered by National Health Insurance Fund.
(2020) National report-Bulgaria. p. 7. https://bilitis.org/wp-content/uploads/2021/08/OpenDoors-National-Report-Bulgaria-FINAL_EN.pdf
(2020) Open it-The doors. p. 22. https://bilitis.org/wp-content/uploads/2022/03/opendoors_guide_bg.pdf		-Most recent information
-No HRT or surgery covered by National Health Insurance Fund.
(2020) National report-Bulgaria. p. 7. https://bilitis.org/wp-content/uploads/2021/08/OpenDoors-National-Report-Bulgaria-FINAL_EN.pdf
(2020) Open it-The doors. p. 22. https://bilitis.org/wp-content/uploads/2022/03/opendoors_guide_bg.pdf		-Most recent information
-No HRT or surgery covered by National Health Insurance Fund.
(2020) National report-Bulgaria. p. 7. https://bilitis.org/wp-content/uploads/2021/08/OpenDoors-National-Report-Bulgaria-FINAL_EN.pdf
(2020) Open it-The doors. p. 22. https://bilitis.org/wp-content/uploads/2022/03/opendoors_guide_bg.pdf		-Most recent information
-No HRT or surgery covered by National Health Insurance Fund.
(2020) National report-Bulgaria. p. 7. https://bilitis.org/wp-content/uploads/2021/08/OpenDoors-National-Report-Bulgaria-FINAL_EN.pdf
(2020) Open it-The doors. p. 22. https://bilitis.org/wp-content/uploads/2022/03/opendoors_guide_bg.pdf		-Most recent information
-No HRT or surgery covered by National Health Insurance Fund.
(2020) National report-Bulgaria. p. 7. https://bilitis.org/wp-content/uploads/2021/08/OpenDoors-National-Report-Bulgaria-FINAL_EN.pdf
(2020) Open it-The doors. p. 22. https://bilitis.org/wp-content/uploads/2022/03/opendoors_guide_bg.pdf		-Most recent information
-No HRT or surgery covered by National Health Insurance Fund.
(2020) National report-Bulgaria. p. 7. https://bilitis.org/wp-content/uploads/2021/08/OpenDoors-National-Report-Bulgaria-FINAL_EN.pdf
(2020) Open it-The doors. p. 22. https://bilitis.org/wp-content/uploads/2022/03/opendoors_guide_bg.pdf		Most recent information
-No HRT or surgery covered by National Health Insurance Fund.
-Transgender persons frequently refused health services in general
(2020) Country reports on hman rights practices. https://www.state.gov/wp-content/uploads/2021/03/BULGARIA-2020-HUMAN-RIGHTS-REPORT.pdf
(2020) National report-Bulgaria. p. 7. https://bilitis.org/wp-content/uploads/2021/08/OpenDoors-National-Report-Bulgaria-FINAL_EN.pdf
(2020) Open it-The doors. p. 22. https://bilitis.org/wp-content/uploads/2022/03/opendoors_guide_bg.pdf

Earlier information
-Yes access to GCT and GCT funding, but with conditions. This report doesn't mention limitation of no surgery, though it does report "hormones, no surgery" in the case of other countries. So perhaps they have moved to include hormones?
(2018) Trans and intersex equality rights in Europe. p. 78. https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf
-surgery but not hormones. Doesn't identiify which surgery
(2014) Bulgaria Country report. https://tgeu.org/wp-content/uploads/2016/07/Bulgaria.pdf		-No available information. Went with respondent.-No available information. Went with respondent.-No available information. Went with respondent.As per respondent-No information could be found on this. However, the respondent asserts that this was a difficulty and the general country conditions would seem to agree.-No information could be found on this. However, the respondent asserts that this was a difficulty and the general country conditions would seem to agree.NEI-No information could be found on this. However, the respondent asserts that this was a difficulty and the general country conditions would seem to agree.1
-No information could be found on this. However, the respondent asserts that this was a difficulty and the general country conditions would seem to agree.		-Only because there is no national health insurance coverage of trans health care. Following documentation indicates that asylum seekers only have access to emergency care and undocumented migrants presumably none.
-However, statutorily, they are entitled to the same level of health care as citizens
(2022) Health care: Bulgaria. https://asylumineurope.org/reports/country/bulgaria/reception-conditions/health-care/
(2021) AIDS Country Report-Bulgaria. https://asylumineurope.org/wp-content/uploads/2022/02/AIDA-BG_2021update.pdf		NEINEI-Insufficient information specific to trans prisoners and no public coverage for trans people in Bulgaria.
(2018) Council of Europe: 2018 News. https://www.coe.int/en/web/cpt/-/bulgaria-anti-torture-committee-says-conditions-in-social-care-institutions-could-be-described-as-inhuman-and-degrading-the-situation-in-penitentiary-		-There is no information on this subject.-Following indicates that this is w/o parental or public agency consent, but no more specific information can be found.
(2017) https://fra.europa.eu/de/publication/2017/mapping-minimum-age-requirements-concerning-rights-child-eu/access-transgender-hormone-therapy
11
TGEU Confirmation (score)000000000000000001100Less than 1 month201NEI10NEINEI022NEI01804
12
Cyprus
13
TGEU Confirmation (sources)-"Draft bill contains no trans* health care provisions."
(2020) When one doesn't even exist. p.9-10. https://journals.sagepub.com/doi/full/10.1177/1363460720904648#bibr4-1363460720904648
(2021) https://www.queercyprus.org/wp-content/uploads/2021/12/LGR-Booklet.pdf
(2019) The LGBTI movement in Cyprus. https://library.fes.de/pdf-files/bueros/zypern/15949-20200213.pdf
(2018) Report on the implementation of the committee of ministers of the council of europe on measures to combat discrimination on grounds of sexual orientation or gender identity by the Republic of Cyprus. p. 28-29. https://tgeu.org/wp-content/uploads/2018/10/COE-Report-Oct18-Cyprus.pdf		-"Draft bill contains no trans* health care provisions."
(2020) When one doesn't even exist. p.9-10. https://journals.sagepub.com/doi/full/10.1177/1363460720904648#bibr4-1363460720904648
(2021) https://www.queercyprus.org/wp-content/uploads/2021/12/LGR-Booklet.pdf
(2019) The LGBTI movement in Cyprus. https://library.fes.de/pdf-files/bueros/zypern/15949-20200213.pdf
(2018) Report on the implementation of the committee of ministers of the council of europe on measures to combat discrimination on grounds of sexual orientation or gender identity by the Republic of Cyprus. p. 28-29. https://tgeu.org/wp-content/uploads/2018/10/COE-Report-Oct18-Cyprus.pdf		-"Draft bill contains no trans* health care provisions."
(2020) When one doesn't even exist. p.9-10. https://journals.sagepub.com/doi/full/10.1177/1363460720904648#bibr4-1363460720904648
(2021) https://www.queercyprus.org/wp-content/uploads/2021/12/LGR-Booklet.pdf
(2019) The LGBTI movement in Cyprus. https://library.fes.de/pdf-files/bueros/zypern/15949-20200213.pdf
(2018) Report on the implementation of the committee of ministers of the council of europe on measures to combat discrimination on grounds of sexual orientation or gender identity by the Republic of Cyprus. p. 28-29. https://tgeu.org/wp-content/uploads/2018/10/COE-Report-Oct18-Cyprus.pdf		--Recent information suggests that hormones are no longer covered (see below); however, I could not confirm this and the source didn't include a citation.
-"While hormones were previously offered by the state, the new Cyprus General Health System (GESY) excludes them, which has made... them unavailable for many."
(2022) ILGA annual report. p.50. https://ilga-europe.org/files/uploads/2022/04/annual-review-2022.pdf
-"The NGO Accept LGBTI Cyprus reported transgender persons undergoing hormone replacement therapy experienced discrimination in access to health care following the introduction of GESY in June (p.21)."(2019). Cyprus 2019 Human Rights Report. p. 21. https://www.state.gov/wp-content/uploads/2020/02/CYPRUS-2019-HUMAN-RIGHTS-REPORT.pdf
(2020) When one doesn't even exist. p.9-10. https://journals.sagepub.com/doi/full/10.1177/1363460720904648#bibr4-1363460720904648
-"Only hormones, no surgery (p.78)."
(2018) Trans and intersex equality rights in Europe. p. 78. https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf		--Recent information suggests that hormones are no longer covered (see below); however, I could not confirm this and the source didn't include a citation.
-"While hormones were previously offered by the state, the new Cyprus General Health System (GESY) excludes them, which has made... them unavailable for many."
(2022) ILGA annual report. p.50. https://ilga-europe.org/files/uploads/2022/04/annual-review-2022.pdf
-"The NGO Accept LGBTI Cyprus reported transgender persons undergoing hormone replacement therapy experienced discrimination in access to health care following the introduction of GESY in June (p.21)."(2019). Cyprus 2019 Human Rights Report. p. 21. https://www.state.gov/wp-content/uploads/2020/02/CYPRUS-2019-HUMAN-RIGHTS-REPORT.pdf
(2020) When one doesn't even exist. p.9-10. https://journals.sagepub.com/doi/full/10.1177/1363460720904648#bibr4-1363460720904648
-"Only hormones, no surgery (p.78)."
(2018) Trans and intersex equality rights in Europe. p. 78. https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf		-"Draft bill contains no trans* health care provisions."
(2020) When one doesn't even exist. p.9-10. https://journals.sagepub.com/doi/full/10.1177/1363460720904648#bibr4-1363460720904648
(2021) https://www.queercyprus.org/wp-content/uploads/2021/12/LGR-Booklet.pdf
(2019) The LGBTI movement in Cyprus. https://library.fes.de/pdf-files/bueros/zypern/15949-20200213.pdf
(2018) Report on the implementation of the committee of ministers of the council of europe on measures to combat discrimination on grounds of sexual orientation or gender identity by the Republic of Cyprus. p. 28-29. https://tgeu.org/wp-content/uploads/2018/10/COE-Report-Oct18-Cyprus.pdf		-"Draft bill contains no trans* health care provisions."
(2020) When one doesn't even exist. p.9-10. https://journals.sagepub.com/doi/full/10.1177/1363460720904648#bibr4-1363460720904648
(2021) https://www.queercyprus.org/wp-content/uploads/2021/12/LGR-Booklet.pdf
(2019) The LGBTI movement in Cyprus. https://library.fes.de/pdf-files/bueros/zypern/15949-20200213.pdf
(2018) Report on the implementation of the committee of ministers of the council of europe on measures to combat discrimination on grounds of sexual orientation or gender identity by the Republic of Cyprus. p. 28-29. https://tgeu.org/wp-content/uploads/2018/10/COE-Report-Oct18-Cyprus.pdf		-"Draft bill contains no trans* health care provisions."
(2020) When one doesn't even exist. p.9-10. https://journals.sagepub.com/doi/full/10.1177/1363460720904648#bibr4-1363460720904648
(2021) https://www.queercyprus.org/wp-content/uploads/2021/12/LGR-Booklet.pdf
(2019) The LGBTI movement in Cyprus. https://library.fes.de/pdf-files/bueros/zypern/15949-20200213.pdf
(2018) Report on the implementation of the committee of ministers of the council of europe on measures to combat discrimination on grounds of sexual orientation or gender identity by the Republic of Cyprus. p. 28-29. https://tgeu.org/wp-content/uploads/2018/10/COE-Report-Oct18-Cyprus.pdf		-"Draft bill contains no trans* health care provisions."
(2020) When one doesn't even exist. p.9-10. https://journals.sagepub.com/doi/full/10.1177/1363460720904648#bibr4-1363460720904648
(2021) https://www.queercyprus.org/wp-content/uploads/2021/12/LGR-Booklet.pdf
(2019) The LGBTI movement in Cyprus. https://library.fes.de/pdf-files/bueros/zypern/15949-20200213.pdf
(2018) Report on the implementation of the committee of ministers of the council of europe on measures to combat discrimination on grounds of sexual orientation or gender identity by the Republic of Cyprus. p. 28-29. https://tgeu.org/wp-content/uploads/2018/10/COE-Report-Oct18-Cyprus.pdf		-"Draft bill contains no trans* health care provisions."
(2020) When one doesn't even exist. p.9-10. https://journals.sagepub.com/doi/full/10.1177/1363460720904648#bibr4-1363460720904648
(2021) https://www.queercyprus.org/wp-content/uploads/2021/12/LGR-Booklet.pdf
(2019) The LGBTI movement in Cyprus. https://library.fes.de/pdf-files/bueros/zypern/15949-20200213.pdf
(2018) Report on the implementation of the committee of ministers of the council of europe on measures to combat discrimination on grounds of sexual orientation or gender identity by the Republic of Cyprus. p. 28-29. https://tgeu.org/wp-content/uploads/2018/10/COE-Report-Oct18-Cyprus.pdf		-"Draft bill contains no trans* health care provisions."
(2020) When one doesn't even exist. p.9-10. https://journals.sagepub.com/doi/full/10.1177/1363460720904648#bibr4-1363460720904648
(2021) https://www.queercyprus.org/wp-content/uploads/2021/12/LGR-Booklet.pdf
(2019) The LGBTI movement in Cyprus. https://library.fes.de/pdf-files/bueros/zypern/15949-20200213.pdf
(2018) Report on the implementation of the committee of ministers of the council of europe on measures to combat discrimination on grounds of sexual orientation or gender identity by the Republic of Cyprus. p. 28-29. https://tgeu.org/wp-content/uploads/2018/10/COE-Report-Oct18-Cyprus.pdf		-"Draft bill contains no trans* health care provisions."
(2020) When one doesn't even exist. p.9-10. https://journals.sagepub.com/doi/full/10.1177/1363460720904648#bibr4-1363460720904648
(2021) https://www.queercyprus.org/wp-content/uploads/2021/12/LGR-Booklet.pdf
(2019) The LGBTI movement in Cyprus. https://library.fes.de/pdf-files/bueros/zypern/15949-20200213.pdf
(2018) Report on the implementation of the committee of ministers of the council of europe on measures to combat discrimination on grounds of sexual orientation or gender identity by the Republic of Cyprus. p. 28-29. https://tgeu.org/wp-content/uploads/2018/10/COE-Report-Oct18-Cyprus.pdf		-"Draft bill contains no trans* health care provisions."
(2020) When one doesn't even exist. p.9-10. https://journals.sagepub.com/doi/full/10.1177/1363460720904648#bibr4-1363460720904648
(2021) https://www.queercyprus.org/wp-content/uploads/2021/12/LGR-Booklet.pdf
(2019) The LGBTI movement in Cyprus. https://library.fes.de/pdf-files/bueros/zypern/15949-20200213.pdf
(2018) Report on the implementation of the committee of ministers of the council of europe on measures to combat discrimination on grounds of sexual orientation or gender identity by the Republic of Cyprus. p. 28-29. https://tgeu.org/wp-content/uploads/2018/10/COE-Report-Oct18-Cyprus.pdf		-"Draft bill contains no trans* health care provisions."
(2020) When one doesn't even exist. p.9-10. https://journals.sagepub.com/doi/full/10.1177/1363460720904648#bibr4-1363460720904648
(2021) https://www.queercyprus.org/wp-content/uploads/2021/12/LGR-Booklet.pdf
(2019) The LGBTI movement in Cyprus. https://library.fes.de/pdf-files/bueros/zypern/15949-20200213.pdf
(2018) Report on the implementation of the committee of ministers of the council of europe on measures to combat discrimination on grounds of sexual orientation or gender identity by the Republic of Cyprus. p. 28-29. https://tgeu.org/wp-content/uploads/2018/10/COE-Report-Oct18-Cyprus.pdf		-"Draft bill contains no trans* health care provisions."
(2020) When one doesn't even exist. p.9-10. https://journals.sagepub.com/doi/full/10.1177/1363460720904648#bibr4-1363460720904648
(2021) https://www.queercyprus.org/wp-content/uploads/2021/12/LGR-Booklet.pdf
(2019) The LGBTI movement in Cyprus. https://library.fes.de/pdf-files/bueros/zypern/15949-20200213.pdf
(2018) Report on the implementation of the committee of ministers of the council of europe on measures to combat discrimination on grounds of sexual orientation or gender identity by the Republic of Cyprus. p. 28-29. https://tgeu.org/wp-content/uploads/2018/10/COE-Report-Oct18-Cyprus.pdf		-"The state currently covers the costs for hormone treatments when a trans person questions those. As no gender affirming procedures are carried in Cypris, the state is obliged by EU law to send trans persons abroad to complete their treatment. Unfortunately, the current law specifically prohibits this (p.14)."
--Note that new policy/documentation indicates that HRT is no longer being covered.
(2019) The LGBTI movement in Cyprus. p. 14. https://library.fes.de/pdf-files/bueros/zypern/15949-20200213.pdf
(2018) Trans and intersex equality rights in Europe. p. 78. https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf
-"Hardly any information specific to transgender persons living in Cyprus (p. 27)."		-As per respondent. Could not locate explicit information on this.-As per respondent. Could not locate explicit information on this.-As per respondent. Could not locate explicit information on this.As per respondentNEINEINEI-Specific to LGR
(2020) When one doesn't even exist. p.10. https://journals.sagepub.com/doi/full/10.1177/1363460720904648#bibr4-1363460720904648		1
-Specific to LGR
(2020) When one doesn't even exist. p.10. https://journals.sagepub.com/doi/full/10.1177/1363460720904648#bibr4-1363460720904648		-Only entitled to free care in public medical institutions and only after applying for asylum. Put no because it appears (though is not confirmed) not hormone prescriptions are available in the private system.
(2022) https://asylumineurope.org/reports/country/cyprus/reception-conditions/health-care/		-Entitled to healthcare on the same terms as Cypriot nationals once refugee status is granted.-No evidence one way or another. Put no because, though BMI limits for trans surgeries are common, there are no surgeons in Cyprus.NEI-Never. Despite all efforts to search, however, it does not appear to be banned. Marked this as 18.-18 w/o parental or public authority consent
(2017) Access to transgender hormone therapy. https://fra.europa.eu/de/publication/2017/mapping-minimum-age-requirements-concerning-rights-child-eu/access-transgender-hormone-therapy
14
TGEU Confirmation (score)0001100000000002011003-6 months2NEI1NEI10001311801803
15
Croatia
16
TGEU Confirmation (sources)(2021) Lack of transparent information. National Health Insurance Fund says no
(2021) https://epath.eu/past-conferences/conference-2021/programme/transgender-health-care-in-europe/		-Lack of transparent information. National Health Insurance Fund says no
(2021) https://ilga-europe.org/files/uploads/2022/04/annual-review-2021.pdf
(n.d.) https://kolektirv.hr/trans-zdravlje/		-Lack of transparent information. National Health Insurance Fund says no
(2021) https://ilga-europe.org/files/uploads/2022/04/annual-review-2021.pdf
(2021) https://epath.eu/past-conferences/conference-2021/programme/transgender-health-care-in-europe/		-(As per EPATH Summer School Croatian clinician) psychologist free, endocrinologist and hormones sometimes free. May be denied initially by insurer, but can challenge with paperwork from practitioner stating it is medically necessary and "they will back off"
-Lack of transparent information. National Health Insurance Fund says no
(2021) https://ilga-europe.org/files/uploads/2022/04/annual-review-2021.pdf
(2017) https://www.thedubrovniktimes.com/news/croatia/item/3446-croatian-transgender-travelling-to-serbia-for-surgery		-HRT only covered partially for trans women
(2021) https://ilga-europe.org/files/uploads/2022/04/annual-review-2021.pdf
(2018) https://ilga-europe.org/files/uploads/2022/04/annual-review-2021.pdf
(2017) https://www.thedubrovniktimes.com/news/croatia/item/3446-croatian-transgender-travelling-to-serbia-for-surgery		-Lack of transparent information. National Health Insurance Fund says no
(2021) https://ilga-europe.org/files/uploads/2022/04/annual-review-2021.pdf
(2021) https://epath.eu/past-conferences/conference-2021/programme/transgender-health-care-in-europe/		-National Health Insurance Fund says no, however, it appears that individual cases are happening anyway. Note that is was offically covered w/ supplemental insurance until 2017.
-"In October, the Zagreb County Court ruled in favour of a trans man, finding that the Insurance Fund and the hospital discriminated against him when denying him insurance coverage of his mastectomy. The man was informed of the change on the day of his surgery (p.48)."
(2022) ILGA annual review. p. 48. https://ilga-europe.org/files/uploads/2022/04/annual-review-2022.pdf
"The surgeon performing mastectomies in Croatia recommended several trans people this year to appeal to the Ministry of Health for cost coverage. Ten trans people received a positive response and their surgery costs were fully covered. One person was denied surgery by the hospital, despite the Ministry's positive answer, because the applicant did not change their gender marker in the healthcare system, even though it was changed on their ID (p.38)."
(2020) ILGA annual review. p.38. https://ilga-europe.org/files/uploads/2022/04/annual-review-2020.pdf
(2018) Documentation report on the Republic of Croatia. p.68. https://tgeu.org/wp-content/uploads/2018/10/COE-Report-Oct18-croatia_.pdf		-Lack of transparent information. National Health Insurance Fund says no
(2021) https://ilga-europe.org/files/uploads/2022/04/annual-review-2021.pdf
(2021) https://epath.eu/past-conferences/conference-2021/programme/transgender-health-care-in-europe/		-Lack of transparent information. National Health Insurance Fund says no
(2021) https://ilga-europe.org/files/uploads/2022/04/annual-review-2021.pdf
(2021) https://epath.eu/past-conferences/conference-2021/programme/transgender-health-care-in-europe/		-Lack of transparent information. National Health Insurance Fund says no
(2021) https://ilga-europe.org/files/uploads/2022/04/annual-review-2021.pdf
(2021) https://epath.eu/past-conferences/conference-2021/programme/transgender-health-care-in-europe/		-Lack of transparent information. National Health Insurance Fund says no
(2021) https://ilga-europe.org/files/uploads/2022/04/annual-review-2021.pdf
(2021) https://epath.eu/past-conferences/conference-2021/programme/transgender-health-care-in-europe/		No available confirmation. Respondent indicates yes, but given that other HRT sources cite that only HRT coverage is for trans women, marked this is NEI.-Lack of transparent information. National Health Insurance Fund says no
(2021) https://ilga-europe.org/files/uploads/2022/04/annual-review-2021.pdf
(2021) https://epath.eu/past-conferences/conference-2021/programme/transgender-health-care-in-europe/
(2021) https://ilga-europe.org/files/uploads/2022/04/annual-review-2021.pdf		-Lack of transparent information. National Health Insurance Fund says no
(2021) https://ilga-europe.org/files/uploads/2022/04/annual-review-2021.pdf
(2021) https://epath.eu/past-conferences/conference-2021/programme/transgender-health-care-in-europe/		-Speech therapist covered through HZZO
(n.d.) Trans health. https://kolektirv.hr/trans-zdravlje/		-Partial access to GCT in country, but no GCT funding.
(2018) Trans and intersex equality rights in Europe. p. 78. https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf		-"To start hormonal therapy , it is necessary to pass a positive evaluation by a psychiatrist and psychologist, and this process usually lasts from several months to a year. After that, you can contact an endocrinologist, who can prescribe hormonal therapy"
(n.d.) Trans health. (mid page). https://kolektirv.hr/trans-zdravlje/
(2021) ILGA Europe annual review. p. 37-38. https://ilga-europe.org/files/uploads/2022/04/annual-review-2021.pdf		-Not explicitly stated, but this appears to be required.
(n.d.) Trans health. https://kolektirv.hr/trans-zdravlje/		0As per respondent
-(As per Croatian clinician @ EPATH Summer School) Beureaucratic approval process is supposed to take 2-3 months, but can take up to 6. You can sue them if they take longer and the Ministry will then automatically process (approve?) it.
(2022) ILGA annual review. https://ilga-europe.org/files/uploads/2022/04/annual-review-2022.pdf
-Covid significantly increased wait 		-Likely, as guidelines instruct that, due to higher rates of autism in children, special attention should be paid to social reasons for gender?
(2016) Professional guidelines for the preparation of opinions of health workers and psychologists on determining the conditions and assumptions for changing gender and living in a different gender identity. https://narodne-novine.nn.hr/clanci/sluzbeni/2016_01_7_93.html		-HRT may be contraindicated due to serious health problems. Lists PCOS?
(2016) Professional guidelines for the preparation of opinions of health workers and psychologists on determining the conditions and assumptions for changing gender and living in a different gender identity. https://narodne-novine.nn.hr/clanci/sluzbeni/2016_01_7_93.html		NEINEI0-Emergency care only (2016)
-Seems to have improved somewhat (2020)
(2020) Country report: Croatia. https://asylumineurope.org/wp-content/uploads/2021/05/AIDA-HR_2020update.pdf
(2016) Preliminary observations by UN special rapporteur on the right of everyone to the enjoyment of hte highest attainable stadard of physical and mental health. https://www.ohchr.org/en/statements/2016/12/preliminary-observations-un-special-rapporteur-right-everyone-enjoyment-highest		-Both respondents agreeNEINEI(2016) Professional guidelines for the preparation of opinions of health workers and psychologists on determining the conditions and assumptions for changing gender and living in a different gender identity.https://narodne-novine.nn.hr/clanci/sluzbeni/2016_01_7_93.html-Marked as under 18 due to following;
"Following a four-year legal battle with public authorities, an 18-year-old boy was allowed to change his personal documents without undergoing sterilizing gender reassignment surgery. With his mother’s support, the boy had followed hormonal therapy and had lived in his true gender for a long time" [HRT started prior to 18].
(2017) Croatia. https://www.lgbti-era.org/countries/croatia
-"In order for adolescents and their parents to make an informed decision about delaying puberty, it is recommended that adolescents go through the onset of puberty to at least stage 2 on the Tanner scale."
(2016) Professional guidelines for the preparation of opinions of health workers and psychologists on determining the conditions and assumptions for changing gender and living in a different gender identity.https://narodne-novine.nn.hr/clanci/sluzbeni/2016_01_7_93.html
17
TGEU Confirmation (score)00010010000NEI0013011001-3 months210NEINEI11NEINEI31Tanner 22<1816
18
Czechia
19
TGEU Confirmation (sources)-"Regarding the "cosmetic treatments", which include for instance epilation, breast augmentation, insertion of prosthetic testes, voice therapy and thyroid eminence elimination [tracheal shave], are paid for by the patients (p.508)."
(2018) The civil status of transsexual and transgender people in Europe. p.508. https://tlq.ilaw.cas.cz/index.php/tlq/article/view/309
(n.d) Access to trans healthcare: The situation in Europe. https://www.thenewfederalist.eu/access-to-trans-healthcare-the-situation-in-europe?lang=fr		-"Regarding the "cosmetic treatments", which include for instance epilation, breast augmentation, insertion of prosthetic testes, voice therapy and thyroid eminence elimination [tracheal shave], are paid for by the patients (p.508)."
(2018) The civil status of transsexual and transgender people in Europe. p.508. https://tlq.ilaw.cas.cz/index.php/tlq/article/view/309
(n.d.) https://jsemtrans.cz/en/guide/		Respondent notes a case (from Transparent) whereby FFS was covered by insurance via "industrious" methods, but didn't indicate that this was routine by any measure.
-Following sugests it wouldn't be
-"Regarding the "cosmetic treatments", which include for instance epilation, breast augmentation, insertion of prosthetic testes, voice therapy and thyroid eminence elimination [tracheal shave], are paid for by the patients (p.508)."
(2018) The civil status of transsexual and transgender people in Europe. p.508. https://tlq.ilaw.cas.cz/index.php/tlq/article/view/309		-The 2016 and 2012 publications, taken together, show what procedures are available and covered by public health insurance.
(2016) Transgender Europe and ILGA-Europe v. Czech Republic. p.8. https://rm.coe.int/16805a280e
(2012) Journal of the Ministry of Health of the Czech Republic. p.5. https://www.mzcr.cz/wp-content/uploads/wepub/6865/36193/V%C4%9Bstn%C3%ADk%20MZ%20%C4%8CR%208-2012.pdf		-The 2016 and 2012 publications, taken together, show what procedures are available and covered by public health insurance.
(2016) Transgender Europe and ILGA-Europe v. Czech Republic. p.8. https://rm.coe.int/16805a280e
(2012) Journal of the Ministry of Health of the Czech Republic. p.5. https://www.mzcr.cz/wp-content/uploads/wepub/6865/36193/V%C4%9Bstn%C3%ADk%20MZ%20%C4%8CR%208-2012.pdf		-The 2016 and 2012 publications, taken together, show what procedures are available and covered by public health insurance.
(2016) Transgender Europe and ILGA-Europe v. Czech Republic. p.8. https://rm.coe.int/16805a280e
(2012) Journal of the Ministry of Health of the Czech Republic. p.5. https://www.mzcr.cz/wp-content/uploads/wepub/6865/36193/V%C4%9Bstn%C3%ADk%20MZ%20%C4%8CR%208-2012.pdf		-The 2016 and 2012 publications, taken together, show what procedures are available and covered by public health insurance.
(2017) https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf
(2016) Transgender Europe and ILGA-Europe v. Czech Republic. p.8. https://rm.coe.int/16805a280e
(2012) Journal of the Ministry of Health of the Czech Republic. p.5. https://www.mzcr.cz/wp-content/uploads/wepub/6865/36193/V%C4%9Bstn%C3%ADk%20MZ%20%C4%8CR%208-2012.pdf		-The 2016 and 2012 publications, taken together, show what procedures are available and covered by public health insurance.
(2016) Transgender Europe and ILGA-Europe v. Czech Republic. p.8. https://rm.coe.int/16805a280e
(2012) Journal of the Ministry of Health of the Czech Republic. p.5. https://www.mzcr.cz/wp-content/uploads/wepub/6865/36193/V%C4%9Bstn%C3%ADk%20MZ%20%C4%8CR%208-2012.pdf		-The 2016 and 2012 publications, taken together, show what procedures are available and covered by public health insurance.
(2016) Transgender Europe and ILGA-Europe v. Czech Republic. p.8. https://rm.coe.int/16805a280e
(2012) Journal of the Ministry of Health of the Czech Republic. p.5. https://www.mzcr.cz/wp-content/uploads/wepub/6865/36193/V%C4%9Bstn%C3%ADk%20MZ%20%C4%8CR%208-2012.pdf		-The 2016 and 2012 publications, taken together, show what procedures are available and covered by public health insurance.
(2016) Transgender Europe and ILGA-Europe v. Czech Republic. p.8. https://rm.coe.int/16805a280e
(2012) Journal of the Ministry of Health of the Czech Republic. p.5. https://www.mzcr.cz/wp-content/uploads/wepub/6865/36193/V%C4%9Bstn%C3%ADk%20MZ%20%C4%8CR%208-2012.pdf		-The 2016 and 2012 publications, taken together, show what procedures are available and covered by public health insurance.
(2016) Transgender Europe and ILGA-Europe v. Czech Republic. p.8. https://rm.coe.int/16805a280e
(2012) Journal of the Ministry of Health of the Czech Republic. p.5. https://www.mzcr.cz/wp-content/uploads/wepub/6865/36193/V%C4%9Bstn%C3%ADk%20MZ%20%C4%8CR%208-2012.pdf		-Not explicitly, but following article outlines how puberty blockers are provided via the GIC in Brno, which implies that they would be.
(2021) More Czech adolescents identifying as transgender, say researchers. https://www.expats.cz/czech-news/article/number-of-trans-adolescents-rising-in-the-czech-republic-but-the-process-isn-t-easy		-"Regarding the "cosmetic treatments", which include for instance epilation, breast augmentation, insertion of prosthetic testes, voice therapy and thyroid eminence elimination [tracheal shave], are paid for by the patients (p.508)."
(2018) The civil status of transsexual and transgender people in Europe. p.508. https://tlq.ilaw.cas.cz/index.php/tlq/article/view/309		-The 2016 and 2012 publications, taken together, show what procedures are available and covered by public health insurance.
(2016) Transgender Europe and ILGA-Europe v. Czech Republic. p.8. https://rm.coe.int/16805a280e
(2012) Journal of the Ministry of Health of the Czech Republic. p.5. https://www.mzcr.cz/wp-content/uploads/wepub/6865/36193/V%C4%9Bstn%C3%ADk%20MZ%20%C4%8CR%208-2012.pdf		-"Regarding the "cosmetic treatments", which include for instance epilation, breast augmentation, insertion of prosthetic testes, voice therapy and thyroid eminence elimination [tracheal shave], are paid for by the patients (p.508)."
(2018) The civil status of transsexual and transgender people in Europe. p.508. https://tlq.ilaw.cas.cz/index.php/tlq/article/view/309		(2018) https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf
-Access to GCT and GCT funding, but with conditions. 		(2020) Recommended procedure for czech sexologists in the care of trassexual patients. (mid page). http://www.cspsychiatr.cz/detail.php?stat=1327&fbclid=IwAR2vRQS6o7rOqPskSKiurzNVl2ol2eXw7BpTHicLO7bfqzdE1XrWQ9HA0SI
-Specifically transsexualism, not gender identity disorders.
(2017) Trans healthcare lottery. p.18. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf
(2016) Transgender Europe and ILGA-Europe v. Czech Republic. https://rm.coe.int/16805a280e
(2015) Trans people and their experience with health care and legislation. p.18-19. https://rm.coe.int/CoERMPublicCommonSearchServices/DisplayDCTMContent?documentId=090000168064e8bf		(2020) Recommended procedure for czech sexologists in the care of trassexual patients. (mid page). http://www.cspsychiatr.cz/detail.php?stat=1327&fbclid=IwAR2vRQS6o7rOqPskSKiurzNVl2ol2eXw7BpTHicLO7bfqzdE1XrWQ9HA0SI
-Specifically transsexualism, not gender identity disorders.
(2017) Trans healthcare lottery. p.18. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf
(2016) Transgender Europe and ILGA-Europe v. Czech Republic. https://rm.coe.int/16805a280e
(2015) Trans people and their experience with health care and legislation. p.18-19. https://rm.coe.int/CoERMPublicCommonSearchServices/DisplayDCTMContent?documentId=090000168064e8bf
-Health Care Act specified surgery on 'transsexuals'
(2010) Transgender persons rights in EU member states. p. 21. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf		(2010) Transgender persons rights in EU member states. p.20. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdfAs per respondent1
-"Relative contraindications [to surgery]... transsexuality and psychotic illness.. personalitiy disorders... addiction.... (p.6).
(2012) Journal of the Ministry of Health of the Czech Republic. p.6. https://www.mzcr.cz/wp-content/uploads/wepub/6865/36193/V%C4%9Bstn%C3%ADk%20MZ%20%C4%8CR%208-2012.pdf
(n.d.) Trans survival guide. https://jsemtrans.cz/en/guide/		1
-"Relative contraindications [to surgery]... transsexuality and psychotic illness.. personalitiy disorders... addiction.... (p.6).
(2012) Journal of the Ministry of Health of the Czech Republic. p.6. https://www.mzcr.cz/wp-content/uploads/wepub/6865/36193/V%C4%9Bstn%C3%ADk%20MZ%20%C4%8CR%208-2012.pdf
(n.d.) Trans survival guide. https://jsemtrans.cz/en/guide/		1
-Some difficulty specific to bisexuality
(n.d.) Trans survival guide. https://jsemtrans.cz/en/guide/		1
(2015) Trans people and their experience with health care and legislation. p.18-19. https://rm.coe.int/CoERMPublicCommonSearchServices/DisplayDCTMContent?documentId=090000168064e8bf
(n.d.) Trans survival guide. https://jsemtrans.cz/en/guide/		1
(2015) https://rm.coe.int/CoERMPublicCommonSearchServices/DisplayDCTMContent?documentId=090000168064e8bf
(n.d.) Trans survival guide. https://jsemtrans.cz/en/guide/		NEINEI1
-As per respondent. No specific information available, but BMI limits for surgery are common.		1
-Specific legislation barring surgery on trans people in jail.
(2018) Transgender Europe and ILGA-Europe v. the Czech Republic. p.9. https://tgeu.org/wp-content/uploads/2018/10/cc-117-2015-report-en.pdf
-Also advises caution prior to providing surgery for folks with "recent criminal anamnesis [history] (p.6)."
(2012) Journal of the Ministry of Health of the Czech Republic. p.6. https://www.mzcr.cz/wp-content/uploads/wepub/6865/36193/V%C4%9Bstn%C3%ADk%20MZ%20%C4%8CR%208-2012.pdf		(2021) More Czech adolescents identifying as transgender, say researchers. https://www.expats.cz/czech-news/article/number-of-trans-adolescents-rising-in-the-czech-republic-but-the-process-isn-t-easy(2021) Growing number of Czech teenagers identify as transgender. https://kafkadesk.org/2021/09/08/growing-number-of-czech-teenagers-identify-as-transgender/
(2017) https://fra.europa.eu/de/publication/2017/mapping-minimum-age-requirements-concerning-rights-child-eu/access-transgender-hormone-therapy
(2017) http://www.cspsychiatr.cz/detail.php?stat=1327&fbclid=IwAR2vRQS6o7rOqPskSKiurzNVl2ol2eXw7BpTHicLO7bfqzdE1XrWQ9HA0SI
-confirms that this is possible <18		1
20
TGEU Confirmation (score)00011111111101010111003-6 months21111NEINEI1160<1621616
21
Denmark
22
TGEU Confirmation (sources)(2018) Guide on Healthcare Related to Gender Identity. p.15-16. https://www.sst.dk/-/media/Udgivelser/2018/K%C3%B8nsidentitetsforhold/Guide-on-healthcare-related-to-gender-identity.ashx?la=da&hash=6B5102F52102FFA06C3871D33CC363BACCB9CA90,(2018) Guidance on healthcare help for gender identity issues , https://www.retsinformation.dk/eli/retsinfo/2019/9060-In exceptional cases
(2018) Guide on Healthcare Related to Gender Idenitty, p. 15, 21. https://www.sst.dk/-/media/Udgivelser/2018/K%C3%B8nsidentitetsforhold/Guide-on-healthcare-related-to-gender-identity.ashx?la=da&hash=6B5102F52102FFA06C3871D33CC363BACCB9CA90		-No specific page number, but overall indicates that it is covered.
(2018) Guide on Healthcare Related to Gender Identity. https://www.sst.dk/-/media/Udgivelser/2018/K%C3%B8nsidentitetsforhold/Guide-on-healthcare-related-to-gender-identity.ashx?la=da&hash=6B5102F52102FFA06C3871D33CC363BACCB9CA90		-No specific page number but overall indicates that it is covered.
(2018) https://www.sst.dk/-/media/Udgivelser/2018/K%C3%B8nsidentitetsforhold/Guide-on-healthcare-related-to-gender-identity.ashx?la=da&hash=6B5102F52102FFA06C3871D33CC363BACCB9CA90		(2018) Guide on Healthcare Related to Gender Idenitty. p.16. https://www.sst.dk/-/media/Udgivelser/2018/K%C3%B8nsidentitetsforhold/Guide-on-healthcare-related-to-gender-identity.ashx?la=da&hash=6B5102F52102FFA06C3871D33CC363BACCB9CA90 (2018) Guide on Healthcare Related to Gender Idenitty, p. 15, https://www.sst.dk/-/media/Udgivelser/2018/K%C3%B8nsidentitetsforhold/Guide-on-healthcare-related-to-gender-identity.ashx?la=da&hash=6B5102F52102FFA06C3871D33CC363BACCB9CA90(2018) Guide on Healthcare Related to Gender Idenitty, p.16. https://www.sst.dk/-/media/Udgivelser/2018/K%C3%B8nsidentitetsforhold/Guide-on-healthcare-related-to-gender-identity.ashx?la=da&hash=6B5102F52102FFA06C3871D33CC363BACCB9CA90,(2018) Guide on Healthcare Related to Gender Identity. p.17. https://www.sst.dk/-/media/Udgivelser/2018/K%C3%B8nsidentitetsforhold/Guide-on-healthcare-related-to-gender-identity.ashx?la=da&hash=6B5102F52102FFA06C3871D33CC363BACCB9CA90.1(2018) Guide on Healthcare Related to Gender Identity, p.16. https://www.sst.dk/-/media/Udgivelser/2018/K%C3%B8nsidentitetsforhold/Guide-on-healthcare-related-to-gender-identity.ashx?la=da&hash=6B5102F52102FFA06C3871D33CC363BACCB9CA90. (2018) Guide on Healthcare Related to Gender Idenitty. p.16. https://www.sst.dk/-/media/Udgivelser/2018/K%C3%B8nsidentitetsforhold/Guide-on-healthcare-related-to-gender-identity.ashx?la=da&hash=6B5102F52102FFA06C3871D33CC363BACCB9CA90.(2018) Guide on Healthcare Related to Gender Identity. p.20. https://www.sst.dk/-/media/Udgivelser/2018/K%C3%B8nsidentitetsforhold/Guide-on-healthcare-related-to-gender-identity.ashx?la=da&hash=6B5102F52102FFA06C3871D33CC363BACCB9CA90. -In exceptional cases.
(2018) Guide on Healthcare Related to Gender Identity. p.21. https://www.sst.dk/-/media/Udgivelser/2018/K%C3%B8nsidentitetsforhold/Guide-on-healthcare-related-to-gender-identity.ashx?la=da&hash=6B5102F52102FFA06C3871D33CC363BACCB9CA90.		-In exceptional cases
(2018) Guide on Healthcare Related to Gender Identity,. p.17. https://www.sst.dk/-/media/Udgivelser/2018/K%C3%B8nsidentitetsforhold/Guide-on-healthcare-related-to-gender-identity.ashx?la=da&hash=6B5102F52102FFA06C3871D33CC363BACCB9CA90. p. 17		(2018) Guide on Healthcare Related to Gender Identity. p.21. https://www.sst.dk/-/media/Udgivelser/2018/K%C3%B8nsidentitetsforhold/Guide-on-healthcare-related-to-gender-identity.ashx?la=da&hash=6B5102F52102FFA06C3871D33CC363BACCB9CA90. Access to GCT and GCT funding, no conditions.
(2018) European Network of Legal Experts in Gender Equality and Non-Discrimination, p. 80, https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf		(2018) The state decides who I am. p. 23. https://www.amnesty.eu/wp-content/uploads/2018/10/the_state_decides_who_I_am.pdf
(2010) Transgender persons rights in EU member states. p. 21. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf		(2018) The state decides who I am. p. 23. https://www.amnesty.eu/wp-content/uploads/2018/10/the_state_decides_who_I_am.pdf
-Health Care Act specified surgery on 'transsexuals'
(2010) Transgender persons rights in EU member states. p. 21. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf		(2010) Transgender persons rights in EU member states. p. 21. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdfAs per respondent
(2016) Waiting for surgery puts transgender people in Denmark under extreme pressure. https://cphpost.dk/?p=40449		1
(2018) Guide on Healthcare Related to Gender Idenitty, p. 14, 23. https://www.sst.dk/-/media/Udgivelser/2018/K%C3%B8nsidentitetsforhold/Guide-on-healthcare-related-to-gender-identity.ashx?la=da&hash=6B5102F52102FFA06C3871D33CC363BACCB9CA90
(n.d.) TransAktion’s observations on the effect of the COVID-19 pandemic on the trans communities in Denmark, p. 5, https://www.ohchr.org/Documents/Issues/SexualOrientation/IESOGI-COVID-19/CSOs/TransAktion-Denmark.docx		1
(n.d.) TransAktion’s observations on the effect of the COVID-19 pandemic on the trans communities in Denmark, p. 5, https://www.ohchr.org/Documents/Issues/SexualOrientation/IESOGI-COVID-19/CSOs/TransAktion-Denmark.docx
(2022) Annual Review of the Human Rights Situation of Lesbian, Gay, Bisexual, Trans and Intersex People in Europe and Central Asia, p. 53, https://www.ilga-europe.org/files/uploads/2022/04/annual-review-2022.pdf
(2021) Annual Review of the Human Rights Situation of Lesbian, Gay, Bisexual, Trans and Intersex People in Europe and Central Asia.pdf, p. 44, https://ilga-europe.org/files/uploads/2022/04/annual-review-2021.pdf
(2018) Guide on Healthcare Related to Gender Idenitty, p. 23,
https://www.sst.dk/-/media/Udgivelser/2018/K%C3%B8nsidentitetsforhold/Guide-on-healthcare-related-to-gender-identity.ashx?la=da&hash=6B5102F52102FFA06C3871D33CC363BACCB9CA90		NEI1
(2022) Annual Review of the Human Rights Situation of Lesbian, Gay, Bisexual, Trans and Intersex People in Europe and Central Asia, p. 53, https://www.ilga-europe.org/files/uploads/2022/04/annual-review-2022.pdf
(2021) Annual Review of the Human Rights Situation of Lesbian, Gay, Bisexual, Trans and Intersex People in Europe and Central Asia.pdf, p. 44, https://ilga-europe.org/files/uploads/2022/04/annual-review-2021.pdf		1
(2021) Annual Review of the Human Rights Situation of Lesbian, Gay, Bisexual, Trans and Intersex People in Europe and Central Asia, p. 44, https://ilga-europe.org/files/uploads/2022/04/annual-review-2021.pdf		1
(2022) Annual Review of the Human Rights Situation of Lesbian, Gay, Bisexual, Trans and Intersex People in Europe and Central Asia, p. 52, https://www.ilga-europe.org/files/uploads/2022/04/annual-review-2022.pdf
(2021) Annual Review of the Human Rights Situation of Lesbian, Gay, Bisexual, Trans and Intersex People in Europe and Central Asia.pdf, p. 43, https://ilga-europe.org/files/uploads/2022/04/annual-review-2021.pdf
(2017) Current migration situation in the EU. p. 14. https://fra.europa.eu/en/publication/2017/current-migration-situation-eu-lesbian-gay-bisexual-transgender-and-intersex
(n.d.) TransAktion’s observations on the effect of the COVID-19 pandemic on the trans communities in Denmark, p. 5, https://www.ohchr.org/Documents/Issues/SexualOrientation/IESOGI-COVID-19/CSOs/TransAktion-Denmark.docx
(n.d.) https://jsemtrans.cz/en/guide/		NEI1
(n.d.) TransAktion’s observations on the effect of the COVID-19 pandemic on the trans communities in Denmark, p. 5, https://www.ohchr.org/Documents/Issues/SexualOrientation/IESOGI-COVID-19/CSOs/TransAktion-Denmark.docx
(2022) Annual Review of the Human Rights Situation of Lesbian, Gay, Bisexual, Trans and Intersex People in Europe and Central Asia, p. 53, https://www.ilga-europe.org/files/uploads/2022/04/annual-review-2022.pdf
(2021) Annual Review of the Human Rights Situation of Lesbian, Gay, Bisexual, Trans and Intersex People in Europe and Central Asia.pdf, p. 44, https://ilga-europe.org/files/uploads/2022/04/annual-review-2021.pdf		1
(2021) Annual Review of the Human Rights Situation of Lesbian, Gay, Bisexual, Trans and Intersex People in Europe and Central Asia.pdf, p. 44, https://ilga-europe.org/files/uploads/2022/04/annual-review-2021.pdf		(2021) Annual Review of the Human Rights Situation of Lesbian, Gay, Bisexual, Trans and Intersex People in Europe and Central Asia.pdf, p. 44, https://ilga-europe.org/files/uploads/2022/04/annual-review-2021.pdf
-Hormone blockers sometimes denied for individuals below 15
(2018) Guide on Healthcare Related to Gender Idenitty, p. 19-21, https://www.sst.dk/-/media/Udgivelser/2018/K%C3%B8nsidentitetsforhold/Guide-on-healthcare-related-to-gender-identity.ashx?la=da&hash=6B5102F52102FFA06C3871D33CC363BACCB9CA90
-No minimum age		-Tanner 2 + 1ish year?
-Not until after the effect of HRT has been assessed.
-Scored this as under 16, since puberty has occured for at least a year in most individuals by this point.
(2018) Guide on Healthcare Related to Gender Idenitty. p. 23. https://www.sst.dk/-/media/Udgivelser/2018/K%C3%B8nsidentitetsforhold/Guide-on-healthcare-related-to-gender-identity.ashx?la=da&hash=6B5102F52102FFA06C3871D33CC363BACCB9CA90
23
TGEU Confirmation (score)1NEI/0NEI/011111111111113211003-6 months211NEI11NEI1160Tanner 22<1628
24
Estonia
25
TGEU Confirmation (sources)(2022). The right to healthcare related to gender transition. http://www.vikerkaar.ee/archives/28042(2022). The right to healthcare related to gender transition. http://www.vikerkaar.ee/archives/28042(2022). The right to healthcare related to gender transition. http://www.vikerkaar.ee/archives/28042(2022). The right to healthcare related to gender transition. http://www.vikerkaar.ee/archives/28042
-50% of hormones reimbursed
(2020) Joint submission to the third periodic review of Estonia, p. 13. https://humanrights.ee/app/uploads/2020/12/UPR_en.pdf		(2022). The right to healthcare related to gender transition. http://www.vikerkaar.ee/archives/28042
-50% of hormones reimbursed
(2020) Joint submission to the third periodic review of Estonia, p. 13. https://humanrights.ee/app/uploads/2020/12/UPR_en.pdf		(2022). The right to healthcare related to gender transition. http://www.vikerkaar.ee/archives/28042(2022). The right to healthcare related to gender transition. http://www.vikerkaar.ee/archives/28042(2022). The right to healthcare related to gender transition. http://www.vikerkaar.ee/archives/28042(2022). The right to healthcare related to gender transition. http://www.vikerkaar.ee/archives/28042(2022). The right to healthcare related to gender transition. http://www.vikerkaar.ee/archives/28042(2022). The right to healthcare related to gender transition. http://www.vikerkaar.ee/archives/28042By implication
(2022). The right to healthcare related to gender transition. http://www.vikerkaar.ee/archives/28042
-50% of hormones reimbursed
(2020) Joint submission to the third periodic review of Estonia, p. 13. https://humanrights.ee/app/uploads/2020/12/UPR_en.pdf		(2022). The right to healthcare related to gender transition. http://www.vikerkaar.ee/archives/28042(2022). The right to healthcare related to gender transition. http://www.vikerkaar.ee/archives/28042(2022). The right to healthcare related to gender transition. http://www.vikerkaar.ee/archives/28042(2021) A non-transparent system and assessment specialits, i.e. how the Estonian state treats transgender people. https://feministeerium.ee/en/how-the-state-treats-transgender-people/
(2002) Common requirements for medical operations for gender reassignment. https://www.riigiteataja.ee/en/eli/509072019001/consolide		(2021) A non-transparent system and assessment specialits, i.e. how the Estonian state treats transgender people. https://feministeerium.ee/en/how-the-state-treats-transgender-people/
(2002) Common requirements for medical operations for gender reassignment. https://www.riigiteataja.ee/en/eli/509072019001/consolide		See links in other cells-As per respondents
(2022). Gender transition medical services and legal gender recognition. https://www.lgbt.ee/soo-tunnustamine
-Indicates that the committee may have started work in Feb 2022. Sets out self-referral process via email and cheaper user fee. Lists legislatively mandated max wait time as 3 months, but acknowledges that it is longer. Now requires prior meeting and assessment w/ psychiatrist. States that decision is in 1-1.5 months.
(2022). The right to healthcare related to gender transition. http://www.vikerkaar.ee/archives/28042
-Healthcare (e.g. HRT) obtained through appoval of central committee headed by Dr. Imre Rammul, who has led it since inception (meeting lasts 5-10 min). "It is necessary to obtain a special permit from [this committee] operating under the Ministry of Social Affairs" to legally access medical transition in Estonia. If the committee approves they sign a document that can then be presented to prescriber. This committee charges not insignificant user fees. Last year Dr. Rammul disbanded the committee of his own accord. A new committee has been commissioned but hasn't started work so it has been effectively impossible to initially access healthcare legally for the past year.
(2021). A non-transparent system and assessment specialits, i.e. how the Estonian state treats transgender people. https://feministeerium.ee/en/how-the-state-treats-transgender-people/
-Difficult to get a meeting with the committee, as they don't answer emails. Required repeated phone calls to Dr. Rammul directly. Committee typically meetings twice/year and notifies of appointments shortly before.		NEI1
(2022). The right to healthcare related to gender transition. http://www.vikerkaar.ee/archives/28042
-"Symptoms of another mental disorder (e.g. Schizophrenia) must not be present)."
(2021). A non-transparent system and assessment specialits, i.e. how the Estonian state treats transgender people. https://feministeerium.ee/en/how-the-state-treats-transgender-people/
-Depression may also be an obstacle.		NEI1
(2021). A non-transparent system and assessment specialits, i.e. how the Estonian state treats transgender people. https://feministeerium.ee/en/how-the-state-treats-transgender-people/
"He repeatedly asked me when I would finally start wearing a suit and cut off my long hair."		1
(2021). A non-transparent system and assessment specialits, i.e. how the Estonian state treats transgender people. https://feministeerium.ee/en/how-the-state-treats-transgender-people/
"He repeatedly asked me when I would finally start wearing a suit and cut off my long hair."		1
(2010) Policies on health care for undocumented migrants in EU 27-Country Report Estonia, p. 10. https://webgate.ec.europa.eu/chafea_pdb/assets/files/pdb/2006333/2006333_d06-38_en_ps.pdf
-Only emergency medicine		NEI1
-No evidence one way or another. Put yes because respondent indicated it was and because BMI limits for trans surgeries exist widely.		1
-Not explicitly, but it would be virtually impossible for someone in prison to harrass the committee to the extent necssary to get an appointment and unlikely that they would even be able to attend it. This is to say nothing of whether the committee would accept them.
(2022). The right to healthcare related to gender transition. http://www.vikerkaar.ee/archives/28042
(2021). A non-transparent system and assessment specialits, i.e. how the Estonian state treats transgender people. https://feministeerium.ee/en/how-the-state-treats-transgender-people/		-Very difficult to find specific information. Suggestions that it is possible before 18, but no data on how or what specific age. Scored as 17 yrs.
(2022). The right to healthcare related to gender transition. http://www.vikerkaar.ee/archives/28042
-Difficult to access as few endocrinologists with necessary expertise in practice.		(2022). The right to healthcare related to gender transition. http://www.vikerkaar.ee/archives/28042
-No specific age mentioned, but this is the effective age.
(2017) Access to transgender hormone therapy. https://fra.europa.eu/de/publication/2017/mapping-minimum-age-requirements-concerning-rights-child-eu/access-transgender-hormone-therapy
-"Depends on maturity" superceeded by new information
26
TGEU Confirmation (score)0001100000010003011006-12 months1NEI1NEI11NEI1151<1811803
27
Finland
28
TGEU Confirmation (sources)-"breast feminization but not breast augmentation"?
(2021) https://ilga-europe.org/files/uploads/2022/04/annual-review-2021.pdf
(2020) https://palveluvalikoima.fi/documents/1237350/22895838/Transsukupuolisuus+suositus.pdf/82b60104-291c-7d8c-9e88-1b1fc9bba527/Transsukupuolisuus+suositus.pdf?t=1592318544000
(2017) https://palveluvalikoima.fi/documents/1237350/22895838/Summary+transgender.pdf/2cc3f053-2e34-39ce-4e21-becd685b3044/Summary+transgender.pdf
(2017) https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		(2020) https://palveluvalikoima.fi/documents/1237350/22895623/Muunsukupuolinen+suositus.pdf/058ac8f5-560d-da00-7b03-20644f97674a/Muunsukupuolinen+suositus.pdf?t=1592318040000
(2017) https://palveluvalikoima.fi/documents/1237350/22895838/Summary+transgender.pdf/2cc3f053-2e34-39ce-4e21-becd685b3044/Summary+transgender.pdf		(2017) https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf(might not always be 100%)
(2017) https://palveluvalikoima.fi/documents/1237350/22895838/Summary+transgender.pdf/2cc3f053-2e34-39ce-4e21-becd685b3044/Summary+transgender.pdf
(2017) https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		(might not always be 100%)
(2017) https://palveluvalikoima.fi/documents/1237350/22895838/Summary+transgender.pdf/2cc3f053-2e34-39ce-4e21-becd685b3044/Summary+transgender.pdf
(2017) https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		(2017) https://palveluvalikoima.fi/documents/1237350/22895838/Summary+transgender.pdf/2cc3f053-2e34-39ce-4e21-becd685b3044/Summary+transgender.pdf
(2017) https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		(might not always be 100%)
(2020) https://palveluvalikoima.fi/documents/1237350/22895838/Summary+transgender.pdf/2cc3f053-2e34-39ce-4e21-becd685b3044/Summary+transgender.pdf?t=1592318543000
(2017) https://palveluvalikoima.fi/documents/1237350/22895838/Summary+transgender.pdf/2cc3f053-2e34-39ce-4e21-becd685b3044/Summary+transgender.pdf
(2017) https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		(2020) https://palveluvalikoima.fi/documents/1237350/22895838/Transsukupuolisuus+suositus.pdf/82b60104-291c-7d8c-9e88-1b1fc9bba527/Transsukupuolisuus+suositus.pdf?t=1592318544000
(2020) https://www.reddit.com/r/transnord/comments/igkm05/metoidioplasty_in_finland/		(2017) https://palveluvalikoima.fi/documents/1237350/22895838/Summary+transgender.pdf/2cc3f053-2e34-39ce-4e21-becd685b3044/Summary+transgender.pdf
(2017) https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		(2017) https://palveluvalikoima.fi/documents/1237350/22895838/Summary+transgender.pdf/2cc3f053-2e34-39ce-4e21-becd685b3044/Summary+transgender.pdf
(2017) https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		(2020) https://palveluvalikoima.fi/documents/1237350/22895838/Transsukupuolisuus+suositus.pdf/82b60104-291c-7d8c-9e88-1b1fc9bba527/Transsukupuolisuus+suositus.pdf?t=1592318544000(2020) https://segm.org/sites/default/files/Finnish_Guidelines_2020_Minors_Unofficial%20Translation.pdf(2018) https://tgeu.org/wp-content/uploads/2018/10/COE-Report-Oct18-Finland.pdf
(2017) https://palveluvalikoima.fi/documents/1237350/22895838/Summary+transgender.pdf/2cc3f053-2e34-39ce-4e21-becd685b3044/Summary+transgender.pdf		(2020) https://palveluvalikoima.fi/documents/1237350/22895838/Transsukupuolisuus+suositus.pdf/82b60104-291c-7d8c-9e88-1b1fc9bba527/Transsukupuolisuus+suositus.pdf?t=1592318544000
(2017) https://palveluvalikoima.fi/documents/1237350/22895838/Summary+transgender.pdf/2cc3f053-2e34-39ce-4e21-becd685b3044/Summary+transgender.pdf		(2020) https://palveluvalikoima.fi/documents/1237350/22895838/Summary+transgender.pdf/2cc3f053-2e34-39ce-4e21-becd685b3044/Summary+transgender.pdf?t=1592318543000
(2017) https://palveluvalikoima.fi/documents/1237350/22895838/Summary+transgender.pdf/2cc3f053-2e34-39ce-4e21-becd685b3044/Summary+transgender.pdf"		(2018) Access to GCT but GCT funding, but with conditions. https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf-Confirmation of transsexualism and gender dysphoria (having lasted 2 years) required to prepare and execute treatment plan + psychological support at local healthcare unit required before accessing specialist services
(2018) The state decides who I am. p. 23, 41. https://www.amnesty.eu/wp-content/uploads/2018/10/the_state_decides_who_I_am.pdf
(2017) Medical treatments for gender dysphoria that reduces functional capacity in transgender people – recommendation. p.1-2. https://palveluvalikoima.fi/documents/1237350/22895838/Summary+transgender.pdf/2cc3f053-2e34-39ce-4e21-becd685b3044/Summary+transgender.pdf
(2017) Trans healthcare lottery. p.16. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf
(2016) The cruel, inhuman and degrading treatment of trans and intersex people in Finland. p.5. https://tbinternet.ohchr.org/Treaties/CAT/Shared%20Documents/FIN/INT_CAT_CSS_FIN_25540_E.pdf		-Confirmation of transsexualism and gender dysphoria (having lasted 2 years) required to prepare and execute treatment plan + psychological support at local healthcare unit required before accessing specialist services
(2018) The state decides who I am. p. 23, 41. https://www.amnesty.eu/wp-content/uploads/2018/10/the_state_decides_who_I_am.pdf
(2017) Medical treatments for gender dysphoria that reduces functional capacity in transgender people – recommendation. p.1-2. https://palveluvalikoima.fi/documents/1237350/22895838/Summary+transgender.pdf/2cc3f053-2e34-39ce-4e21-becd685b3044/Summary+transgender.pdf
(2017) Trans healthcare lottery. p.16. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf
(2016) The cruel, inhuman and degrading treatment of trans and intersex people in Finland. p.5. https://tbinternet.ohchr.org/Treaties/CAT/Shared%20Documents/FIN/INT_CAT_CSS_FIN_25540_E.pdf		See links in other cells>2 years of persistant gender dysphoria before referral to GIC (new) but for waiting times, going with respondent's answer
-Mandatory therapy may take 1 year or longer
-Doctors will draw up a plan on treatment that will also outline the estimated time to reach the intended goals. Two decisions on delay in access to medical evaluation (The first decision (EOAK/2842/2017 (24.10.2018) concerned the trans clinic in Helsinki, the second decision (EOAK/501/2019 (April 2020)) concerned the trans clinic in Tampere. Both are available from the Parliamentary Ombudsman)
(2017) https://palveluvalikoima.fi/documents/1237350/22895838/Summary+transgender.pdf/2cc3f053-2e34-39ce-4e21-becd685b3044/Summary+transgender.pdf
-Practitioners have also been reported to arbitraily impose forced 'breaks' in the process
(2016) https://tbinternet.ohchr.org/Treaties/CAT/Shared%20Documents/FIN/INT_CAT_CSS_FIN_25540_E.pdf		-Based on conversations with Finnish clinicians at EPATH Summer School
(2020) https://palveluvalikoima.fi/documents/1237350/22895623/Muunsukupuolinen+suositus.pdf/058ac8f5-560d-da00-7b03-20644f97674a/Muunsukupuolinen+suositus.pdf?t=1592318040000
-Autism spectrum rehabilitative interventions must also be taken care of
(2020) https://segm.org/sites/default/files/Finnish_Guidelines_2020_Minors_Unofficial%20Translation.pdf
(2017) https://palveluvalikoima.fi/documents/1237350/22895838/Summary+transgender.pdf/2cc3f053-2e34-39ce-4e21-becd685b3044/Summary+transgender.pdf		Based on conversations with Finnish clinicians at EPATH Summer School
(2020) https://segm.org/sites/default/files/Finnish_Guidelines_2020_Minors_Unofficial%20Translation.pdf
(2017) https://palveluvalikoima.fi/documents/1237350/22895838/Summary+transgender.pdf/2cc3f053-2e34-39ce-4e21-becd685b3044/Summary+transgender.pdf		NEIAlso, no access to transitional medical care because it requires a diagnosis of 'transsexualism'
(2021) https://ilga-europe.org/files/uploads/2022/04/annual-review-2021.pdf. p. 47
(2020) https://palveluvalikoima.fi/documents/1237350/22895623/Summary_non-binary_en.pdf/8e5f9035-6c98-40d9-6acd-7459516d6f92/Summary_non-binary_en.pdf?t=1592318035000
(2017) Trans healthcare lottery. p. 39. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf
(2016) https://tbinternet.ohchr.org/Treaties/CAT/Shared%20Documents/FIN/INT_CAT_CSS_FIN_25540_E.pdf		1
(2018) https://www.amnesty.eu/wp-content/uploads/2018/10/the_state_decides_who_I_am.pdf		-HRT only if initiated prior to entry into country.
(2017) Current migration situation in the EU. p. 14. https://fra.europa.eu/en/publication/2017/current-migration-situation-eu-lesbian-gay-bisexual-transgender-and-intersex
Medical care of refugees and asylum-seekers in Finland. https://www.eu-healthcare.fi/healthcare-in-finland/moving-to-finland/medical-care-of-refugees-and-asylum-seekers-in-finland/		-The reception centres usually have a public health nurse and the reception centre also purchases health care services from the private sector, municipality or the joint municipal authority. Kela is not responsible for the costs of medical care provided to asylum-seekers"
-Unclear if they would/can purchase trans health care services.
(n.d.) Medical care of refugees and asylum-seekers in Finland. https://www.eu-healthcare.fi/healthcare-in-finland/moving-to-finland/medical-care-of-refugees-and-asylum-seekers-in-finland/		(2021) https://ilga-europe.org/files/uploads/2022/04/annual-review-2021.pdf p. 47
-BMI limit for "elective thoracic surgery"
(2020) https://palveluvalikoima.fi/documents/1237350/22895838/Transsukupuolisuus+suositus.pdf/82b60104-291c-7d8c-9e88-1b1fc9bba527/Transsukupuolisuus+suositus.pdf?t=1592318544000
(2018) Monitoring implementation of hte Council of Euope recommendation to the member states on measures to combat discrimination on grounds of sexual orientation or gende ridentity. p. 7. https://tgeu.org/wp-content/uploads/2018/10/COE-Report-Oct18-Finland.pdf		NEI16
New guidelines raised the min age. Previous average was 14.8 (12-18 yrs)
(2021) https://ilga-europe.org/files/uploads/2022/04/annual-review-2021.pdf
(2020) https://segm.org/sites/default/files/Finnish_Guidelines_2020_Minors_Unofficial%20Translation.pdf
-"Patients under 18 receive three to six month in GnRH analogue treatment prior to the intiiation of cross-sec hormones."
(2020) https://segm.org/sites/default/files/Finnish_Guidelines_2020_Minors_Unofficial%20Translation.pdf
Can be initiated but based on a diagnostic examination if the medical indications for the treatment are present
(2020) https://palveluvalikoima.fi/documents/1237350/22895008/Summary_minors_en+(1).pdf/fa2054c5-8c35-8492-59d6-b3de1c00de49/Summary_minors_en+(1).pdf?t=1631773838474
-Note that following article argues that transition only occurs or youth under strict research protocol or not at all. However, author is a TERF and veracity is in question.
(2021) https://jamanetwork.com/journals/jamapediatrics/article-abstract/2787009		Requirements have recently increasedhttps://segm.org/sites/default/files/Finnish_Guidelines_2020_Minors_Unofficial%20Translation.pdf
-May be considered before 18 years only if it can be ascertained that their identity is of a permanent nature and causes severe dysphoria. Assessment process is long, so in practice this may be difficult to meet.
(2020) Medical Treatment Methods for Dysphoria Related to Gender Variance In Minors. p.5. https://segm.org/sites/default/files/Finnish_Guidelines_2020_Minors_Unofficial%20Translation.pdf
-As per Finnish GIC clinician at EPATH Summer School (possible to start hormones <18, but must be 18 for surgery.
(2020) https://palveluvalikoima.fi/documents/1237350/22895008/Summary_minors_en+(1).pdf/fa2054c5-8c35-8492-59d6-b3de1c00de49/Summary_minors_en+(1).pdf?t=1631773838474
(2017) https://fra.europa.eu/de/publication/2017/mapping-minimum-ag-requirements-concerning-rights-child-eu/access-transgender-hormone-therapy
-Note that this conflicts with information in the larger data set, which indicates 18 yrs or this and surgery.
29
TGEU Confirmation (score)11111111111111115211006-12 months111NEI11NEI
-"Hormone therapy (testosterone/estrogen and anti-androgen) can be started after the diagnostic evaluations, but no earlier than age 16"
Recommendation of the Council for Choices in Health Care in Finland (PALKO / COHERE Finland). p.5. https://segm.org/sites/default/files/Finnish_Guidelines_2020_Minors_Unofficial%20Translation.pdf
-May be considered before 18 years only if it can be ascertained that their identity is of a permanent nature and causes severe dysphoria. Assessment process is long, so in practice this may be difficult to meet.
(2020) Medical Treatment Methods for Dysphoria Related to Gender Variance In Minors. p.5. https://segm.org/sites/default/files/Finnish_Guidelines_2020_Minors_Unofficial%20Translation.pdf
-As per Finnish GIC clinician at EPATH Summer School (possible to start hormones >18, but must be 18 for surgery.
(2020) https://palveluvalikoima.fi/documents/1237350/22895008/Summary_minors_en+(1).pdf/fa2054c5-8c35-8492-59d6-b3de1c00de49/Summary_minors_en+(1).pdf?t=1631773838474
(2017) https://fra.europa.eu/de/publication/2017/mapping-minimum-ag-requirements-concerning-rights-child-eu/access-transgender-hormone-therapy
-Note that this conflicts with information in the larger data set, which indicates 18 yrs or this and surgery.		1NEI511611616
30
France
31
TGEU Confirmation (sources)-in some cases
(2022) Report on the health and care pathways of trans people, p. 31. https://solidarites-sante.gouv.fr/IMG/pdf/rapport_sante_des_personnes_trans_2022.pdf
(2017) Trans Healthcare Lottery. p. 23. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf
(n.d.) Access to trans healthcare: The situation in Europe. https://www.thenewfederalist.eu/access-to-trans-healthcare-the-situation-in-europe?lang=fr		(2022) Report on the health and care pathways of trans people, p. 22. https://solidarites-sante.gouv.fr/IMG/pdf/rapport_sante_des_personnes_trans_2022.pdf
-Coverage is situational and depends on location of care		(2022) Report on the health and care pathways of trans people, p. 31. https://solidarites-sante.gouv.fr/IMG/pdf/rapport_sante_des_personnes_trans_2022.pdf(2022) Report on the health and care pathways of trans people, p. 30. https://solidarites-sante.gouv.fr/IMG/pdf/rapport_sante_des_personnes_trans_2022.pdf(2022) Report on the health and care pathways of trans people, p. 30. https://solidarites-sante.gouv.fr/IMG/pdf/rapport_sante_des_personnes_trans_2022.pdf(2022) Report on the health and care pathways of trans people, p. 37. https://solidarites-sante.gouv.fr/IMG/pdf/rapport_sante_des_personnes_trans_2022.pdf(2022) Report on the health and care pathways of trans people, p. 31. https://solidarites-sante.gouv.fr/IMG/pdf/rapport_sante_des_personnes_trans_2022.pdf(2022) Report on the health and care pathways of trans people, p. 31. https://solidarites-sante.gouv.fr/IMG/pdf/rapport_sante_des_personnes_trans_2022.pdf(2022) Report on the health and care pathways of trans people, p. 37. https://solidarites-sante.gouv.fr/IMG/pdf/rapport_sante_des_personnes_trans_2022.pdf-It appears that theoretically the ALD will cover any procedure dependent on the prescribing providers recommendation, but that it is situationally applied in practice? Confirm more.
(2017) Trans healthcare lottery. P. 20. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		(2022) Report on the health and care pathways of trans people, p. 31. https://solidarites-sante.gouv.fr/IMG/pdf/rapport_sante_des_personnes_trans_2022.pdf(2022) Report on the health and care pathways of trans people, p. 41. https://solidarites-sante.gouv.fr/IMG/pdf/rapport_sante_des_personnes_trans_2022.pdf-It appears that theoretically the ALD will cover any procedure dependent on the prescribing providers recommendation, but that it is situationally applied in practice? Confirm more.
(2017) Trans healthcare lottery. P. 20. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		(2022) Report on the health and care pathways of trans people, p. 31. https://solidarites-sante.gouv.fr/IMG/pdf/rapport_sante_des_personnes_trans_2022.pdf-It appears that theoretically the ALD will cover any procedure dependent on the prescribing providers recommendation, but that it is situationally applied in practice? However, this is not specifically indicated as covered and respondent indicates no.
(2017) Trans healthcare lottery. P. 20. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		-Must be F.64
--They appear to be moving towards depathologization, but not implemented and still requires an F.64 (transsexualism) diagnosis for cost coverage*
(2022) Report on the health and care pathways of trans people. p. 4. https://solidarites-sante.gouv.fr/IMG/pdf/rapport_sante_des_personnes_trans_2022.pdf
(2018) The state decides who I am. p. 51. https://www.amnesty.eu/wp-content/uploads/2018/10/the_state_decides_who_I_am.pdf
-Moving towards depathologization, but still requires an F.64 (transsexualism) diagnosis for cost coverage
(2017). Trans healthcare lottery. p.17. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf

*(2010) Transgender persons' rights in the EU member states. p.11, 24-26. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf		-Must be F.64
--They appear to be moving towards depathologization, but not implemented and still requires an F.64 (transsexualism) diagnosis for cost coverage*
(2022) Report on the health and care pathways of trans people. p. 4. https://solidarites-sante.gouv.fr/IMG/pdf/rapport_sante_des_personnes_trans_2022.pdf
(2018) The state decides who I am. p.53. https://www.amnesty.eu/wp-content/uploads/2018/10/the_state_decides_who_I_am.pdf
(2017) Trans healthcare lottery. p. 17. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf

*(2010) Transgender persons' rights in the EU member states. p.11, 24-26. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf		See links in other cellsAs per respondent
(2020) The expectations of transgender people in the face of their helath-care access difficulties and how they can be overcome. A qualitative study in France. https://www.cambridge.org/core/journals/primary-health-care-research-and-development/article/expectations-of-transgender-people-in-the-face-of-their-healthcare-access-difficulties-and-how-they-can-be-overcome-a-qualitative-study-in-france/A0A151385D44C3FB8B971956DBFB5EFF
-Can be very long depending on healthcare path (SoFECT vs. community)		-On the basis of autism at least
(2015) SoFECT guidelines. p. 6-7. (see Google folder)		(2017) Trans Healthcare Lottery. p.32. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf
(2015) SoFECT guidelines. p. 6-7. (see Google folder)		(2017) Trans Healthcare Lottery. p. 26. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf
(2014). The state decides who I am. p. 53. https://www.amnesty.eu/wp-content/uploads/2018/10/the_state_decides_who_I_am.pdf
(2010) https://de.frwiki.wiki/wiki/FPATH		(2020) The expectations of transgender people in the face of their helath-care access difficulties and how they can be overcome. A qualitative study in France. p. 5. https://www.cambridge.org/core/journals/primary-health-care-research-and-development/article/expectations-of-transgender-people-in-the-face-of-their-healthcare-access-difficulties-and-how-they-can-be-overcome-a-qualitative-study-in-france/A0A151385D44C3FB8B971956DBFB5EFF
(2017) Trans Healthcare Lottery. p. 26. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		1
(2020) The expectations of transgender people in the face of their helath-care access difficulties and how they can be overcome. A qualitative study in France. p. 5. https://www.cambridge.org/core/journals/primary-health-care-research-and-development/article/expectations-of-transgender-people-in-the-face-of-their-healthcare-access-difficulties-and-how-they-can-be-overcome-a-qualitative-study-in-france/A0A151385D44C3FB8B971956DBFB5EFF
(2017) Trans Healthcare Lottery. p. 26. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf
(2018) The state decides who I am. P. 51. https://www.amnesty.eu/wp-content/uploads/2018/10/the_state_decides_who_I_am.pdf		-Judgement call. Procedure beureucratic and difficult in practice.
-Provision of trans healthcare specifically included
(2017) Current migration situation in the EU. p. 14. https://fra.europa.eu/en/publication/2017/current-migration-situation-eu-lesbian-gay-bisexual-transgender-and-intersex
(2016) Wellcome to stay: Building trans communities inclusive of asylum seekers. p. 9. https://tgeu.org/wp-content/uploads/2017/09/TGEU_TransAsylumBrochure_LR.pdf		NEI-At least in some cases physicians treat it as a contraindication.
(2009) Current situation and prospects for development of medical care of transsexualism in France. p. 124. https://www.has-sante.fr/upload/docs/application/pdf/2009-12/rapport_transsexualisme.pdf		-in policy
(2018) The plight of trans women in prison. https://www.buzzfeed.com/rozennlecarboulec/trans-women-in-french-prisons
(2015) In the European court of Human Rights-Bogdanova v Russia, p. 6. https://tgeu.org/wp-content/uploads/2015/07/Bogdanova-v-Russia_third-party-intervention-FINAL.pdf
(n.d.) Prison Insider comparison tool. https://www.prison-insider.com/en/compare/fr/be?profiles%5B0%5D=129180&profiles%5B1%5D=123333;		Acceptess-T has a prison Committee
-http://prison.eu.org/acceptess-t,14855;		(2022) Report on the health and care pathways of trans people. p.5. https://solidarites-sante.gouv.fr/IMG/pdf/rapport_sante_des_personnes_trans_2022.pdf
(2015) SoFECT guidelines. p. 14. (see Google folder)		15 or 16 usually, but can be younger
(2022) Report on the health and care pathways of trans people, p. 41. https://solidarites-sante.gouv.fr/IMG/pdf/rapport_sante_des_personnes_trans_2022.pdf
-15 usually, at the time of entry into high school
(2015) SoFECT guidelines. p. 14. (see Google folder)
-typically 16, but can be younger
32
TGEU Confirmation (score)11111111111111014211006-12 months111110NEI1160Tanner 22<1627
33
Germany
34
TGEU Confirmation (sources)(2020) Gender reassignment measures for transsexualism (ICD-10, F64). p. 25. https://md-bund.de/fileadmin/dokumente/Publikationen/GKV/Begutachtungsgrundlagen_GKV/BGA_Transsexualismus_201113.pdf
(2017) Trans healthcare lottery. p. 24. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf
(n.d.) Access to trans healthcare: The situation in Europe. https://www.thenewfederalist.eu/access-to-trans-healthcare-the-situation-in-europe?lang=fr		(2020) Gender reassignment measures for transsexualism (ICD-10, F64). p. 25. https://md-bund.de/fileadmin/dokumente/Publikationen/GKV/Begutachtungsgrundlagen_GKV/BGA_Transsexualismus_201113.pdf-Available information suggests this is theoretically possible. However. both respondents agree that it is not.
(2020) Gender reassignment measures for transsexualism (ICD-10, F64). p. 25. https://md-bund.de/fileadmin/dokumente/Publikationen/GKV/Begutachtungsgrundlagen_GKV/BGA_Transsexualismus_201113.pdf		(2020) Healthcare for Trans*gender People in Germany: Gaps, Challenges, and Perspectives. p. 3. https://www.frontiersin.org/articles/10.3389/fnins.2021.718335/full
(2017) Trans healthcare lottery. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		(2020) Healthcare for Trans*gender People in Germany: Gaps, Challenges, and Perspectives. p. 3. https://www.frontiersin.org/articles/10.3389/fnins.2021.718335/full
(2017) Trans healthcare lottery. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		(2020) Gender reassignment measures for transsexualism (ICD-10, F64). p. 28. https://md-bund.de/fileadmin/dokumente/Publikationen/GKV/Begutachtungsgrundlagen_GKV/BGA_Transsexualismus_201113.pdf(2020) Gender reassignment measures for transsexualism (ICD-10, F64). p. 25. https://md-bund.de/fileadmin/dokumente/Publikationen/GKV/Begutachtungsgrundlagen_GKV/BGA_Transsexualismus_201113.pdf
(2017) Trans healthcare lottery. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		(2020) Gender reassignment measures for transsexualism (ICD-10, F64). p. 28. https://md-bund.de/fileadmin/dokumente/Publikationen/GKV/Begutachtungsgrundlagen_GKV/BGA_Transsexualismus_201113.pdf(2020) Gender reassignment measures for transsexualism (ICD-10, F64). p. 28. https://md-bund.de/fileadmin/dokumente/Publikationen/GKV/Begutachtungsgrundlagen_GKV/BGA_Transsexualismus_201113.pdf(2020) Gender reassignment measures for transsexualism (ICD-10, F64). p. 28. https://md-bund.de/fileadmin/dokumente/Publikationen/GKV/Begutachtungsgrundlagen_GKV/BGA_Transsexualismus_201113.pdf-"Surgical penoid constuction (p.28)."
(2020) Gender reassignment measures for transsexualism (ICD-10, F64). p. 28. https://md-bund.de/fileadmin/dokumente/Publikationen/GKV/Begutachtungsgrundlagen_GKV/BGA_Transsexualismus_201113.pdf		-Could not confirm this, despite information touching on this issue. Went with respondent's answer, since HRT is covered and PB are available.-It seems possible that this might be covered given the wording of the policy below. However, it is not stated. Note also that "laryngeal surgery" is sometimes noted, which might conceivably include tracheal surgery, though this is not guaranteed.
(2020) Gender reassignment measures for transsexualism (ICD-10, F64). p. 28. https://md-bund.de/fileadmin/dokumente/Publikationen/GKV/Begutachtungsgrundlagen_GKV/BGA_Transsexualismus_201113.pdf		(2020) Gender reassignment measures for transsexualism (ICD-10, F64). p. 28. https://md-bund.de/fileadmin/dokumente/Publikationen/GKV/Begutachtungsgrundlagen_GKV/BGA_Transsexualismus_201113.pdf(2020) Gender reassignment measures for transsexualism (ICD-10, F64). p. 25. https://md-bund.de/fileadmin/dokumente/Publikationen/GKV/Begutachtungsgrundlagen_GKV/BGA_Transsexualismus_201113.pdfAccess to GCT but GCT funding, but with conditions.
(2018) https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf
(2017) German trans surgery bureaucracy 101. https://wunder2welt.wordpress.com/2017/10/14/german-trans-surgery-bureaucracy-101/
-Outlines process for getting approval.		-Diagnosis given according to ICD 10 w/ mandatory psychotherapy.
(2021) Four requests to improve healthcare for trans people. https://lgbtalliance.eu/four-requests-to-improve-healthcare-for-trans-people/
-Deals mostly with diagnosis as a requirement for LGR
(2018) The state decides who I am. p.83-89. https://www.amnesty.eu/wp-content/uploads/2018/10/the_state_decides_who_I_am.pdf
-Extensive diagnosis requirements, including long term psychotherapy
(2017). Trans healthcare lottery. p.20. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		-Diagnosis given according to ICD 10 w/ mandatory psychotherapy.
(2021) Four requests to improve healthcare for trans people. https://lgbtalliance.eu/four-requests-to-improve-healthcare-for-trans-people/
-Extensive diagnosis requirements, including long term psychotherapy
(2017) Trans healthcare lottery. p.20. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf
(2018) The state decides who I am. p.83-89. https://www.amnesty.eu/wp-content/uploads/2018/10/the_state_decides_who_I_am.pdf		See links in other cellsAs per respondents(2020) Gender reassignment measures for transsexualism (ICD-10, F64). p. 15(2020). Leaked report into German health insurance imposes tough new rules for trans people and erases non-binary people completely. https://www.pinknews.co.uk/2020/11/27/germany-trans-gender-affirmation-health-insurance-mds-gkv-spitzenverband/
-It says that any pre-existing mental illnesses must be “excluded or be adequately treated and stabilised” before gender dysphoria can be
diagnosed.
(2020) Gender Incongruity, Gender Dysphoria and Trans-Health: Diagnosis, Counseling, Treatment. https://www.awmf.org/leitlinien/detail/ll/138-001.html
-Discussion of needing to assess capacity to consent in cases of intellectual disability		-Could not confirm and only one respondent indicated this was an issue.(2021) https://ilga-europe.org/files/uploads/2022/04/annual-review-2021.pdf
(2020) Leaked report into German health insurance imposes tough new rules for trans people and erases non-binary people completely. https://www.pinknews.co.uk/2020/11/27/germany-trans-gender-affirmation-health-insurance-mds-gkv-spitzenverband/
(2020) Gender reassignment measures for transsexualism (ICD-10, F64.0). https://md-bund.de/fileadmin/dokumente/Publikationen/GKV/Begutachtungsgrundlagen_GKV/BGA_Transsexualismus_201113.pdf
(2017). Trans healthcare lottery. p. 31. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf
-Especially because, due to insurance policies, it can be difficult/impossible to receive surgery if one hasn't first received hormones.		1
(2017). Trans healthcare lottery. p. 31. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		(n.d.) https://www.queer-refugees.de/trans-3/
-If asylum procedure not completed or rejected
(2021) Queering asylum in Europe, p. 169, 392-393.https://library.oapen.org/bitstream/handle/20.500.12657/50709/978-3-030-69441-8.pdf?sequence=1&isAllowed=y
-Travel long distances to receive HRT
(2016) For the record-Documenting violence against trans people. p. 28. https://tgeu.org/wp-content/uploads/2017/04/FortheRecord_FINAL.pdf
(2016) Wellcome to stay: Building trans communities inclusive of asylum seekers. p. 5. https://tgeu.org/wp-content/uploads/2017/09/TGEU_TransAsylumBrochure_LR.pdf
(n.d.) https://www.queer-refugees.de/trans-3/
(n.d.) https://www.gesetze-im-internet.de/asylblg/AsylbLG.pdf; (n.d.) https://www.gesetze-im-internet.de/asylblg/__4.html
-One of the respondents recommended this doc. It suggests that "1) Other benefits may be granted, in particular, if they are essential in individual cases to ensure subsistence or health, to cover the special needs of children or to fulfill an administrative obligation to cooperate. The benefits are to be granted as benefits in kind or, in the case of special circumstances, as cash benefits."		-No information specific to trans individuals. However, refugees are not entitled to all healthcare (publicly) in Germany and the manner of accessing and degree to which they receive it differs according to their length of stay.
(n.d.) Health insurance for refugees/asylum seekers in Germany. https://www.germany-visa.org/insurances-germany/health-insurance/refugees-asylum-seekers/		-Could not confirm, but both respondents agree(proposed legislation) to regulate trans people's stay in Prison. Follow up indicates it passed and was adopted.
(2020) Statement on the Berlin draft law on the subject of accommodation of trans* and inter* people in prisons. https://www.bundesverband-trans.de/stellungnahme-zum-berliner-gesetzesentwurf-zum-thema-unterbringung-von-trans-und-inter-personen-im-justizvollzug/
(2020) Draft law to amend Berlin prison laws. https://www.bundesverband-trans.de/wp-content/uploads/2020/03/BVT_Stellungnahme_Justizvollzugsgesetz-Berlin.pdf
(n.d.) Prison-Insider. https://www.prison-insider.com/en/fichepays/allemagne-2021?s=populations-specifiques-5d9b19c2d4a4f
-"Transgender individuals can assert their rights to their own medical care. In certain cases. They can ask for 'psychotherapy care'."
(n.d.) Re-socialisation of offenders in the EU-Enhancing the role of the civil society. https://csd.bg/fileadmin/user_upload/publications_library/files/old_reinserted/14_2GER_22146.pdf		Note that the Law on Transsexuals specifically applied to asylum seekers and foreigners with a residence in Germany. This does not imply cost coverage however.
(2010) https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf"		(2020) Hormontal treatment of youth with trans identity. p. 2. https://link.springer.com/content/pdf/10.1007/s41969-020-00090-0.pdf16 is possible depedent on maturity and Timo Nieder also confirmed that <16 is possible
(2020) Hormontal treatment of youth with trans identity. p. 2. https://link.springer.com/content/pdf/10.1007/s41969-020-00090-0.pdf
-Usually 16.
(2017) Access to transgender hormone therapy. https://fra.europa.eu/de/publication/2017/mapping-minimum-age-requirements-concerning-rights-child-eu/access-transgender-hormone-therapy
35
TGEU Confirmation (score)11011111111101113211003-12 months11111111070Tanner 22<1627
36
Greece
37
TGEU Confirmation (sources)(2018) Trans and intersex equality rights in Europe. P. 78. https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf
-No info on healthcare procedures
(2010) Policy department C: Citizens' rights and constitutional affairs. p. 24 .https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf
-Indicates that SRS was covered on one occasion, but doesn't specify when or where. Marked as not covered, since this can't be verified or replicated in any way.		(2018) Trans and intersex equality rights in Europe. P. 78. https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf
-No info on healthcare procedures
(2010) Policy department C: Citizens' rights and constitutional affairs. p. 24 .https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf
-Indicates that SRS was covered on one occasion, but doesn't specify when or where. Marked as not covered, since this can't be verified or replicated in any way.		(2018) Trans and intersex equality rights in Europe. P. 78. https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf
-No info on healthcare procedures
(2010) Policy department C: Citizens' rights and constitutional affairs. p. 24 .https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf
-Indicates that SRS was covered on one occasion, but doesn't specify when or where. Marked as not covered, since this can't be verified or replicated in any way.		(2021) Analysis report on existing barriers and gaps to national health care sysstems regarding care for transgender people. p. 17. https://transcare-project.eu/wp-content/uploads/2021/03/D.2.1-Analysis-Report_EN.pdf(2021) Analysis report on existing barriers and gaps to national health care sysstems regarding care for transgender people. p. 17. https://transcare-project.eu/wp-content/uploads/2021/03/D.2.1-Analysis-Report_EN.pdf(2018) Trans and intersex equality rights in Europe. P. 78. https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf
-No info on healthcare procedures
(2010) Policy department C: Citizens' rights and constitutional affairs. p. 24 .https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf
-Indicates that SRS was covered on one occasion, but doesn't specify when or where. Marked as not covered, since this can't be verified or replicated in any way.		(2018) Trans and intersex equality rights in Europe. P. 78. https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf
-No info on healthcare procedures
(2010) Policy department C: Citizens' rights and constitutional affairs. p. 24 .https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf
-Indicates that SRS was covered on one occasion, but doesn't specify when or where. Marked as not covered, since this can't be verified or replicated in any way.		(2018) Trans and intersex equality rights in Europe. P. 78. https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf
-No info on healthcare procedures
(2010) Policy department C: Citizens' rights and constitutional affairs. p. 24 .https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf
-Indicates that SRS was covered on one occasion, but doesn't specify when or where. Marked as not covered, since this can't be verified or replicated in any way.		(2018) Trans and intersex equality rights in Europe. P. 78. https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf
-No info on healthcare procedures
(2010) Policy department C: Citizens' rights and constitutional affairs. p. 24 .https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf
-Indicates that SRS was covered on one occasion, but doesn't specify when or where. Marked as not covered, since this can't be verified or replicated in any way.		0(2018) Trans and intersex equality rights in Europe. P. 78. https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf
-No info on healthcare procedures
(2010) Policy department C: Citizens' rights and constitutional affairs. p. 24 .https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf
-Indicates that SRS was covered on one occasion, but doesn't specify when or where. Marked as not covered, since this can't be verified or replicated in any way.		(2018) Trans and intersex equality rights in Europe. P. 78. https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf
-No info on healthcare procedures
(2010) Policy department C: Citizens' rights and constitutional affairs. p. 24 .https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf
-Indicates that SRS was covered on one occasion, but doesn't specify when or where. Marked as not covered, since this can't be verified or replicated in any way.		-Could not confirm this specifically, as there don't appear to be any specific guidelines. Went with respondent statement, given that HRT was otherwise covered.
(2018) Trans and intersex equality rights in Europe. P. 78. https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf		(2018) Trans and intersex equality rights in Europe. P. 78. https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf
-No info on healthcare procedures
(2010) Policy department C: Citizens' rights and constitutional affairs. p. 24 .https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf
-Indicates that SRS was covered on one occasion, but doesn't specify when or where. Marked as not covered, since this can't be verified or replicated in any way.		(2018) Trans and intersex equality rights in Europe. P. 78. https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf
-No info on healthcare procedures
(2010) Policy department C: Citizens' rights and constitutional affairs. p. 24 .https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf
-Indicates that SRS was covered on one occasion, but doesn't specify when or where. Marked as not covered, since this can't be verified or replicated in any way.		0(2018) Trans and intersex equality rights in Europe. P. 78. https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf
-No info on healthcare procedures
(2010) Policy department C: Citizens' rights and constitutional affairs. p. 24. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf
-Indicates that SRS was covered on one occasion, but doesn't specify when or where. Marked as not covered, since this can't be verified or replicated in any way.		-Very little information on trans healthcare in Greece.
-As per below, diagnosis "required in order to undergo sterilization/hormone therapy/other gender reassignment measures (p.11)."
(2017) Psychiatry in legal gender recognition procedures in Europe. p.10-11. ttp://hlcmr.de/wp-content/uploads/2017/01/Psychiatry-in-legal-gender-recognition-procedures-in-Europe.pdf		-Very little information on trans healthcare in Greece.
-As per below, diagnosis "required in order to undergo sterilization/hormone therapy/other gender reassignment measures (p.11)."
(2017) Psychiatry in legal gender recognition procedures in Europe. p.10-11. ttp://hlcmr.de/wp-content/uploads/2017/01/Psychiatry-in-legal-gender-recognition-procedures-in-Europe.pdf		See links in other cellsAs per respondent-No information could be found on this. However, the respondent asserts that this was a difficulty and the general country conditions would seem to agree.NEI-No information could be found on this. However, the respondent asserts that this was a difficulty and the general country conditions would seem to agree.-No information could be found on this. However, the respondent asserts that this was a difficulty and the general country conditions would seem to agree.1
-No information could be found on this. However, the respondent asserts that this was a difficulty and the general country conditions would seem to agree.		(2018) Trans refugees fled to Greece for a better life. They found intolerance. https://www.vox.com/identities/2018/3/6/16929836/trans-refugees-greece-middle-east
(2017) Current migration situation in the EU. p 15. https://fra.europa.eu/sites/default/files/fra_uploads/fra-march-2017-monthly-migration-report-focus-lgbti_en.pdf		NEINo evidence one way or another. Put yes because respondent indicated it was and because BMI limits for trans surgeries exist widely.(2021) Press release: positive and important development in the direction of removing direcrimination and violence faced by trans people in prisons or in detention. https://tgender.gr/deltio-typoy-thetiki-kai-simantiki-ex/NEI18 (w/o parental or public authority consent)
(2017) Access to transgender hormone therapy. https://fra.europa.eu/de/publication/2017/mapping-minimum-age-requirements-concerning-rights-child-eu/access-transgender-hormone-therapy
38
TGEU Confirmation (score)NEINEINEI11NEINEINEINEINEINEI1NEINEINEI3011001-2 months21NEI111NEI1160NEI01802
39
Hungary
40
TGEU Confirmation (sources)NEI
-No evidence one way or another, but given limitations this is highly unlikely		NEI
-No evidence one way or another, but given limitations this is highly unlikely		NEI
-No evidence one way or another, but given limitations this is highly unlikely		(2022) Tranz Kisokos. p. 15. https://transvanilla.hu/images/letoltesek/transz_kisokos.pdf
(2015). Legal aspects of gender dysphoria and the treatment process in Hungary. p. 6. https://www.researchgate.net/publication/280114497_Legal_aspects_and_the_treatment_procedure_of_gender_dysphoria_in_Hungary
-Healthcare: Theoretically possible to have larger amount of cost covered, but probably unlikely.		(2022) Tranz Kisokos. p. 15. https://transvanilla.hu/images/letoltesek/transz_kisokos.pdf
(2015). Legal aspects of gender dysphoria and the treatment process in Hungary. p. 6. https://www.researchgate.net/publication/280114497_Legal_aspects_and_the_treatment_procedure_of_gender_dysphoria_in_Hungary
-Healthcare: Theoretically possible to have larger amount of cost covered, but probably unlikely.		NEINEI
-Note, however, that respondent indicateed that chest masculinization was covered when they might have meant this.		NEI
-No evidence one way or another, but given limitations this is highly unlikely		NEINEI-Healthcare is getting worse. Could not independently confirm access to these specific procedures. However, I could confirm that some limited surgery remains available. Opted to take the respondent's suggestion.
-One university clinic that provides genital surgery w/ 10% insurance support.
(2022) Tranz Kisokoos. p. 16, 37. https://transvanilla.hu/images/letoltesek/transz_kisokos.pdf
-No nationally valid guidelines for trans-specific healthcare. Increasingly available in private clinics only.
(2018) Trans and intersex equality rights in Europe. p. 78. https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf.
(2010) Transgender persons' rights in the EU member states. p. 29. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf		-Treatment not available (see questions re: youth)NEI
-No evidence one way or another, but given limitations this is highly unlikely		-Healthcare is getting worse. Could not independently confirm access to these specific procedures. However, I could confirm that some limited surgery remains available. Opted to take the respondent's suggestion.
-One university clinic that provides genital surgery w/ 10% insurance support.
(2022) Tranz Kisokoos. p. 16, 37. https://transvanilla.hu/images/letoltesek/transz_kisokos.pdf
-No nationally valid guidelines for trans-specific healthcare. Increasingly available in private clinics only.
(2018) Trans and intersex equality rights in Europe. p. 80. https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf.
(2010) Transgender persons' rights in the EU member states. p. 31. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf		NEI
-No evidence one way or another, but given limitations this is highly unlikely		-Healthcare is getting worse. Could not independently confirm access to these specific procedures. However, I could confirm that some limited surgery remains available. Opted to take the respondent's suggestion.
-One university clinic that provides genital surgery w/ 10% insurance support.
(2022) Tranz Kisokoos. p. 16, 37. https://transvanilla.hu/images/letoltesek/transz_kisokos.pdf
-No nationally valid guidelines for trans-specific healthcare. Increasingly available in private clinics only.
(2018) Trans and intersex equality rights in Europe. p. 80. https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf.
(2010) Transgender persons' rights in the EU member states. p. 31. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf		(2021) A guide to trans-specific health care based on human rights. p.5. https://mail.transvanilla.hu/images/letoltesek/utmutatoazemberijogokonalapulo_keszwebre.pdf
(2017) Psychiatry in legal gender recognition procedures in Europe. p.10. ttp://hlcmr.de/wp-content/uploads/2017/01/Psychiatry-in-legal-gender-recognition-procedures-in-Europe.pdf		(2021) A guide to trans-specific health care based on human rights. p.5. https://mail.transvanilla.hu/images/letoltesek/utmutatoazemberijogokonalapulo_keszwebre.pdf
(2017) Psychiatry in legal gender recognition procedures in Europe. p.10. ttp://hlcmr.de/wp-content/uploads/2017/01/Psychiatry-in-legal-gender-recognition-procedures-in-Europe.pdf		See links in other cellsAs per respondent(2021) A guide to trans-specific health care based on human rights. p.5. https://mail.transvanilla.hu/images/letoltesek/utmutatoazemberijogokonalapulo_keszwebre.pdf(2021) A guide to trans-specific health care based on human rights. p.5. https://mail.transvanilla.hu/images/letoltesek/utmutatoazemberijogokonalapulo_keszwebre.pdf(2021) A guide to trans-specific health care based on human rights. p.5. https://mail.transvanilla.hu/images/letoltesek/utmutatoazemberijogokonalapulo_keszwebre.pdf(2021) A guide to trans-specific health care based on human rights. p.5. https://mail.transvanilla.hu/images/letoltesek/utmutatoazemberijogokonalapulo_keszwebre.pdf1
(2021) A guide to trans-specific health care based on human rights. p.5. https://mail.transvanilla.hu/images/letoltesek/utmutatoazemberijogokonalapulo_keszwebre.pdf		(2021) A guide to trans-specific health care based on human rights. p.5, 7. https://mail.transvanilla.hu/images/letoltesek/utmutatoazemberijogokonalapulo_keszwebre.pdf
(2018) Trans healthcare in Asylum reception conditions. p. 3. https://tgeu.org/trans-healthcare-in-asylum-reception-conditions/
(2017) Current migration situation in the EU. p. 15. https://fra.europa.eu/en/publication/2017/current-migration-situation-eu-lesbian-gay-bisexual-transgender-and-intersex
-Hormones/SRS repudedly illegal prior to document change, which isn't possible for non-Hungarians (p.9).
(2016) Wellcome to stay: Building trans communities inclusive of asylum seekers. p. 5. https://tgeu.org/wp-content/uploads/2017/09/TGEU_TransAsylumBrochure_LR.pdf		(2021) A guide to trans-specific health care based on human rights. p.5, 7. https://mail.transvanilla.hu/images/letoltesek/utmutatoazemberijogokonalapulo_keszwebre.pdf
-Hormones/SRS repudedly illegal prior to document change, which isn't possible for non-Hungarians (p.9).
(2018) Trans healthcare in Asylum reception conditions. p. 3. https://tgeu.org/trans-healthcare-in-asylum-reception-conditions/
(2016) Wellcome to stay: Building trans communities inclusive of asylum seekers. p. 5. https://tgeu.org/wp-content/uploads/2017/09/TGEU_TransAsylumBrochure_LR.pdf		-No evidence one way or another. Put yes because one respondent indicated it was and because BMI limits for trans surgeries exist widely.-Could not confirm, but both respondents agree."In practice gender affirming interventions can be accessed over 18."
(2022) Tranz Kisokoos. p. 26. https://transvanilla.hu/images/letoltesek/transz_kisokos.pdf
(2017) https://fra.europa.eu/de/publication/2017/mapping-minimum-age-requirements-concerning-rights-child-eu/access-transgender-hormone-therapy
-States 18 w/o parental consent. However, this appears to be superceded by more recent policy/legislation.		"In practice gender affirming interventions can be accessed over 18."
(2022) Tranz Kisokoos. p. 26-27.https://transvanilla.hu/images/letoltesek/transz_kisokos.pdf
(2017) https://fra.europa.eu/de/publication/2017/mapping-minimum-age-requirements-concerning-rights-child-eu/access-transgender-hormone-therapy
-States 18 w/o parental consent. However, this appears to be superceded by more recent policy/legislation.
41
TGEU Confirmation (score)NEINEINEI11NEINEINEINEINEI10NEI1NEI4011001-6 months211111111801801802
42
Ireland
43
TGEU Confirmation (sources)NEINEI(n.d.) National gender service Ireland. https://nationalgenderserviceireland.com/surgery/(2022) My first-hand experience with transgender healthcare in Ireland. https://trinitynews.ie/2022/06/my-first-hand-experience-with-transgender-healthcare-in-ireland/
(2018) https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf		(2022) My first-hand experience with transgender healthcare in Ireland. https://trinitynews.ie/2022/06/my-first-hand-experience-with-transgender-healthcare-in-ireland/
(2018) https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf		(n.d.) National gender service Ireland.https://nationalgenderserviceireland.com/surgery/-referral provided by GIC. No public access, but possible to apply for funding if private insurance unavailable. References cross-border directive (pay up front and get reimbursed)
-Note that respondent very publicly crowd funded his top surgery because of obstructive wait lists.
(2021) HSE takes steps towards delivering healthcare for trans young in Ireland. https://gcn.ie/hse-takes-steps-towards-delivering-healthcare-trans-youth-ireland/
(n.d.) National gender service Ireland.https://nationalgenderserviceireland.com/surgery/		-Some information that this is possible via "treatment abroad scheme." Specifically, "the scheme will fund bottom surgery anywhere in the EU". However, neither respondent could confirm and current situation in Ireland may make this impossible in practice.
(n.d.) National gender service Ireland.https://nationalgenderserviceireland.com/surgery/
(n.d. ) https://www2.hse.ie/services/schemes-allowances/treatment-abroad/about/"		-Some information that this is possible via "treatment abroad scheme." However, neither respondent could confirm and current situation in Ireland may make this impossible in practice.
(n.d.) National gender service Ireland.https://nationalgenderserviceireland.com/surgery/		(n.d.) National gender service Ireland.https://nationalgenderserviceireland.com/surgery/-Some information that this is possible via "treatment abroad scheme." However, neither respondent could confirm and current situation in Ireland may make this impossible in practice.
(n.d.) National gender service Ireland.https://nationalgenderserviceireland.com/surgery/
(n.d.) https://www2.hse.ie/services/schemes-allowances/treatment-abroad/about/		-May be available under regular circumstances, but no care possible at this time (see citations for youth care)(n.d.) National gender service Ireland.https://nationalgenderserviceireland.com/surgery/-Some information that this is possible via "treatment abroad scheme." However, neither respondent could confirm and current situation in Ireland may make this impossible in practice.
(n.d.) National gender service Ireland.https://nationalgenderserviceireland.com/surgery/
(n.d.) https://www2.hse.ie/services/schemes-allowances/treatment-abroad/about/		-Could not confirm, but both respondents agree.Only access to hormones/no surgery, access to GCT funding, but with conditions. Also specifies that Ireland covers surgery abroad, but not what procedures.
(2018) https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf
(2014) The state decides who I am. p. 60. https://www.amnesty.eu/wp-content/uploads/2018/10/the_state_decides_who_I_am.pdf
-No policies or standards of care governing access to healthcare.		(2022) My first-hand experience with transgender healthcare in Ireland. https://trinitynews.ie/2022/06/my-first-hand-experience-with-transgender-healthcare-in-ireland/
(2018) The state decides who I am. p. 58-69. https://www.amnesty.eu/wp-content/uploads/2018/10/the_state_decides_who_I_am.pdf		(2022) My first-hand experience with transgender healthcare in Ireland. https://trinitynews.ie/2022/06/my-first-hand-experience-with-transgender-healthcare-in-ireland/
(2018) The state decides who I am. p. 58-69. https://www.amnesty.eu/wp-content/uploads/2018/10/the_state_decides_who_I_am.pdf		See links in other cells(2021) Four requests to improve healthcare for trans people. https://lgbtalliance.eu/four-requests-to-improve-healthcare-for-trans-people/
(2021) A state of collapse: Trans healthcare in Ireland is a national emergency. https://gcn.ie/trans-healthcare-ireland-national-emergency/
(n.d.) https://nationalgenderserviceireland.com/waiting-times-2/
-National Gender service says 2.5-3 yrs for first appointment, but this is clearly not accurate.		(2022) My first-hand experience with transgender healthcare in Ireland. https://trinitynews.ie/2022/06/my-first-hand-experience-with-transgender-healthcare-in-ireland/
(2022) https://gcn.ie/national-gender-service-crisis-ireland-fails-who-obligation/
(2021) A state of collapse: Trans healthcare in Ireland is a national emergency. https://gcn.ie/trans-healthcare-ireland-national-emergency/
(2014) The state decides who I am. p. 66. https://www.amnesty.org/en/documents/eur01/001/2014/en/		(2022) National gender service crisis ireland. https://gcn.ie/national-gender-service-crisis-ireland-fails-who-obligation/
(2018) Oppression squared. https://tgeu.org/wp-content/uploads/2018/02/Oppression-Squared.pdf
(2014) The state decides who I am. p. 66. https://www.amnesty.org/en/documents/eur01/001/2014/en/		-Seems likely depending on healthcare provider (e.g. O'Shea)Could not conform, but both respondents agree1
(2014) being trans in the european union, p. 45. https://fra.europa.eu/sites/default/files/fra-2014-being-trans-eu-comparative-0_en.pdf		"Access to health care is free for protection applicants living in Direct Provision and is expressly provided for in the Reception Conditions Regulations.[1] The Minister for Health is required to ensure that a recipient has access to emergency health care, treatment for serious illnesses and mental disorders, other health care for maintaining their health, and mental health care assessed as necessary for vulnerable persons."
(n.d.) Aida Health Care Public of Ireland. https://asylumineurope.org/reports/country/republic-ireland/reception-conditions/health-care/		-Could not confirm. Though both respondents agree, this may be due to conflating refugee healthcare with asylum/undocumented migrant care. No available information suggests that documented and accepted refugees are legislatively treated differently, though there may be discrimination by individual providers.
(2022). Health care: Republic of Ireland. https://asylumineurope.org/reports/country/republic-ireland/reception-conditions/health-care/		(2021) Guide for providing care for transgender patients in primary care. p. 13, https://www.icgp.ie/speck/properties/asset/asset.cfm?type=LibraryAsset&id=11C10660%2DB01B%2D4F35%2DB91232E649543AC1&property=asset&revision=tip&disposition=inline&app=icgp&filename=ICGP%5FTrans%5FHealth%5FQRG%5Fv%2E2%5F%5F1%5F%2Epdf-Prison authorities indicate there are no problems, but report expresses doubt.
(2016). Out on the inside. P. 22. https://www.iprt.ie/site/assets/files/6369/iprt_out_on_the_inside_2016_embargo_to_1030_feb_02_2016.pdf		-Because the clinic is currently closed and not seeing patients. I marked this as 18 because it's effectively impossible to receive this care.
(2022) My first-hand experience with transgender healthcare in Ireland. https://trinitynews.ie/2022/06/my-first-hand-experience-with-transgender-healthcare-in-ireland/
(2022) ILGA Annual review. https://ilga-europe.org/files/uploads/2022/04/annual-review-2022.pdf
(2021) Four requests to improve healthcare for trans people. https://lgbtalliance.eu/four-requests-to-improve-healthcare-for-trans-people/
(2021). Trans children being referred to healthcare service that 'doesn't exist yet'. https://www.thejournal.ie/transgender-healthcare-crumlin-ireland-5351942-Feb2021/		Children's GIC not currently taking referrals at all, so effectively no care prior to 18 and probably closer to 28 given wait list.
(2021) https://gcn.ie/hse-ending-care-for-young-trans-people/		-Because the clinic is currently closed and not seeing patients. I marked this as 18 because it's effectively impossible to receive this care.
16 w/o parental consent (however, currently not accepting further referrals)
(2021) HSE takes steps towards delivering healthcare for trans young in Ireland. https://gcn.ie/hse-takes-steps-towards-delivering-healthcare-trans-youth-ireland/
-Recruiting a clinician. Currently care outsourced to UK. Not sure how that works with their current stance on PB.
(2021) HSE ending care for young trans people. https://gcn.ie/hse-ending-care-for-young-trans-people/
(2017) https://fra.europa.eu/en/publication/2017/mapping-minimum-age-requirements-concerning-rights-child-eu/access-sex-reassignment-surgery
44
TGEU Confirmation (score)NEINEI01111NEINEI1NEI00NEI16111002-5-10 years011110011601801801
45
Italy
46
TGEU Confirmation (sources)(n.d.) Infotrans. https://www.infotrans.it/en-schede-65-augmentation_mammoplasty_transgender(2017) Trans healthcare lottery. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf
(n.d.) Access to trans healthcare: The situation in Europe. https://www.thenewfederalist.eu/access-to-trans-healthcare-the-situation-in-europe?lang=fr		(2017). Trans healthcare lottery. P. 25. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf
(n.d.) Access to trans healthcare: The situation in Europe. https://www.thenewfederalist.eu/access-to-trans-healthcare-the-situation-in-europe?lang=fr		(n.d.) Infotrans. https://www.infotrans.it/en-schede-63-hormonal_therapy
(2021) https://ilga-europe.org/files/uploads/2022/04/annual-review-2021.pdf
(2017) Trans healthcare lottery. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		(n.d.) Infotrans. https://www.infotrans.it/en-schede-63-hormonal_therapy
(2021) https://ilga-europe.org/files/uploads/2022/04/annual-review-2021.pdf
(2020) https://www.gay.it/transgender-azione-legale-aifa-evisione-modalita-accesso-farmaci
-Apparently AIFA (Italian Medicines Agency) has or tried to enact a policy whereby HRT (or possibly only testosterone) required treatment from a GIC and a transsexuality diagnosis, regardless of whether treatment was covered by public health or not
(2017) Trans healthcare lottery. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		(2017) Trans healthcare lottery. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf
(n.d.). Infotrans. https://www.infotrans.it/en-schede-70-hysterectomy_ovariectomy_transgender		(2017) Trans healthcare lottery. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf
(2010) https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf
(n.d.) Infotrans. https://www.infotrans.it/en-schede-65-augmentation_mammoplasty_transgender		(n.d.) Infotrans. https://www.infotrans.it/en-schede-65-augmentation_mammoplasty_transgender(2017) Trans healthcare lottery. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf
(n.d.) Infotrans. https://www.infotrans.it/en-schede-66-bilateral_orchiectomy_transgender		(2017) Trans healthcare lottery. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf
(n.d.) Infotrans. https://www.infotrans.it/en-schede-70-hysterectomy_ovariectomy_transgender		(n.d.) Infotrans. https://www.infotrans.it/en-schede-91-transgender_phalloplasty_surgery(2020) p. 6. Gender diverse children adn adolescents in italy. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7766564/-No solid information, but appears unlikely.(n.d.) Infotrans. https://www.infotrans.it/en-schede-67-penile_scrotal_inversion_vaginoplasty_transgenderNEIConflicting info; (Sources) Limited to the removal of the testes and uterus; private insurers do not list trans healthcare because it is linked to a psychiatric disorder; facial feminisation and hair removal excluded, though ff has been sporadically covered by private insurers; (Spoke w/ GIC practitioner Lorenzo from Turin @ EPATH Summer School) All procedures available and covered, including phallo, but individual GICs may decide whether or not to forward someone's application for coverage and some do not do so for particular procedures. Difficult for non-binary folks.(2021) ILGA annual report.p.64. https://ilga-europe.org/files/uploads/2022/04/annual-review-2021.pdf
-Diagnosis implicitly "required in order to undergo sterilization/hormone therapy/other gender reassignment measures (p.11)."
(2017) Psychiatry in legal gender recognition procedures in Europe. p.10-11. http://hlcmr.de/wp-content/uploads/2017/01/Psychiatry-in-legal-gender-recognition-procedures-in-Europe.pdf
-Court judgement required to undergo
(2017) Trans healthcare lottery. p. 39. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		(2021) ILGA annual report.p.64. https://ilga-europe.org/files/uploads/2022/04/annual-review-2021.pdf
-Diagnosis implicitly "required in order to undergo sterilization/hormone therapy/other gender reassignment measures (p.11)."
(2017) Psychiatry in legal gender recognition procedures in Europe. p.10-11. http://hlcmr.de/wp-content/uploads/2017/01/Psychiatry-in-legal-gender-recognition-procedures-in-Europe.pdf
-Court judgement required to undergo
(2017) Trans healthcare lottery. p. 39. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		(2021) https://ilga-europe.org/files/uploads/2022/04/annual-review-2021.pdfAs per respondents(2020) Legal gender recognition in the EU: The journeys of trans people towards full equality. p. 130. https://ec.europa.eu/info/sites/default/files/legal_gender_recognition_in_the_eu_the_journeys_of_trans_people_towards_full_equality_sept_en.pdf
(n.d.) https://www.infotrans.it/en-schede-61-the_psychiatrist_s_role		(2020) Legal gender recognition in the EU. p. 144. https://ec.europa.eu/info/sites/default/files/legal_gender_recognition_in_the_eu_the_journeys_of_trans_people_towards_full_equality_sept_en.pdf
(2020) p. 6. Gender diverse children adn adolescents in italy. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7766564/
(n.d.) https://www.infotrans.it/en-schede-61-the_psychiatrist_s_role		-No information could be found on this. However, the respondent asserts that this was a difficulty and the general country conditions would seem to agree.
-Note also that I biased here towards the trans respondent (anonymous)		-"Another non-binary person living in Italy pointed to a lack of understanding about the diversity of transgender identities, and of what it means to be non-binary (p.38)."
(2020). Legal gender recognition in the EU. p. 38. https://ec.europa.eu/info/sites/default/files/legal_gender_recognition_in_the_eu_the_journeys_of_trans_people_towards_full_equality_sept_en.pdf
-"taly is still not ready for non-binary people or people in transition! (p.8)."
(2020) Gender diverse children and adolescents in italy. p.8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7766564/		1
-"They noted that the psychologists involved act as gatekeepers for hormone therapy and that this particularly impacts on non-binary people and those who do not conform to gender stereotypes, who may not fit the characteristics that healthcare professionals are looking for in order to determine if someone is trans (p.46)."
(2020). Legal gender recognition in the EU. p. 46. https://ec.europa.eu/info/sites/default/files/legal_gender_recognition_in_the_eu_the_journeys_of_trans_people_towards_full_equality_sept_en.pdf		(2021) Queering asylum in Europe, 169, 393. https://library.oapen.org/bitstream/handle/20.500.12657/50709/978-3-030-69441-8.pdf?sequence=1&isAllowed=y
(n.d.) Health services. https://help.unhcr.org/italy/services/health/
(From Lorenzo, Turin GIC, spoke to at EPATH Summer School) States that asylum seekers are covered for all stages of trans healthcare (may be regionally specific)		-Not as distinct from asylum seekers or undocumented migrants, other than language barriers.NEI-Can continue treatment started before prison, but no right to start in prison.
-As per conversation w/ Lorenzo. It can be difficult and take time to get prison authorities to comply.
(2020). Contemporary transgender health experience and health situation in prisons: A scoping review of extant published literature. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8726645/
-Agrees w/ Lorenzo that there are policies leaning towards guaranteeing access. Problem appears to be in prison administration and bureaucracy.
(2020) Mapping of good practices for the management of transgender prisoners: Literature review. p. 35. https://www.undp.org/sites/g/files/zskgke326/files/migration/th/UNDP-TH-the-mapping-of-good-practices-for-the-management-of-transgender-prisoners.pdf
(n.d.) https://www.prison-insider.com/en/compare/fr/be?profiles=132074-140096		(2020) Gender diverse children and adolescents in italy.p. 2 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7766564/16
(2020) Gender diverse children and adolescents in italy.p. 2 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7766564/
(2017) https://fra.europa.eu/de/publication/2017/mapping-minimum-age-requirements-concerning-rights-child-eu/access-transgender-hormone-therapy
47
TGEU Confirmation (score)100111111111NEI1NEI11211003-12 months1111100NEI151<1621617
48
Latvia
49
TGEU Confirmation (sources)-No specific access to GCT and transition explicitly not funded.
-"Sex change is not considered a necessary health-related medical treatment and is highly expensive. It is currently unclear whether the costs of sex change operations are tax deductible (p. 28)."
(2015). If I were pretty, I would like to be a girl! Debating transsexualism in the Latvian parliament. https://sciendo.com/pdf/10.1515/genst-2015-0013
(2010) Transgender persons' rights in the EU member states. p. 28. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf		-No specific access to GCT and transition explicitly not funded.
-"Sex change is not considered a necessary health-related medical treatment and is highly expensive. It is currently unclear whether the costs of sex change operations are tax deductible (p. 28)."
(2015). If I were pretty, I would like to be a girl! Debating transsexualism in the Latvian parliament. https://sciendo.com/pdf/10.1515/genst-2015-0013
(2010) Transgender persons' rights in the EU member states. p. 28. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf		-No specific access to GCT and transition explicitly not funded.
-"Sex change is not considered a necessary health-related medical treatment and is highly expensive. It is currently unclear whether the costs of sex change operations are tax deductible (p. 28)."
(2015). If I were pretty, I would like to be a girl! Debating transsexualism in the Latvian parliament. https://sciendo.com/pdf/10.1515/genst-2015-0013
(2010) Transgender persons' rights in the EU member states. p. 28. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf		-No specific access to GCT and transition explicitly not funded.
-"Sex change is not considered a necessary health-related medical treatment and is highly expensive. It is currently unclear whether the costs of sex change operations are tax deductible (p. 28)."
(2015). If I were pretty, I would like to be a girl! Debating transsexualism in the Latvian parliament. https://sciendo.com/pdf/10.1515/genst-2015-0013
(2010) Transgender persons' rights in the EU member states. p. 28. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf		-No specific access to GCT and transition explicitly not funded.
-"Sex change is not considered a necessary health-related medical treatment and is highly expensive. It is currently unclear whether the costs of sex change operations are tax deductible (p. 28)."
(2015). If I were pretty, I would like to be a girl! Debating transsexualism in the Latvian parliament. https://sciendo.com/pdf/10.1515/genst-2015-0013
(2010) Transgender persons' rights in the EU member states. p. 28. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf		-No specific access to GCT and transition explicitly not funded.
-"Sex change is not considered a necessary health-related medical treatment and is highly expensive. It is currently unclear whether the costs of sex change operations are tax deductible (p. 28)."
(2015). If I were pretty, I would like to be a girl! Debating transsexualism in the Latvian parliament. https://sciendo.com/pdf/10.1515/genst-2015-0013
(2010) Transgender persons' rights in the EU member states. p. 28. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf		-No specific access to GCT and transition explicitly not funded.
-"Sex change is not considered a necessary health-related medical treatment and is highly expensive. It is currently unclear whether the costs of sex change operations are tax deductible (p. 28)."
(2015). If I were pretty, I would like to be a girl! Debating transsexualism in the Latvian parliament. https://sciendo.com/pdf/10.1515/genst-2015-0013
(2010) Transgender persons' rights in the EU member states. p. 28. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf		-No specific access to GCT and transition explicitly not funded.
-"Sex change is not considered a necessary health-related medical treatment and is highly expensive. It is currently unclear whether the costs of sex change operations are tax deductible (p. 28)."
(2015). If I were pretty, I would like to be a girl! Debating transsexualism in the Latvian parliament. https://sciendo.com/pdf/10.1515/genst-2015-0013
(2010) Transgender persons' rights in the EU member states. p. 28. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf		-No specific access to GCT and transition explicitly not funded.
-"Sex change is not considered a necessary health-related medical treatment and is highly expensive. It is currently unclear whether the costs of sex change operations are tax deductible (p. 28)."
(2015). If I were pretty, I would like to be a girl! Debating transsexualism in the Latvian parliament. https://sciendo.com/pdf/10.1515/genst-2015-0013
(2010) Transgender persons' rights in the EU member states. p. 28. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf		-No specific access to GCT and transition explicitly not funded.
-"Sex change is not considered a necessary health-related medical treatment and is highly expensive. It is currently unclear whether the costs of sex change operations are tax deductible (p. 28)."
(2015). If I were pretty, I would like to be a girl! Debating transsexualism in the Latvian parliament. https://sciendo.com/pdf/10.1515/genst-2015-0013
(2010) Transgender persons' rights in the EU member states. p. 28. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf		-No specific access to GCT and transition explicitly not funded.
-"Sex change is not considered a necessary health-related medical treatment and is highly expensive. It is currently unclear whether the costs of sex change operations are tax deductible (p. 28)."
(2015). If I were pretty, I would like to be a girl! Debating transsexualism in the Latvian parliament. https://sciendo.com/pdf/10.1515/genst-2015-0013
(2010) Transgender persons' rights in the EU member states. p. 28. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf		-No specific access to GCT and transition explicitly not funded.
-"Sex change is not considered a necessary health-related medical treatment and is highly expensive. It is currently unclear whether the costs of sex change operations are tax deductible (p. 28)."
(2015). If I were pretty, I would like to be a girl! Debating transsexualism in the Latvian parliament. https://sciendo.com/pdf/10.1515/genst-2015-0013
(2010) Transgender persons' rights in the EU member states. p. 28. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf		-No specific access to GCT and transition explicitly not funded.
-"Sex change is not considered a necessary health-related medical treatment and is highly expensive. It is currently unclear whether the costs of sex change operations are tax deductible (p. 28)."
(2015). If I were pretty, I would like to be a girl! Debating transsexualism in the Latvian parliament. https://sciendo.com/pdf/10.1515/genst-2015-0013
(2010) Transgender persons' rights in the EU member states. p. 28. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf		-No specific access to GCT and transition explicitly not funded.
-"Sex change is not considered a necessary health-related medical treatment and is highly expensive. It is currently unclear whether the costs of sex change operations are tax deductible (p. 28)."
(2015). If I were pretty, I would like to be a girl! Debating transsexualism in the Latvian parliament. https://sciendo.com/pdf/10.1515/genst-2015-0013
(2010) Transgender persons' rights in the EU member states. p. 28. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf		-No specific access to GCT and transition explicitly not funded.
-"Sex change is not considered a necessary health-related medical treatment and is highly expensive. It is currently unclear whether the costs of sex change operations are tax deductible (p. 28)."
(2015). If I were pretty, I would like to be a girl! Debating transsexualism in the Latvian parliament. https://sciendo.com/pdf/10.1515/genst-2015-0013
(2010) Transgender persons' rights in the EU member states. p. 28. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf		-Very little to no information. Interesting article on a phalloplasty performed in Latvian SSR during 60s though.
(2018) The trans man whose pioneering surgery was a state secret for decades. https://www.buzzfeednews.com/article/turovsky/soviet-doctor-trans-history
-No specific access to GCT and transition explicitly not funded.
-"Sex change is not considered a necessary health-related medical treatment and is highly expensive. It is currently unclear whether the costs of sex change operations are tax deductible (p. 28)."
(2015). If I were pretty, I would like to be a girl! Debating transsexualism in the Latvian parliament. https://sciendo.com/pdf/10.1515/genst-2015-0013
(2010) Transgender persons' rights in the EU member states. p. 28. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf		-That said, available information indicates that one is required.
-Diagnosis implicitly "required in order to undergo sterilization/hormone therapy/other gender reassignment measures (p.11)."
(2017) Psychiatry in legal gender recognition procedures in Europe. p.10-11. http://hlcmr.de/wp-content/uploads/2017/01/Psychiatry-in-legal-gender-recognition-procedures-in-Europe.pdf		-That said, available information indicates that one is required.
-Diagnosis implicitly "required in order to undergo sterilization/hormone therapy/other gender reassignment measures (p.11)."
(2017) Psychiatry in legal gender recognition procedures in Europe. p.10-11. http://hlcmr.de/wp-content/uploads/2017/01/Psychiatry-in-legal-gender-recognition-procedures-in-Europe.pdf		-No coverageAs per respondent
I could not find any reference to the state clinic online and thus couldn't determine their waiting period (the respondent makes reference to a longer one, but doesn't specify length)		NEI-No information could be found on this. However, the respondent asserts that this was a difficulty and the general country conditions would seem to agree.NEINEINEI-Latvia does appear to provide healthcare (emergency and primary) to asylum seekers, refugees, and those with alternative status. Since they don't really provide trans healthcare, it can be assumed that this is also true for migrants et al.
(2021) Social assistance, protection and health care. https://www.redcross.lv/uploads/2021/10/social-assistance-and-health-care-eng.pdf		NEINEI-Almost certainly not. No information one way or the other, but this seems obvious.I could verify barely any for Latvia. It seems problematic to give the country a good score in this regard.18
No information. As per respondent.
50
TGEU Confirmation (score)0000000000000000011006-12 months1NEI1NEINEINEINEINEINEI121801803
51
Lithuania
52
TGEU Confirmation (sources)
-GRS banned.
(2022) Restriction of access to healthcare and discrimination of individuals of sexual and gender minority. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8909593/
(2022) Legal gender recognition in Lithuania: Steps towards ensuring respect for private life of transgender persons. https://www.einnetwork.org/ein-voices/2022/5/2/legal-gender-recognition-in-lithuania-steps-towards-ensuring-respect-for-the-private-life-of-transgender-persons
(2022) Decree on the Diagnostic and Treatment Protocol of the Gender Incongruity Disorder. https://www.e-tar.lt/portal/en/legalAct/a824f0f0141711edb4cae1b158f98ea5
(2021). Without institutional support, Lithuanian trans teens struggle with taboo and predjudice. https://www.lrt.lt/en/news-in-english/19/1431455/without-institutional-support-lithuanian-trans-teens-struggle-with-taboo-and-prejudice-No legislation and process stalled.
(2015). If I were pretty, I would like to be a girl! Debating transsexualism in the Latvian parliament. https://sciendo.com/pdf/10.1515/genst-2015-0013
(2010) Transgender persons' rights in the EU member states. p. 22-28. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf
-GRS banned.
(2022) Restriction of access to healthcare and discrimination of individuals of sexual and gender minority. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8909593/
(2022) Legal gender recognition in Lithuania: Steps towards ensuring respect for private life of transgender persons. https://www.einnetwork.org/ein-voices/2022/5/2/legal-gender-recognition-in-lithuania-steps-towards-ensuring-respect-for-the-private-life-of-transgender-persons
(2022) Decree on the Diagnostic and Treatment Protocol of the Gender Incongruity Disorder. https://www.e-tar.lt/portal/en/legalAct/a824f0f0141711edb4cae1b158f98ea5
(2021). Without institutional support, Lithuanian trans teens struggle with taboo and predjudice. https://www.lrt.lt/en/news-in-english/19/1431455/without-institutional-support-lithuanian-trans-teens-struggle-with-taboo-and-prejudice-No legislation and process stalled.
(2015). If I were pretty, I would like to be a girl! Debating transsexualism in the Latvian parliament. https://sciendo.com/pdf/10.1515/genst-2015-0013
(2010) Transgender persons' rights in the EU member states. p. 22-28. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf
-GRS banned.
(2022) Restriction of access to healthcare and discrimination of individuals of sexual and gender minority. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8909593/
(2022) Legal gender recognition in Lithuania: Steps towards ensuring respect for private life of transgender persons. https://www.einnetwork.org/ein-voices/2022/5/2/legal-gender-recognition-in-lithuania-steps-towards-ensuring-respect-for-the-private-life-of-transgender-persons
(2022) Decree on the Diagnostic and Treatment Protocol of the Gender Incongruity Disorder. https://www.e-tar.lt/portal/en/legalAct/a824f0f0141711edb4cae1b158f98ea5
(2021). Without institutional support, Lithuanian trans teens struggle with taboo and predjudice. https://www.lrt.lt/en/news-in-english/19/1431455/without-institutional-support-lithuanian-trans-teens-struggle-with-taboo-and-prejudice-No legislation and process stalled.
(2015). If I were pretty, I would like to be a girl! Debating transsexualism in the Latvian parliament. https://sciendo.com/pdf/10.1515/genst-2015-0013
(2010) Transgender persons' rights in the EU member states. p. 22-28. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf
-Lithuania just (Aug 2022) announced that they will cover HRT. The guidance indicates how this will be done, but it is yet to be seen what it will look like in practice.
(2022) Decree on the Diagnostic and Treatment Protocol of the Gender Incongruity Disorder. https://www.e-tar.lt/portal/en/legalAct/a824f0f0141711edb4cae1b158f98ea5		-Lithuania just (Aug 2022) announced that they will cover HRT. The guidance indicates how this will be done, but it is yet to be seen what it will look like in practice.
(2022) Decree on the Diagnostic and Treatment Protocol of the Gender Incongruity Disorder. https://www.e-tar.lt/portal/en/legalAct/a824f0f0141711edb4cae1b158f98ea5
-GRS banned.
(2022) Restriction of access to healthcare and discrimination of individuals of sexual and gender minority. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8909593/
(2022) Legal gender recognition in Lithuania: Steps towards ensuring respect for private life of transgender persons. https://www.einnetwork.org/ein-voices/2022/5/2/legal-gender-recognition-in-lithuania-steps-towards-ensuring-respect-for-the-private-life-of-transgender-persons
(2022) Decree on the Diagnostic and Treatment Protocol of the Gender Incongruity Disorder. https://www.e-tar.lt/portal/en/legalAct/a824f0f0141711edb4cae1b158f98ea5
(2021). Without institutional support, Lithuanian trans teens struggle with taboo and predjudice. https://www.lrt.lt/en/news-in-english/19/1431455/without-institutional-support-lithuanian-trans-teens-struggle-with-taboo-and-prejudice-No legislation and process stalled.
(2015). If I were pretty, I would like to be a girl! Debating transsexualism in the Latvian parliament. https://sciendo.com/pdf/10.1515/genst-2015-0013
(2010) Transgender persons' rights in the EU member states. p. 22-28. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf
-GRS banned.
(2022) Restriction of access to healthcare and discrimination of individuals of sexual and gender minority. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8909593/
(2022) Legal gender recognition in Lithuania: Steps towards ensuring respect for private life of transgender persons. https://www.einnetwork.org/ein-voices/2022/5/2/legal-gender-recognition-in-lithuania-steps-towards-ensuring-respect-for-the-private-life-of-transgender-persons
(2022) Decree on the Diagnostic and Treatment Protocol of the Gender Incongruity Disorder. https://www.e-tar.lt/portal/en/legalAct/a824f0f0141711edb4cae1b158f98ea5
(2021). Without institutional support, Lithuanian trans teens struggle with taboo and predjudice. https://www.lrt.lt/en/news-in-english/19/1431455/without-institutional-support-lithuanian-trans-teens-struggle-with-taboo-and-prejudice-No legislation and process stalled.
(2015). If I were pretty, I would like to be a girl! Debating transsexualism in the Latvian parliament. https://sciendo.com/pdf/10.1515/genst-2015-0013
(2010) Transgender persons' rights in the EU member states. p. 22-28. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf
-GRS banned.
(2022) Restriction of access to healthcare and discrimination of individuals of sexual and gender minority. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8909593/
(2022) Legal gender recognition in Lithuania: Steps towards ensuring respect for private life of transgender persons. https://www.einnetwork.org/ein-voices/2022/5/2/legal-gender-recognition-in-lithuania-steps-towards-ensuring-respect-for-the-private-life-of-transgender-persons
(2022) Decree on the Diagnostic and Treatment Protocol of the Gender Incongruity Disorder. https://www.e-tar.lt/portal/en/legalAct/a824f0f0141711edb4cae1b158f98ea5
(2021). Without institutional support, Lithuanian trans teens struggle with taboo and predjudice. https://www.lrt.lt/en/news-in-english/19/1431455/without-institutional-support-lithuanian-trans-teens-struggle-with-taboo-and-prejudice-No legislation and process stalled.
(2015). If I were pretty, I would like to be a girl! Debating transsexualism in the Latvian parliament. https://sciendo.com/pdf/10.1515/genst-2015-0013
(2010) Transgender persons' rights in the EU member states. p. 22-28. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf
-GRS banned.
(2022) Restriction of access to healthcare and discrimination of individuals of sexual and gender minority. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8909593/
(2022) Legal gender recognition in Lithuania: Steps towards ensuring respect for private life of transgender persons. https://www.einnetwork.org/ein-voices/2022/5/2/legal-gender-recognition-in-lithuania-steps-towards-ensuring-respect-for-the-private-life-of-transgender-persons
(2022) Decree on the Diagnostic and Treatment Protocol of the Gender Incongruity Disorder. https://www.e-tar.lt/portal/en/legalAct/a824f0f0141711edb4cae1b158f98ea5
(2021). Without institutional support, Lithuanian trans teens struggle with taboo and predjudice. https://www.lrt.lt/en/news-in-english/19/1431455/without-institutional-support-lithuanian-trans-teens-struggle-with-taboo-and-prejudice-No legislation and process stalled.
(2015). If I were pretty, I would like to be a girl! Debating transsexualism in the Latvian parliament. https://sciendo.com/pdf/10.1515/genst-2015-0013
(2010) Transgender persons' rights in the EU member states. p. 22-28. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf
-GRS banned.
(2022) Restriction of access to healthcare and discrimination of individuals of sexual and gender minority. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8909593/
(2022) Legal gender recognition in Lithuania: Steps towards ensuring respect for private life of transgender persons. https://www.einnetwork.org/ein-voices/2022/5/2/legal-gender-recognition-in-lithuania-steps-towards-ensuring-respect-for-the-private-life-of-transgender-persons
(2022) Decree on the Diagnostic and Treatment Protocol of the Gender Incongruity Disorder. https://www.e-tar.lt/portal/en/legalAct/a824f0f0141711edb4cae1b158f98ea5
(2021). Without institutional support, Lithuanian trans teens struggle with taboo and predjudice. https://www.lrt.lt/en/news-in-english/19/1431455/without-institutional-support-lithuanian-trans-teens-struggle-with-taboo-and-prejudice-No legislation and process stalled.
(2015). If I were pretty, I would like to be a girl! Debating transsexualism in the Latvian parliament. https://sciendo.com/pdf/10.1515/genst-2015-0013
(2010) Transgender persons' rights in the EU member states. p. 22-28. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf
-GRS banned.
(2022) Restriction of access to healthcare and discrimination of individuals of sexual and gender minority. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8909593/
(2022) Legal gender recognition in Lithuania: Steps towards ensuring respect for private life of transgender persons. https://www.einnetwork.org/ein-voices/2022/5/2/legal-gender-recognition-in-lithuania-steps-towards-ensuring-respect-for-the-private-life-of-transgender-persons
(2022) Decree on the Diagnostic and Treatment Protocol of the Gender Incongruity Disorder. https://www.e-tar.lt/portal/en/legalAct/a824f0f0141711edb4cae1b158f98ea5
(2021). Without institutional support, Lithuanian trans teens struggle with taboo and predjudice. https://www.lrt.lt/en/news-in-english/19/1431455/without-institutional-support-lithuanian-trans-teens-struggle-with-taboo-and-prejudice-No legislation and process stalled.
(2015). If I were pretty, I would like to be a girl! Debating transsexualism in the Latvian parliament. https://sciendo.com/pdf/10.1515/genst-2015-0013
(2010) Transgender persons' rights in the EU member states. p. 22-28. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf
-GRS banned.
(2022) Restriction of access to healthcare and discrimination of individuals of sexual and gender minority. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8909593/
(2022) Legal gender recognition in Lithuania: Steps towards ensuring respect for private life of transgender persons. https://www.einnetwork.org/ein-voices/2022/5/2/legal-gender-recognition-in-lithuania-steps-towards-ensuring-respect-for-the-private-life-of-transgender-persons
(2022) Decree on the Diagnostic and Treatment Protocol of the Gender Incongruity Disorder. https://www.e-tar.lt/portal/en/legalAct/a824f0f0141711edb4cae1b158f98ea5
(2021). Without institutional support, Lithuanian trans teens struggle with taboo and predjudice. https://www.lrt.lt/en/news-in-english/19/1431455/without-institutional-support-lithuanian-trans-teens-struggle-with-taboo-and-prejudice-No legislation and process stalled.
(2015). If I were pretty, I would like to be a girl! Debating transsexualism in the Latvian parliament. https://sciendo.com/pdf/10.1515/genst-2015-0013
(2010) Transgender persons' rights in the EU member states. p. 22-28. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf
-GRS banned.
(2022) Restriction of access to healthcare and discrimination of individuals of sexual and gender minority. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8909593/
(2022) Legal gender recognition in Lithuania: Steps towards ensuring respect for private life of transgender persons. https://www.einnetwork.org/ein-voices/2022/5/2/legal-gender-recognition-in-lithuania-steps-towards-ensuring-respect-for-the-private-life-of-transgender-persons
(2022) Decree on the Diagnostic and Treatment Protocol of the Gender Incongruity Disorder. https://www.e-tar.lt/portal/en/legalAct/a824f0f0141711edb4cae1b158f98ea5
(2021). Without institutional support, Lithuanian trans teens struggle with taboo and predjudice. https://www.lrt.lt/en/news-in-english/19/1431455/without-institutional-support-lithuanian-trans-teens-struggle-with-taboo-and-prejudice-No legislation and process stalled.
(2015). If I were pretty, I would like to be a girl! Debating transsexualism in the Latvian parliament. https://sciendo.com/pdf/10.1515/genst-2015-0013
(2010) Transgender persons' rights in the EU member states. p. 22-28. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf
-GRS banned.
(2022) Restriction of access to healthcare and discrimination of individuals of sexual and gender minority. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8909593/
(2022) Legal gender recognition in Lithuania: Steps towards ensuring respect for private life of transgender persons. https://www.einnetwork.org/ein-voices/2022/5/2/legal-gender-recognition-in-lithuania-steps-towards-ensuring-respect-for-the-private-life-of-transgender-persons
(2022) Decree on the Diagnostic and Treatment Protocol of the Gender Incongruity Disorder. https://www.e-tar.lt/portal/en/legalAct/a824f0f0141711edb4cae1b158f98ea5
(2021). Without institutional support, Lithuanian trans teens struggle with taboo and predjudice. https://www.lrt.lt/en/news-in-english/19/1431455/without-institutional-support-lithuanian-trans-teens-struggle-with-taboo-and-prejudice-No legislation and process stalled.
(2015). If I were pretty, I would like to be a girl! Debating transsexualism in the Latvian parliament. https://sciendo.com/pdf/10.1515/genst-2015-0013
(2010) Transgender persons' rights in the EU member states. p. 22-28. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf
-GRS banned.
(2022) Restriction of access to healthcare and discrimination of individuals of sexual and gender minority. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8909593/
(2022) Legal gender recognition in Lithuania: Steps towards ensuring respect for private life of transgender persons. https://www.einnetwork.org/ein-voices/2022/5/2/legal-gender-recognition-in-lithuania-steps-towards-ensuring-respect-for-the-private-life-of-transgender-persons
(2022) Decree on the Diagnostic and Treatment Protocol of the Gender Incongruity Disorder. https://www.e-tar.lt/portal/en/legalAct/a824f0f0141711edb4cae1b158f98ea5
(2021). Without institutional support, Lithuanian trans teens struggle with taboo and predjudice. https://www.lrt.lt/en/news-in-english/19/1431455/without-institutional-support-lithuanian-trans-teens-struggle-with-taboo-and-prejudice-No legislation and process stalled.
(2015). If I were pretty, I would like to be a girl! Debating transsexualism in the Latvian parliament. https://sciendo.com/pdf/10.1515/genst-2015-0013
(2010) Transgender persons' rights in the EU member states. p. 22-28. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf
-Lithuania just (Aug 2022) announced that they will cover HRT. The guidance fully indicates how this will be done, but it is yet to be seen what it will look like in practice.
-GRS still banned.
(2022) Restriction of access to healthcare and discrimination of individuals of sexual and gender minority. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8909593/
(2022) Legal gender recognition in Lithuania: Steps towards ensuring respect for private life of transgender persons. https://www.einnetwork.org/ein-voices/2022/5/2/legal-gender-recognition-in-lithuania-steps-towards-ensuring-respect-for-the-private-life-of-transgender-persons
(2022) Decree on the Diagnostic and Treatment Protocol of the Gender Incongruity Disorder. https://www.e-tar.lt/portal/en/legalAct/a824f0f0141711edb4cae1b158f98ea5
(2021). Without institutional support, Lithuanian trans teens struggle with taboo and predjudice. https://www.lrt.lt/en/news-in-english/19/1431455/without-institutional-support-lithuanian-trans-teens-struggle-with-taboo-and-prejudice-No legislation and process stalled.
(2015). If I were pretty, I would like to be a girl! Debating transsexualism in the Latvian parliament. https://sciendo.com/pdf/10.1515/genst-2015-0013
(2010) Transgender persons' rights in the EU member states. p. 22-28. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf		-Diagnosis of transsexuality required.
(2022) Minister of health protection of the republic of Lithuania: Order approval of the description of the diagnosis and treatment procedure of gendere identity disorder (transsexuality). https://www.e-tar.lt/portal/lt/legalAct/a824f0f0141711edb4cae1b158f98ea5
-Diagnosis presumably implicitly "required in order to undergo sterilization/hormone therapy/other gender reassignment measures (p.11)."
(2017) Psychiatry in legal gender recognition procedures in Europe. p.10-11. http://hlcmr.de/wp-content/uploads/2017/01/Psychiatry-in-legal-gender-recognition-procedures-in-Europe.pdf		-Diagnosis of transsexuality required.
(2022) Minister of health protection of the republic of Lithuania: Order approval of the description of the diagnosis and treatment procedure of gendere identity disorder (transsexuality). https://www.e-tar.lt/portal/lt/legalAct/a824f0f0141711edb4cae1b158f98ea5
-Diagnosis presumably implicitly "required in order to undergo sterilization/hormone therapy/other gender reassignment measures (p.11)."
(2017) Psychiatry in legal gender recognition procedures in Europe. p.10-11. http://hlcmr.de/wp-content/uploads/2017/01/Psychiatry-in-legal-gender-recognition-procedures-in-Europe.pdf		See links in other cells-As per respondent, given the recent ministerial declaration regarding greater covreage, this could quickly get longer.
(2022) Decree on the Diagnostic and Treatment Protocol of the Gender Incongruity Disorder. https://www.e-tar.lt/portal/en/legalAct/a824f0f0141711edb4cae1b158f98ea5
-Diagnosis likely to take much longer
(n.d.) Trans day of visibility: Why do trans people want to be seen? https://transautonomija.lt/trans-matomumo-diena-2022/		-No specific information, but both respondents agree and information on discrimination re: disability is prevalent.
(2022) Decree on the Diagnostic and Treatment Protocol of the Gender Incongruity Disorder. https://www.e-tar.lt/portal/en/legalAct/a824f0f0141711edb4cae1b158f98ea5
(2022) Trans day of visibility: Why do trans people want to be seen? https://transautonomija.lt/trans-matomumo-diena-2022/		(2022) Decree on the Diagnostic and Treatment Protocol of the Gender Incongruity Disorder. https://www.e-tar.lt/portal/en/legalAct/a824f0f0141711edb4cae1b158f98ea5
(2022) Trans day of visibility: Why do trans people want to be seen? https://transautonomija.lt/trans-matomumo-diena-2022/		-No information could be found on this. However, the respondent asserts that this was a difficulty and the general country conditions would seem to agree.-Access to HRT under the new guidelines is prefaced on a diagnosis of transsexuality of at least 2 years duration.
(2022) Decree on the Diagnostic and Treatment Protocol of the Gender Incongruity Disorder. https://www.e-tar.lt/portal/en/legalAct/a824f0f0141711edb4cae1b158f98ea5		1
-No information could be found on this. However, the respondent asserts that this was a difficulty and the general country conditions would seem to agree.		-No information specific to trans people. However, MSF wass providing basic healthcae in some reception centres (prisons) in lieu of the state providing such services.
(2022) A "hierarchy of suffering" exacerbates asylum seekers mental health in Lithuania. https://www.msf.org/discriminatory-and-cruel-migration-practices-compound-suffering-lithuania
(2022) Experts of the committee against torture welcome Lithuania's holistic approach on promoting human rights and fighting torture, and ask about the state of emergency on the border with Belarus. A "hierarchy of suffering" exacerbates asylum seekers mental health in Lithuania. https://www.msf.org/discriminatory-and-cruel-migration-practices-compound-suffering-lithuania
-UNHCR has inquired into what policies they have adopted to improve reception centre conditions for "asylum-seekers with specific needs."
(2021) https://www.ohchr.org/en/press-releases/2021/12/experts-committee-against-torture-welcome-lithuanias-holistic-approach		-Could not confirm that this was specific to trans people or distinct from the experiences of migrants or asylum seekers. Accepted refugees do appear to receive full healthcare.
(2010) Policies on health care for undocumented migrants in EU 27. p.10. https://www.diva-portal.org/smash/get/diva2:1410183/FULLTEXT01.pdf		No evidence one way or another. Put yes because respondent indicated it was and because BMI limits for trans surgeries exist widely.-Could not confirm. However, given that HRT is currently difficult to access and that this is done through individual practitioners in the community, it seems likely.-Healthcare not available-New policy that HRT is explicitly exclusive to adults.
(2022) Decree on the Diagnostic and Treatment Protocol of the Gender Incongruity Disorder. https://www.e-tar.lt/portal/en/legalAct/a824f0f0141711edb4cae1b158f98ea5
(2021) Without institutional support, Lithuanian trans teens struggle with taboo and predjudice. https://www.lrt.lt/en/news-in-english/19/1431455/without-institutional-support-lithuanian-trans-teens-struggle-with-taboo-and-prejudice
(2017) Access to transgender hormone therapy. https://fra.europa.eu/de/publication/2017/mapping-minimum-age-requirements-concerning-rights-child-eu/access-transgender-hormone-therapy
53
TGEU Confirmation (score)0000000000000000011001-3 months
As per respondent, given the recent ministerial declaration regarding greater covreage, this could quickly get longer.
(2022) Decree on the Diagnostic and Treatment Protocol of the Gender Incongruity Disorder. https://www.e-tar.lt/portal/en/legalAct/a824f0f0141711edb4cae1b158f98ea5
-Diagnosis likely to take much longer
(n.d.) Trans day of visibility: Why do trans people want to be seen? https://transautonomija.lt/trans-matomumo-diena-2022/		211111111801801802
54
Luxembourg
55
TGEU Confirmation (sources)-I could not find any verification of this procedure being covered in public health care. I have accepted the respondent's answer as is and based on other statements (e.g. Trans healthcare lottery) regarding Luxembourg's generally good coverage)
(2017) Trans healthcare lottery. p. 27. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		(2017) Trans healthcare lottery. p. 25. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf
(n.d.) Access to trans healthcare: The situation in Europe. https://www.thenewfederalist.eu/access-to-trans-healthcare-the-situation-in-europe?lang=fr		(2017) Trans healthcare lottery. p. 25. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf
(n.d.) Access to trans healthcare: The situation in Europe. https://www.thenewfederalist.eu/access-to-trans-healthcare-the-situation-in-europe?lang=fr		(2017) Trans healthcare lottery. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf p. 18(2017) Trans healthcare lottery. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf p. 18-I could not find any verification of this procedure being covered in public health care. I have accepted the respondent's answer as is and based on other statements (e.g. Trans healthcare lottery) regarding Luxembourg's generally good coverage)
(2017) Trans healthcare lottery. p. 27. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		-Specific techniques not covered or only performed abroad. Abroad covereage is not automatic and requires preapproval.
(2017) Trans healthcare lottery. p. 27. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		-Specific techniques not covered or only performed abroad. Coverage is not automatic and requires pre-approval.
(2017) Trans healthcare lottery. p. 27. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		-I could not find any verification of this procedure being covered in public health care. I have accepted the respondent's answer as is and based on other statements (e.g. Trans healthcare lottery) regarding Luxembourg's generally good coverage). Also, vaginoplasty is covered, which implies orchi).
(2017) Trans healthcare lottery. p. 27. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		-I could not find any verification of this procedure being covered in public health care. I have accepted the respondent's answer as is and based on other statements (e.g. Trans healthcare lottery) regarding Luxembourg's generally good coverage). Also phallo is covered, which implies ovariectomy.
(2017) Trans healthcare lottery. p. 27. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		-Specific techniques not covered or only performed abroad. Coverage is not automatic and requires pre-approval.
(2017) Trans healthcare lottery. p. 27. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		-Despite information below, I indicated that this was covered given the age of available information on other procedures, expertise of the respondent on trans children, and available information on age at which PB/hormones is possible.
(2009) Supplementary report to the 3rd and 4th national report (2001-2009) on the rights of the child in Luxembourg-The rights of trans children and intersex children. p. 17. http://itgl.lu/wp-content/uploads/2015/04/RADELUX_enfants-trans-et-intersexes.pdf		Respondent stated "unklar". No corrobating information.-Specific techniques not covered or only performed abroad. Coverage is not automatic and requires pre-approval.
(2017) Trans healthcare lottery. p. 27. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		I could not find any verification of this procedure being covered in public health care. I have accepted the respondent's answer as is and based on other statements (e.g. Trans healthcare lottery) regarding Luxembourg's generally good coverage).
(2017) Trans healthcare lottery. p. 27. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		-Available information appears to be limited.
-Access to GCT, and funding for it, but with conditions.
-"There are no doctors in Luxembourg with specialised training or experienced [sic] which would qualify them to undertake gender reassignment surgery (p. 29)."
-Surgery allowed and paid for abroad with prior approval and assessment (p.29).
(2010) Transgender persons' rights in the EU member states. p. 29. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf		-Diagnosis implicitly "required in order to undergo sterilization/hormone therapy/other gender reassignment measures (p.11)."
(2017) Psychiatry in legal gender recognition procedures in Europe. p.10-11. http://hlcmr.de/wp-content/uploads/2017/01/Psychiatry-in-legal-gender-recognition-procedures-in-Europe.pdf
-Legislation has depathologized, but may not have reached public health requirements yet. Still requires psychiatric assessment and proof of real life test (p.17).
(2017) Trans healthcare lottery. p.17-18 https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf
(2010) Transgender persons' rights in the EU member states. p.29. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf		-Diagnosis implicitly "required in order to undergo sterilization/hormone therapy/other gender reassignment measures (p.11)."
(2017) Psychiatry in legal gender recognition procedures in Europe. p.10-11. http://hlcmr.de/wp-content/uploads/2017/01/Psychiatry-in-legal-gender-recognition-procedures-in-Europe.pdf
-Legislation has depathologized, but may not have reached public health requirements yet. Still requires psychiatric assessment and proof of real life test (p.17)
(2017) Trans healthcare lottery. p.17-18 https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf
(2010) Transgender persons' rights in the EU member states. p.29. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf		See links in other cells6-12 months-Author is a clinician who expresses concern about autism and mental health vis a vis trans people and hormones.
(2014) Normed children. p. 343. https://www.transcript-publishing.com/media/pdf/c8/b9/cd/oa9783839430200S9wfbc3SBIulB.pdf		-Author is a clinician in Luxembourg who expresses concern about autism and mental health vis a vis trans people and hormones.
(2014) Normed children. https://www.transcript-publishing.com/media/pdf/c8/b9/cd/oa9783839430200S9wfbc3SBIulB.pdf		NEI-Author is a clinician in Luxembourg and the book deals with gender normativity extensively.
(2014) Normed children. https://www.transcript-publishing.com/media/pdf/c8/b9/cd/oa9783839430200S9wfbc3SBIulB.pdf		1
-Author is a clinician and the book deals with gender normativity extensively.
(2014) Normed children. https://www.transcript-publishing.com/media/pdf/c8/b9/cd/oa9783839430200S9wfbc3SBIulB.pdf		-No independent verification possible. As per respondent.-No independent verification possible. As per respondent.NEINEI-Not available in the country (at least as late as 2009). Attributes this to "no doctor trained in Luxembourg"
(2009) Supplementary report to the 3rd and 4th national report (2001-2009) on the rights of the child in Luxembourg-The rights of trans children and intersex children. p. 17. http://itgl.lu/wp-content/uploads/2015/04/RADELUX_enfants-trans-et-intersexes.pdf		Depends on maturity (<18)
(2017) Access to transgender hormone therapy. https://fra.europa.eu/de/publication/2017/mapping-minimum-age-requirements-concerning-rights-child-eu/access-transgender-hormone-therapy
-Not available in the country (at least as late as 2009). Attributes this to "no doctor trained in Luxembourg"
(2009) Supplementary report to the 3rd and 4th national report (2001-2009) on the rights of the child in Luxembourg-The rights of trans children and intersex children. p. 17. http://itgl.lu/wp-content/uploads/2015/04/RADELUX_enfants-trans-et-intersexes.pdf
56
TGEU Confirmation (score)100111111111NEI1112211006-12 months11NEINEI111NEINEI41NEI0<1815
57
Malta
58
TGEU Confirmation (sources)-On an individual basis
(n.d.) https://deputyprimeminister.gov.mt/en/Documents/National-Health-Strategies/Transgender%20Healthcare.pdf		-(2021) https://deputyprimeministercms.gov.mt/en/CMO/transgender-health/Pages/transgender-care/hair-removal.aspx-(2022) https://deputyprimeministercms.gov.mt/en/CMO/transgender-health/Pages/transgender-care/facial-surgery.aspx-(n.d.) https://deputyprimeminister.gov.mt/en/CMO/transgender-health/Pages/care-path.aspx"""-(n.d.) https://deputyprimeminister.gov.mt/en/CMO/transgender-health/Pages/care-path.aspx"""-(n.d.) https://deputyprimeminister.gov.mt/en/CMO/transgender-health/Pages/care-path.aspx-(n.d.) https://deputyprimeminister.gov.mt/en/CMO/transgender-health/Pages/care-path.aspx-(2021) https://deputyprimeministercms.gov.mt/en/CMO/transgender-health/Pages/transgender-care/surgery-for-trans-men-and-non-binary-people-assigned-female-at-birth.aspx
(n.d.) https://deputyprimeminister.gov.mt/en/Documents/National-Health-Strategies/Transgender%20Healthcare.pdf		-(2021) https://deputyprimeministercms.gov.mt/en/CMO/transgender-health/Pages/transgender-care/surgery-for-trans-women-and-non-binary-people-assigned-male-at-birth.aspx-(n.d.) https://deputyprimeminister.gov.mt/en/CMO/transgender-health/Pages/care-path.aspx"""-(2021) https://deputyprimeministercms.gov.mt/en/CMO/transgender-health/Pages/transgender-care/surgery-for-trans-men-and-non-binary-people-assigned-female-at-birth.aspx
(n.d.) https://deputyprimeminister.gov.mt/en/Documents/National-Health-Strategies/Transgender%20Healthcare.pdf		-(n.d.) https://deputyprimeminister.gov.mt/en/CMO/transgender-health/Pages/care-path.aspx-(2021) https://deputyprimeministercms.gov.mt/en/CMO/transgender-health/Pages/transgender-care/facial-surgery.aspx-They do not appear to have a surgeon on island who can provide it and their ability to cover procedures out of country is limited.(n.d.) https://deputyprimeminister.gov.mt/en/CMO/transgender-health/Pages/care-path.aspx
(2021) https://deputyprimeministercms.gov.mt/en/CMO/transgender-health/Pages/transgender-care/voice.aspx		-Access to GCT. Funding and conditions listed as pending
(2018) Trans and intersex equality rights in Europe. https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf		(2022) Noah had a conversation w/ Maltese clinicians at EPATH Summer school. They were emphatic that a diagnosis per se was not required.
-"Malta has depathologised gender identitya nd access to transgender care does not require any diagnoses and is based on the principles of self-determination and informed consent."
(n.d.) Transgender care. https://deputyprimeministercms.gov.mt/en/CMO/transgender-health/Pages/transgender-care/transgender-care.aspx		(2022) Noah had a conversation w/ Maltese clinicians at EPATH Summer school. They were emphatic that a diagnosis per se was not required.
-"Malta has depathologised gender identitya nd access to transgender care does not require any diagnoses and is based on the principles of self-determination and informed consent."
(n.d.) Transgender care. https://deputyprimeministercms.gov.mt/en/CMO/transgender-health/Pages/transgender-care/transgender-care.aspx		See links in other cellsAs per respondents
They have about 300 patients since the clinic opened (EPATH Summer School)
No information about waitlists. Using data from respondents.
(2021) https://ilga-europe.org/files/uploads/2022/04/annual-review-2021.pdf
-Closed during covid		-Based on emails w/ Maltese clinicians. They have concerns about capacity to consent here.-As per clinicians at EPATH Summer School, depression must be resolved prior to beginning hormones. That said, "existence of psychiatric problems is not used as an exclusion criterion."
(n.d.) https://deputyprimeminister.gov.mt/en/CMO/transgender-health/Pages/care-path.aspx		NEI-Unlikely given specific mention of NB folks in process for obtaining surgical care0-Specifically if folks are without status
-As per Maltese GIC Clinicians @ EPATH Summer School; Akin to situation in Netherlands, asylum seekers without status may not be able to receive trans health care.		-Only those who are without status (from conversation w/ clinicians at EPATH Summer School)NEI(2020) Mapping of good practices for the management of transgender prisoners: Literature review. p. 35. https://www.undp.org/sites/g/files/zskgke326/files/migration/th/UNDP-TH-the-mapping-of-good-practices-for-the-management-of-transgender-prisoners.pdf
(2020). Contemporary transgender health experience and health situation in prisons: A scoping review of extant published literature. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8726645/
- I suspect that things aren't as positive in reality, but they appear to have laid out a solid policy that guarantees access.
-Appears not to have been the case before the gender identity law circa 2016. Note that TGEU published Malta's policy specific to trans inmates. Respondents say no, but available evidence states that this is often a difficulty. Following article seems to indicate that they have to pay for their own hormones? Report also indicates that government's response was that the gender identity law "fixed this".
(2016) Trans, gender variant & intersex inmates policy. https://homeaffairs.gov.mt/en/media/Policies-Documents/Documents/Trans%20Gender%20Variant%20and%20Intersex%20Inmates%20Policy%20-%20August%202016%20(Final-%20Final).pdf
-"Access to trans, gender variant and/or intersex healthcare services should be guaranteed to inmates regardless of their legal gender
identity (p. 13)."
(2016) https://timesofmalta.com/articles/view/transgender-inmates-sue-home-affairs-minister-prisons-director.618667
(2016) Malta prison policy. https://tgeu.org/malta-prison-policy-august-2016/		<16 (tanner stage 2)
Tanner 2-3=roughly age 8-15
(2010) https://www.ncbi.nlm.nih.gov/books/NBK138588/
(n.d.) https://deputyprimeminister.gov.mt/en/CMO/transgender-health/Pages/care-path.aspx		(2017) https://fra.europa.eu/de/publication/2017/mapping-minimum-age-requirements-concerning-rights-child-eu/access-transgender-hormone-therapy
-Information here is a little confusingly reported, but both respondents agree
59
TGEU Confirmation (score)1001111011010019100123-6 months21NEINEINEI1NEINEINEI22Tanner 2216110
60
Netherlands
61
TGEU Confirmation (sources)-This is not covered privately, but funded through a grant provided by the government.
"State Secretary of Public Health announced reimbursement of breast surgery for trans women to be implemented in spring but no regulation was adopted.
(2019) ILGA Annual review. https://ilga-europe.org/files/uploads/2022/04/annual-review-2019.pdf
(2022) Developments in waiting times, number of people waiting and capacity of care. p.12. https://open.overheid.nl/repository/ronl-6f7934b990e8af6dcce194f4df43db40e6b38421/1/pdf/ontwikkelingen-in-de-wachttijden-aantal-wachtenden-en-capaciteit-van-zorg.pdf		(2021) https://lgbtalliance.eu/four-requests-to-improve-healthcare-for-trans-people/
(n.d.) https://transvisie.nl/transitie/algemeen/dutch-healtcare-for-foreigners/		-Yes, but not always
(2022) Developments in waiting times, number of people waiting and capacity of care. p.12. https://open.overheid.nl/repository/ronl-6f7934b990e8af6dcce194f4df43db40e6b38421/1/pdf/ontwikkelingen-in-de-wachttijden-aantal-wachtenden-en-capaciteit-van-zorg.pdf
(2017) https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		(2017) Trans healthcare lottery. p.29. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf
(n.d.) Dutch healthcare for foreigners. https://transvisie.nl/transitie/algemeen/dutch-healtcare-for-foreigners/
(n.d.) Overview of reimbursements. https://transvisie.nl/transitie/algemeen/zorgverzekering-vergoedingen/		-However, inidvidual may need to purchase more "efficient" testosterone
(2021) Four requests to improve healthcare for trans people. https://lgbtalliance.eu/four-requests-to-improve-healthcare-for-trans-people/
(2017) Trans healthcare lottery. p.29. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf
(n.d.) Dutch healthcare for foreigners. https://transvisie.nl/transitie/algemeen/dutch-healtcare-for-foreigners/
(n.d.) Overview of reimbursements. https://transvisie.nl/transitie/algemeen/zorgverzekering-vergoedingen/		(2022) Developments in waiting times, number of people waiting and capacity of care. p.12. https://open.overheid.nl/repository/ronl-6f7934b990e8af6dcce194f4df43db40e6b38421/1/pdf/ontwikkelingen-in-de-wachttijden-aantal-wachtenden-en-capaciteit-van-zorg.pdf(2022) Developments in waiting times, number of people waiting and capacity of care. p.12. https://open.overheid.nl/repository/ronl-6f7934b990e8af6dcce194f4df43db40e6b38421/1/pdf/ontwikkelingen-in-de-wachttijden-aantal-wachtenden-en-capaciteit-van-zorg.pdf1(2022) Developments in waiting times, number of people waiting and capacity of care. p.12. https://open.overheid.nl/repository/ronl-6f7934b990e8af6dcce194f4df43db40e6b38421/1/pdf/ontwikkelingen-in-de-wachttijden-aantal-wachtenden-en-capaciteit-van-zorg.pdf(2022) Developments in waiting times, number of people waiting and capacity of care. p.12. https://open.overheid.nl/repository/ronl-6f7934b990e8af6dcce194f4df43db40e6b38421/1/pdf/ontwikkelingen-in-de-wachttijden-aantal-wachtenden-en-capaciteit-van-zorg.pdf(2022) Developments in waiting times, number of people waiting and capacity of care. p.12. https://open.overheid.nl/repository/ronl-6f7934b990e8af6dcce194f4df43db40e6b38421/1/pdf/ontwikkelingen-in-de-wachttijden-aantal-wachtenden-en-capaciteit-van-zorg.pdf(2022) Developments in waiting times, number of people waiting and capacity of care. p.12. https://open.overheid.nl/repository/ronl-6f7934b990e8af6dcce194f4df43db40e6b38421/1/pdf/ontwikkelingen-in-de-wachttijden-aantal-wachtenden-en-capaciteit-van-zorg.pdf(n.d.) Overview of reimbursements. https://transvisie.nl/transitie/algemeen/zorgverzekering-vergoedingen/-but not always
(2022) Developments in waiting times, number of people waiting and capacity of care. p.12. https://open.overheid.nl/repository/ronl-6f7934b990e8af6dcce194f4df43db40e6b38421/1/pdf/ontwikkelingen-in-de-wachttijden-aantal-wachtenden-en-capaciteit-van-zorg.pdf		(2022) Developments in waiting times, number of people waiting and capacity of care. p.12. https://open.overheid.nl/repository/ronl-6f7934b990e8af6dcce194f4df43db40e6b38421/1/pdf/ontwikkelingen-in-de-wachttijden-aantal-wachtenden-en-capaciteit-van-zorg.pdfNEIAccess to GCT, and funding (dependent on insurance contract). No conditions.
(2018) https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf		(2017) Trans healthcare lottery. p.16, 20. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf
(n.d.) P survey: Trans health in the Netherlands. p. 7. http://www.principle17.org/sites/default/files/Report%20P17%20trans%20health%20care%20Netherlands_0.pdf		(2017) Trans healthcare lottery. p.16, 20. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf
(n.d.) P survey: Trans health in the Netherlands. p. 7. http://www.principle17.org/sites/default/files/Report%20P17%20trans%20health%20care%20Netherlands_0.pdf		-Free clinic does not require this for HRT. Unclear if HRT would then be covered, but presumably people can fill their prescriptions. Also circa changes w/ ICD 11, they appear to be opening up avenues that don't require diagnosis, however tentatively. Recently decentralized; university hospitals (Amsterdam UMC, Groningen UMC, Radboud UMC, UMC Nijmegen); surgerical procedures require a gender clinic referral, hormones can be paid for if referred by a GP etc. but providers w/ expertise limited; mainly centralized
(2021) Centralized and decentralized delivery of transgender health care services: A systematic review and a global expert survey in 39 countries. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8497761/
(2019) For us, by us: Amsterdam's life-saving transgender clinic. https://www.equaltimes.org/for-us-by-us-amsterdam-s-life?lang=en		As per respondents
-Increased during covid
-Currently over 100 weeks.
(2022) ILGA annual review. p.103. https://www.ilga-europe.org/files/uploads/2022/04/annual-review-2022.pdf
(2021) ILGA annual review. p.85. https://ilga-europe.org/files/uploads/2022/04/annual-review-2021.pdf
(n.d.) P survey: Trans health in the Netherlands. p. 7. http://www.principle17.org/sites/default/files/Report%20P17%20trans%20health%20care%20Netherlands_0.pdf
(2017) http://www.principle17.org/sites/default/files/Report%20P17%20trans%20health%20care%20Netherlands_0.pdf
-Earlier reports say 8 mths		(n.d.) Double diagnosis: Autism and gender dysphoria
https://transmagazine.nl/daily-dose-of-double-diagnoses/		(2019) https://zorgvuldigadvies.nl/wp-content/uploads/2019/06/Bijlage-2.-Handreiking-netwerksamenwerking-transgenderzorg-definitieve-versie.pdfNEI-NB and GNC often have to wait twice as long to access services
(2017) Trans healthcare lottery. P. 32. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		1
-NB and GNC often have to wait twice as long to access services
(2017) Trans healthcare lottery. P. 32. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		-Only covers hormones if they were prescribed in country of origin. Otherwise no. Nothing else while waiting for status. Also, approved providers of asylee health care have limited knowledge of trans issues. Policy for those receiving HRT in country of origin is unclear.
-As per GIC Clinician at EPATH Summer School, those w/o status in Netherlands cannot receive trans health care, though there are some clinics that provide it anyway outside of legislation and without receiving (or being able to reimburse) payment.
(2017) Current migration situation in the EU. p. 14. https://fra.europa.eu/en/publication/2017/current-migration-situation-eu-lesbian-gay-bisexual-transgender-and-intersex
(n.d.) Dutch healthcare for foreigners. https://transvisie.nl/transitie/algemeen/dutch-healtcare-for-foreigners/		-Appears to be the same as for other residents
(n.d.) Dutch healthcare for foreigners. https://transvisie.nl/transitie/algemeen/dutch-healtcare-for-foreigners/		-BMI between 18 and 30 for genital surgery. No surgery performed over 35.
(2018) Quality standard transgender healthcare somatic. p.17. https://richtlijnendatabase.nl/gerelateerde_documenten/f/19927/Kwaliteitsstandaard%20Transgenderzorg%20-%20Somatisch.pdf
(n.d.) P survey: Trans health in the Netherlands. p. 17. http://www.principle17.org/sites/default/files/Report%20P17%20trans%20health%20care%20Netherlands_0.pdf		NEI(2018) Quality standard transgender care somatic. p.15, 17. https://richtlijnendatabase.nl/gerelateerde_documenten/f/19927/Kwaliteitsstandaard%20Transgenderzorg%20-%20Somatisch.pdf-at least 2 years after PB, or 16 after at least 6 months PB (16 most common)
(2018) Quality standard transgender care somatic. p.15, 16. https://richtlijnendatabase.nl/gerelateerde_documenten/f/19927/Kwaliteitsstandaard%20Transgenderzorg%20-%20Somatisch.pdf
62
TGEU Confirmation (score)01111111111111NEI13211112-3 years011NEI1101NEI51Tanner 221528
63
Poland
64
TGEU Confirmation (sources)-Gender reaassignment surgery is non-refundable. It means that a concerned person has to pay for it. An exception to this, is the hysterectomy and mastectomy for the transgender men, as these surgeries are partially financed (in order to prevent or treat cancer) (p.21)."
(2020) National report poland. p. 21. https://opendoorshealth.eu/sites/default/files/attachments/opendoors_national_poland_EN.pdf		-Gender reaassignment surgery is non-refundable. It means that a concerned person has to pay for it. An exception to this, is the hysterectomy and mastectomy for the transgender men, as these surgeries are partially financed (in order to prevent or treat cancer) (p.21)."
(2020) National report poland. p. 21. https://opendoorshealth.eu/sites/default/files/attachments/opendoors_national_poland_EN.pdf		-Gender reaassignment surgery is non-refundable. It means that a concerned person has to pay for it. An exception to this, is the hysterectomy and mastectomy for the transgender men, as these surgeries are partially financed (in order to prevent or treat cancer) (p.21)."
(2020) National report poland. p. 21. https://opendoorshealth.eu/sites/default/files/attachments/opendoors_national_poland_EN.pdf		-ad hoc
(2018) https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf, p. 78-79
(2017) Trans healthcare lottery. p. 12, 30. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf
-Discount of 30%
(2017) Overdiagnosed but underserved. p. 37. https://tgeu.org/wp-content/uploads/2017/10/Overdiagnosed_Underserved-TransHealthSurvey.pdf		-ad hoc
(2018) https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf, p. 78-79
(2017) Trans healthcare lottery. p. 12, 30. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf
-Discount of 30%
(2017) Overdiagnosed but underserved. p. 37.
https://tgeu.org/wp-content/uploads/2017/10/Overdiagnosed_Underserved-TransHealthSurvey.pdf		-Gender reaassignment surgery is non-refundable. It means that a concerned person has to pay for it. An exception to this, is the hysterectomy and mastectomy for the transgender men, as these surgeries are partially financed (in order to prevent or treat cancer) (p.21).
(2020) National report poland. p. 21. https://opendoorshealth.eu/sites/default/files/attachments/opendoors_national_poland_EN.pdf		(2022). How to make a top hat? A mastectomy guide. https://tranzycja.pl/krok-po-kroku/mastektomia-poradnik/?section=czy-otylosc-stanowi-przeciwwskazanie-do-operacji&q=BMI#fn12
-"Gender reaassignment surgery is non-refundable. It means that a concerned person has to pay for it. An exception to this, is the hysterectomy and mastectomy for the transgender men, as these surgeries are partially financed (in order to prevent or treat cancer) (p.21)."
(2020) National report poland. p. 21. https://opendoorshealth.eu/sites/default/files/attachments/opendoors_national_poland_EN.pdf
(2017) Trans healthcare lottery. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		-Gender reaassignment surgery is non-refundable. It means that a concerned person has to pay for it. An exception to this, is the hysterectomy and mastectomy for the transgender men, as these surgeries are partially financed (in order to prevent or treat cancer) (p.21)."
(2020) National report poland. p. 21. https://opendoorshealth.eu/sites/default/files/attachments/opendoors_national_poland_EN.pdf		-Specifically not covered. Note, however, that this source also states hysto isn't covered, which later sources refute.
(2017) Overdiagnosed but underserved. p. 37. https://tgeu.org/wp-content/uploads/2017/10/Overdiagnosed_Underserved-TransHealthSurvey.pdf		-Gender reaassignment surgery is non-refundable. It means that a concerned person has to pay for it. An exception to this, is the hysterectomy and mastectomy for the transgender men, as these surgeries are partially financed (in order to prevent or treat cancer) (p.21)."
-While ovariectomy is not specified, the country documentation indicates that hysterectomy is for cancer specific reasons. The same logic applies to the ovaries, which would be the reason for doing a hytso according to cancer prevention.
(2020) National report poland. p. 21. https://opendoorshealth.eu/sites/default/files/attachments/opendoors_national_poland_EN.pdf		-Gender reaassignment surgery is non-refundable. It means that a concerned person has to pay for it. An exception to this, is the hysterectomy and mastectomy for the transgender men, as these surgeries are partially financed (in order to prevent or treat cancer) (p.21)."
(2020) National report poland. p. 21. https://opendoorshealth.eu/sites/default/files/attachments/opendoors_national_poland_EN.pdf		-Gender reaassignment surgery is non-refundable. It means that a concerned person has to pay for it. An exception to this, is the hysterectomy and mastectomy for the transgender men, as these surgeries are partially financed (in order to prevent or treat cancer) (p.21)."
(2020) National report poland. p. 21. https://opendoorshealth.eu/sites/default/files/attachments/opendoors_national_poland_EN.pdf		-Gender reaassignment surgery is non-refundable. It means that a concerned person has to pay for it. An exception to this, is the hysterectomy and mastectomy for the transgender men, as these surgeries are partially financed (in order to prevent or treat cancer) (p.21)."
(2020) National report poland. p. 21. https://opendoorshealth.eu/sites/default/files/attachments/opendoors_national_poland_EN.pdf		-Gender reaassignment surgery is non-refundable. It means that a concerned person has to pay for it. An exception to this, is the hysterectomy and mastectomy for the transgender men, as these surgeries are partially financed (in order to prevent or treat cancer) (p.21)."
(2020) National report poland. p. 21. https://opendoorshealth.eu/sites/default/files/attachments/opendoors_national_poland_EN.pdf		-Gender reaassignment surgery is non-refundable. It means that a concerned person has to pay for it. An exception to this, is the hysterectomy and mastectomy for the transgender men, as these surgeries are partially financed (in order to prevent or treat cancer) (p.21)."
(2020) National report poland. p. 21. https://opendoorshealth.eu/sites/default/files/attachments/opendoors_national_poland_EN.pdf		-"Procedures resulting in permanent sterilization are illegal before gender status is changed (p. 4)."
-Does not appear to be access to National Health Fund re: transitional care.
(2019) Transgender healthcare in Poland. https://epath.eu/wp-content/uploads/2019/04/BartoszGrabski_Poland.pdf
-"There is a great need for comprehensive legislation establishing the rights of transsexuals in the health service... Currently [2010]... sex reassignment surgery is not covered by public insurance (p.32)."
(2010) Transgender persons' rights in the EU member states. p. 29. https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf
(2018) https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf		(2017). Trans healthcare lottery. p.16. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf(2017). Trans healthcare lottery. p.16. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdfSee links in other cellsAas per respondent-Below source does not explicitly make this connection, but suggests that it may sometimes occur.
(2022). Autism spectrum and transgenderism. https://tranzycja.pl/publikacje/autyzm-transplciowosc/?section=przydatne-zasoby-wiedzy&q=Autism
-Recommends prolonged diagnostic process for those with "mental conditions, including personality and psychotic disorders."
(2020) Recommendations of the Polish Sexological Society on medical care in transgender adults – position statement of the expert panel. p. 704. https://www.researchgate.net/publication/344246996_Recommendations_of_the_Polish_Sexological_Society_on_medical_care_in_transgender_adults_-_position_statement_of_the_expert_panel
(2017) Trans Healthcare Lottery. p. 32. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		-Recommends prolonged diagnostic process for those with "mental conditions, including personality and psychotic disorders."
(2020) Recommendations of the Polish Sexological Society on medical care in transgender adults – position statement of the expert panel. p. 704. https://www.researchgate.net/publication/344246996_Recommendations_of_the_Polish_Sexological_Society_on_medical_care_in_transgender_adults_-_position_statement_of_the_expert_panel
(2017) Trans Healthcare Lottery. p. 32. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		-Could not independently verify, but seems likely given country situation. Also respondent agrees.(2017) Overdiagnosed but underserved. p. 39. https://tgeu.org/wp-content/uploads/2017/10/Overdiagnosed_Underserved-TransHealthSurvey.pdf1
(2017) Overdiagnosed but underserved. p. 39. https://tgeu.org/wp-content/uploads/2017/10/Overdiagnosed_Underserved-TransHealthSurvey.pdf		-Seems to suggest that transgender refugees (assume here they mean asylum seekers) have trouble accessing HRT.
(2022) Women's rights and LGBTQ+ rights in Poland. https://citizenstakeover.eu/blog/events/womens-rights-and-lgbtq-rights-in-poland/
-This guide is specific to trans refugees from Ukraine in Poland. States that, despite targeted policies for Ukrainian's, even they are having trouble accessing trans healthcare.
(2022) Guide for transgender people from Ukraine. https://tranzycja.pl/publications/transgender-people-ukraine/
-Technically asylees has equal access. In practice the situation appears different.
(2022) Health care Poland. https://asylumineurope.org/reports/country/poland/reception-conditions/health-care/
(2017) Current migration situation in the EU. p. 15. https://fra.europa.eu/en/publication/2017/current-migration-situation-eu-lesbian-gay-bisexual-transgender-and-intersex		NEI
-Information difficult to determine with all the data on Ukraine at this time. However, it is assumed tht accepted refuges recieve healthcare on the same terms as Polish citizens.		NEI(2021) Ref. W.W. v. Poland. https://www.hfhr.pl/wp-content/uploads/2021/11/20211108-WW-amicus-skan.pdfNEI(2017) Access to transgender hormone therapy. https://fra.europa.eu/de/publication/2017/mapping-minimum-age-requirements-concerning-rights-child-eu/access-transgender-hormone-therapy1
65
TGEU Confirmation (score)0001111001000005011003-6 months211111NEINEI160NEI01613
66
Portugal
67
TGEU Confirmation (sources)-"breast reconstruction"
(2022) “Of trans people who resorted to the SNS, more than half suffered discrimination” . https://www.esquerda.net/saude/das-pessoas-trans-que-recorreram-ao-sns-mais-de-metade-sofreu-discriminacao/81199
(n.d.) Genito-urinary and sexual reconstruction unit. p. 5. https://www.dgs.pt/ficheiros-de-upload-2013/urgus-pdf.aspx		-Does not appear so from existing information, though no statement of it's explicit exclusion.-Not explicitly, but appears so and respondent agrees.
(2021) Guide on health and laws trans me Portugal. p. 19. https://www.rea.pt/imgs/uploads/guia-trans.pdf		(2018) Trans and intersex equality rights in Europe. https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf.
(n.d.) Genito-urinary and sexual reconstruction unit. https://www.dgs.pt/ficheiros-de-upload-2013/urgus-pdf.aspx p. 4		(2018) Trans and intersex equality rights in Europe. https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf.
(n.d.) Genito-urinary and sexual reconstruction unit. https://www.dgs.pt/ficheiros-de-upload-2013/urgus-pdf.aspx p. 4		(n.d.) Genito-urinary and sexual reconstruction unit. p. 5. https://www.dgs.pt/ficheiros-de-upload-2013/urgus-pdf.aspx(2022) “Of trans people who resorted to the SNS, more than half suffered discrimination” . https://www.esquerda.net/saude/das-pessoas-trans-que-recorreram-ao-sns-mais-de-metade-sofreu-discriminacao/81199
(n.d.) Genito-urinary and sexual reconstruction unit. p. 5. https://www.dgs.pt/ficheiros-de-upload-2013/urgus-pdf.aspx		(n.d.) Genito-urinary and sexual reconstruction unit. p.11. https://www.dgs.pt/ficheiros-de-upload-2013/urgus-pdf.aspx(n.d.) Genito-urinary and sexual reconstruction unit. p. 10. https://www.dgs.pt/ficheiros-de-upload-2013/urgus-pdf.aspx(n.d.) Genito-urinary and sexual reconstruction unit. p.10. https://www.dgs.pt/ficheiros-de-upload-2013/urgus-pdf.aspx(n.d.) Genito-urinary and sexual reconstruction unit. p. 5, 11. https://www.dgs.pt/ficheiros-de-upload-2013/urgus-pdf.aspx-(2021) inmplies it. (n.d.) states that this is prov
(2021) Guide on health and laws trans me Portugal. p. 16. https://www.rea.pt/imgs/uploads/guia-trans.pdf
(n.d.) Genito-urinary and sexual reconstruction unit. p. 8-9. https://www.dgs.pt/ficheiros-de-upload-2013/urgus-pdf.aspx		-Not explicitly, but appears so and respondent agrees.
(2021) Guide on health and laws trans me Portugal. p. 18. https://www.rea.pt/imgs/uploads/guia-trans.pdf		(n.d.) Genito-urinary and sexual reconstruction unit. p. 5, 10. https://www.dgs.pt/ficheiros-de-upload-2013/urgus-pdf.aspxNEI(2021) Guide on health and laws trans me Portugal. https://www.rea.pt/imgs/uploads/guia-trans.pdf
(2018) Trans and intersex equality rights in Europe. https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf. See supplemental information
-Approval from Portugeuse Medical Association required to perform surgery
(2012) People's health care experiences transsexuals in Portugal, p. 146. https://revista.appsicologia.org/index.php/rpsicologia/article/view/266/32
(2010) Transgender persons' rights in the EU member states. p. 32. https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf
(n.d.) Genito-urinary and sexual reconstruction unit. p. 5. https://www.dgs.pt/ficheiros-de-upload-2013/urgus-pdf.aspx		-Diagnosis required (p.10).
(2017) Psychiatry in legal gender recognition procedures in Europe. p.10-11. http://hlcmr.de/wp-content/uploads/2017/01/Psychiatry-in-legal-gender-recognition-procedures-in-Europe.pdf
-"...Operations to change an individual's sex are prohibited except where adequate diagnosis confirms a case of transsexualism or gender dysphoria (p.32)."
(2010) Transgender persons' rights in the EU member states. p.32. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf		-Diagnosis required (p.10).
(2017) Psychiatry in legal gender recognition procedures in Europe. p.10-11. http://hlcmr.de/wp-content/uploads/2017/01/Psychiatry-in-legal-gender-recognition-procedures-in-Europe.pdf
-"...Operations to change an individual's sex are prohibited except where adequate diagnosis confirms a case of transsexualism or gender dysphoria (p.32)."
(2010) Transgender persons' rights in the EU member states. p.32. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf		See links in other cellsAs per respondent
-Must go through Combria for surgery. Wait list a few months for first appointment.
(2022) “Of trans people who resorted to the SNS, more than half suffered discrimination” . https://www.esquerda.net/saude/das-pessoas-trans-que-recorreram-ao-sns-mais-de-metade-sofreu-discriminacao/81199		-Some professionals exclude those w/ personality disorders or "psychotic conditions."
(2012) People's health care experiences transsexuals in Portugal, p. 146. https://revista.appsicologia.org/index.php/rpsicologia/article/view/266/32		-Some professionals exclude those w/ personality disorders or "psychotic conditions."
(2012) People's health care experiences transsexuals in Portugal, p. 146. https://revista.appsicologia.org/index.php/rpsicologia/article/view/266/32		-Insisted client can't have bi and homosexual friends. This obviously won't be the case with every practitioner, but it appears it occurs at least episodically.
(2012) People's health care experiences transsexuals in Portugal, p. 146. https://revista.appsicologia.org/index.php/rpsicologia/article/view/266/32		-Excluded from health care
(2022) “Of trans people who resorted to the SNS, more than half suffered discrimination” . https://www.esquerda.net/saude/das-pessoas-trans-que-recorreram-ao-sns-mais-de-metade-sofreu-discriminacao/81199
-Rigid gender roles sometimes enforced
(2012) People's health care experiences transsexuals in Portugal, p. 147. https://revista.appsicologia.org/index.php/rpsicologia/article/view/266/32		1
-Excluded from health care
(2022) “Of trans people who resorted to the SNS, more than half suffered discrimination” . https://www.esquerda.net/saude/das-pessoas-trans-que-recorreram-ao-sns-mais-de-metade-sofreu-discriminacao/81199
-Rigid gender roles sometimes enforced
(2012) People's health care experiences transsexuals in Portugal, p. 147. https://revista.appsicologia.org/index.php/rpsicologia/article/view/266/32		-Health care available from the moment of application and on the same terms as citizens.
-Portugal stands out in positive developments in this regard.
-"The reduction or withdrawal of reception conditions cannot restrict the access of asylum seekers to emergency health care, basic treatment of illnesses and serious mental disturbances or, in the case of applicants with special reception needs, to medical care or other types of necessary assistance, including adequate psychological care where appropriate (p. 132)."
(2021) AIDA Country report Portugal. p. 132. https://asylumineurope.org/wp-content/uploads/2022/05/AIDA-PT_2021update.pdf		-Possibly in practice but explicitly not be design
(2022) Welcoming and caring for refugees. https://www.esquerda.net/saude/acolher-e-cuidar-dos-refugiados/81190		-No evidence one way or another. Put yes because respondent indicated it was and because BMI limits for trans surgeries exist widely.-Judgement call. Could go either way,
-"The law does not specifically mention transgender people. It provides in general terms for the possibility of special medical care or treatment (p.15)."
(2018) Prison Insider Portugal report. https://www.prison-insider.com/files/2e5c708f/fp_en_portugal_04.pdf		-Not explicit, but statement (translated) "puberty only when it gives the first signals (p.8)."
(n.d.) Genito-urinary and sexual reconstruction unit. p. 8. https://www.dgs.pt/ficheiros-de-upload-2013/urgus-pdf.aspx
Probably not entirely reliable because it's from twitter but see: https://twitter.com/noisybits/status/1334065783572484096		-Possible before 16
(2017) Access to transgender hormone therapy. https://fra.europa.eu/de/publication/2017/mapping-minimum-age-requirements-concerning-rights-child-eu/access-transgender-hormone-therapy (says only 18 years)
(2013) Genito-urinary and sexual reconstruction unit. p. 12. https://www.dgs.pt/ficheiros-de-upload-2013/urgus-pdf.aspx
(2012) People's health care experiences transsexuals in Portugal, p. 142. https://revista.appsicologia.org/index.php/rpsicologia/article/view/266/32
68
TGEU Confirmation (score)10111111111111NEI13211006-12 months11111NEI01NEI51Tanner 221806
69
Romania
70
TGEU Confirmation (sources)-Could not explicily confirm, but existing information makes this clear.
(2020) Trans in Romania. https://www.freiheit.org/sites/default/files/2021-06/trans-in-romania_en.pdf		-Could not explicily confirm, but existing information makes this clear.
(2020) Trans in Romania. https://www.freiheit.org/sites/default/files/2021-06/trans-in-romania_en.pdf		-Could not explicily confirm, but existing information makes this clear.
(2020) Trans in Romania. https://www.freiheit.org/sites/default/files/2021-06/trans-in-romania_en.pdf		-Access to HRT very difficult in general and criminalized in many circumstances.
(2022) ILGA annual review. p. 118. https://ilga-europe.org/files/uploads/2022/04/annual-review-2021.pdf
-"Hormone replacement therapy and treatment for gender dysphoria are not covered by insurance in Romania (p.83)."
(2021) Trans on the labour market in Romania. p.83. https://www.researchgate.net/publication/356831938_Trans_on_the_Labour_Market_in_Romania_A_national_report_on_the_career_paths_employability_and_workplace_experiences_of_transgender_non-binary_and_intersex_Romanians_2021/link/61af2602b3c26a1e5d8ed9ab/download
(2020) Trans in Romania. https://www.freiheit.org/sites/default/files/2021-06/trans-in-romania_en.pdf
(2012) Transgender EuroStudy. p.23. https://www.researchgate.net/publication/242527943_Transgender_EuroStudy_Legal_Survey_and_Focus_on_the_Transgender_Experience_of_Health_Care_Written_by		-It appears that testosterone can be partially covered (you pay 10%) after one gets their legal sex changed (e.g. won't be covered for 'women' but will for 'men').
(2020) Trans in Romania. p.32. https://www.freiheit.org/sites/default/files/2021-06/trans-in-romania_en.pdf
(2012) Transgender EuroStudy. p.23. https://www.researchgate.net/publication/242527943_Transgender_EuroStudy_Legal_Survey_and_Focus_on_the_Transgender_Experience_of_Health_Care_Written_by		-Not officially and only if the individual gets it covered for 'cancer' or something like that.
(2020) Trans in Romania. p.35. https://www.freiheit.org/sites/default/files/2021-06/trans-in-romania_en.pdf		-Not officially and only if the individual gets it covered for 'cancer' or something like that.
(2020) Trans in Romania. p.35. https://www.freiheit.org/sites/default/files/2021-06/trans-in-romania_en.pdf		-Could not explicily confirm, but existing information makes this clear.
(2020) Trans in Romania. https://www.freiheit.org/sites/default/files/2021-06/trans-in-romania_en.pdf		-Could not explicily confirm, but existing information makes this clear.
(2020) Trans in Romania. https://www.freiheit.org/sites/default/files/2021-06/trans-in-romania_en.pdf		-Not officially and only if the individual gets it covered for 'cancer' or something like that.
(2020) Trans in Romania. p.35. https://www.freiheit.org/sites/default/files/2021-06/trans-in-romania_en.pdf		-Could not explicily confirm, but existing information makes this clear.
(2020) Trans in Romania. https://www.freiheit.org/sites/default/files/2021-06/trans-in-romania_en.pdf		-Could not explicily confirm, but existing information makes this clear.
(2020) Trans in Romania. https://www.freiheit.org/sites/default/files/2021-06/trans-in-romania_en.pdf		-Could not explicily confirm, but existing information makes this clear.
(2020) Trans in Romania. https://www.freiheit.org/sites/default/files/2021-06/trans-in-romania_en.pdf		-Could not explicily confirm, but existing information makes this clear.
(2020) Trans in Romania. https://www.freiheit.org/sites/default/files/2021-06/trans-in-romania_en.pdf		-Could not explicily confirm, but existing information makes this clear.
(2020) Trans in Romania. https://www.freiheit.org/sites/default/files/2021-06/trans-in-romania_en.pdf		-Some folks getting health care covered by surgeons using false codes (e.g. reduction mammoplasty instead of mastectomy).
(2020) Trans in Romania. p.35. https://www.freiheit.org/sites/default/files/2021-06/trans-in-romania_en.pdf
-"Noted that they had been refused funding froma state insurance scheme for medical treatments they required as part of the LGR process (p.169)."
(2020). Legal gender recognition in the EU. p. 169. https://ec.europa.eu/info/sites/default/files/legal_gender_recognition_in_the_eu_the_journeys_of_trans_people_towards_full_equality_sept_en.pdf
-No access to GCT and no funding.
(2018) https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf
(2010) Transgender persons' rights in the EU member states. p. 33. https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf
-"Transgender persons face structural barriers in accessing appropriate healht services due to limited access to insurance policies, the costs of therapies and the widespread prejudice and discrimination in the medical system. Overall, the medical community has limited experience and knowledge in this area. Transgender persons are often treated as psychiatric patiences, adn there are few endocrinologists who are willing to provide hormonal treatment to transgender persons (p. 33)."		(2020) Trans in Romania.p.28. https://transinromania.ro/wp-content/uploads/Trans-in-Romania_EN.pdf
-Diagnosis implicitly "required in order to undergo sterilization/hormone therapy/other gender reassignment measures (p.11)."
(2017) Psychiatry in legal gender recognition procedures in Europe. p.10-11. http://hlcmr.de/wp-content/uploads/2017/01/Psychiatry-in-legal-gender-recognition-procedures-in-Europe.pdf
-"Transgender persons are often treated as psychiatric patients, and there are few endocrinologists who are willing to provide hormonal treatment to transgender persons (p.33)."
(2010) Transgender persons' rights in the EU member states. p.33. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf		(2020) Trans in Romania.p.28. https://transinromania.ro/wp-content/uploads/Trans-in-Romania_EN.pdf
-Diagnosis implicitly "required in order to undergo sterilization/hormone therapy/other gender reassignment measures (p.11)."
(2017) Psychiatry in legal gender recognition procedures in Europe. p.10-11. http://hlcmr.de/wp-content/uploads/2017/01/Psychiatry-in-legal-gender-recognition-procedures-in-Europe.pdf
-"Transgender persons are often treated as psychiatric patients, and there are few endocrinologists who are willing to provide hormonal treatment to transgender persons (p.33)."
(2010) Transgender persons' rights in the EU member states. p.33. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf		See links in other cellsAs per respondent-Could not indepedently confirm. Took respondent's word.-A person with a disability "may be unable to go through LGR if they cannot go through hormone treatment (p.130)."
(2020). Legal gender recognition in the EU. p. 130. https://ec.europa.eu/info/sites/default/files/legal_gender_recognition_in_the_eu_the_journeys_of_trans_people_towards_full_equality_sept_en.pdf		-Conflating gender identity and sexuality.
(2020). Legal gender recognition in the EU. p. 152. https://ec.europa.eu/info/sites/default/files/legal_gender_recognition_in_the_eu_the_journeys_of_trans_people_towards_full_equality_sept_en.pdf		-"I avoid giving information about being a genderqueer to the medical staff. This saves me from unwanted questions, suspicious looks an dcuriosity. For visits to the doctor, I can pass as a slightly eccentric woman and avoid all explanations (p.42)."
(2020) Trans in Romania. p.42. https://www.freiheit.org/sites/default/files/2021-06/trans-in-romania_en.pdf
-Trans people pressured into getting certain surgical interventions (p. 151-152).
(2020). Legal gender recognition in the EU. p. 151-152. https://ec.europa.eu/info/sites/default/files/legal_gender_recognition_in_the_eu_the_journeys_of_trans_people_towards_full_equality_sept_en.pdf		1
-"Gender stereotypes play a significant role in the assessment of gender identity (p.137)."
(2020). Legal gender recognition in the EU. p. 137. https://ec.europa.eu/info/sites/default/files/legal_gender_recognition_in_the_eu_the_journeys_of_trans_people_towards_full_equality_sept_en.pdf		-The right to free emergency and life saving healthcare only
(n.d.) Rights and duties of asylum-seekers. https://help.unhcr.org/romania/rights-and-duties-of-asylum-seekers/		-"Access to health care for asylum seekers covers the right to recieve free primary care and appropriate treatment."
(2022) Measures imposed during the pandemic. https://asylumineurope.org/reports/country/romania/reception-conditions/health-care/		-"Endocrinologist told me that I needed to lost weight (p. 31)" before HRT.
(2020) Trans in Romania. p.35. https://www.freiheit.org/sites/default/files/2021-06/trans-in-romania_en.pdf		-Could not confirm. Took respondent's word.NEI-There is evidence that a not insignificant number of individuals are accssing PB, but no specific age mentioned and no info on the process required to do so.
(2020) Trans in Romania. https://www.freiheit.org/sites/default/files/2021-06/trans-in-romania_en.pdf
(2017) Access to transgender hormone therapy. https://fra.europa.eu/de/publication/2017/mapping-minimum-age-requirements-concerning-rights-child-eu/access-transgender-hormone-therapy
71
TGEU Confirmation (score)0000100000000001011001-2 months21111111180NEI0<18
-There is evidence that a not insignificant number of individuals are accssing PB, but no specific age mentioned and no info on the process required to do so.
(2020) Trans in Romania. https://www.freiheit.org/sites/default/files/2021-06/trans-in-romania_en.pdf
(2017) Access to transgender hormone therapy. https://fra.europa.eu/de/publication/2017/mapping-minimum-age-requirements-concerning-rights-child-eu/access-transgender-hormone-therapy		13
72
Slovakia
73
TGEU Confirmation (sources)-"In Slovakia, public insurance does not include trans healthcare in its catalogue, but in practice... hormonal treatment, hysterectony, orchiectomy, and bilateral adnexectomy are covered. With the lack of rules however, access to these services is not guaranteed (p.30)."
(2017) Trans healthcare lottery. p. 11. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		-"In Slovakia, public insurance does not include trans healthcare in its catalogue, but in practice... hormonal treatment, hysterectony, orchiectomy, and bilateral adnexectomy are covered. With the lack of rules however, access to these services is not guaranteed (p.30)."
(2017) Trans healthcare lottery. p. 11. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		-"In Slovakia, public insurance does not include trans healthcare in its catalogue, but in practice... hormonal treatment, hysterectony, orchiectomy, and bilateral adnexectomy are covered. With the lack of rules however, access to these services is not guaranteed (p.30)."
(2017) Trans healthcare lottery. p. 11. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		--See explanation in "other"-"In Slovakia, public insurance does not include trans healthcare in its catalogue, but in practice... hormonal treatment, hysterectony, orchiectomy, and bilateral adnexectomy are covered. With the lack of rules however, access to these services is not guaranteed (p.30)."
(2017) Trans healthcare lottery. p. 11. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		-"In Slovakia, public insurance does not include trans healthcare in its catalogue, but in practice... hormonal treatment, hysterectony, orchiectomy, and bilateral adnexectomy are covered. With the lack of rules however, access to these services is not guaranteed (p.30)."
(2017) Trans healthcare lottery. p. 11. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		-"In Slovakia this procedure is performed in private clinics and the trans person pays for it himself."
(n.d.) Medicine. http://www.transfuzia.org/situacia-na-slovensku/medicina		-"Some people go to the Czech Republic for this procedure, which is largely reimbursed after an agreement with the insurance company."
(n.d.) Medicine. http://www.transfuzia.org/situacia-na-slovensku/medicina
-Report states that people can theoretically seek coverage for surgery performed in Czechia, but that they are not aware of anyone who had tried.
(2017) Trans healthcare lottery. p. 11, 28. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		-"In Slovakia, public insurance does not include trans healthcare in its catalogue, but in practice... hormonal treatment, hysterectony, orchiectomy, and bilateral adnexectomy are covered. With the lack of rules however, access to these services is not guaranteed (p.30)."
(2017) Trans healthcare lottery. p. 11. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		-"In Slovakia, public insurance does not include trans healthcare in its catalogue, but in practice... hormonal treatment, hysterectony, orchiectomy, and bilateral adnexectomy are covered. With the lack of rules however, access to these services is not guaranteed (p.30)."
(2017) Trans healthcare lottery. p. 11. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		-"Some people go to the Czech Republic for this procedure, which is largely reimbursed after an agreement with the insurance company."
(n.d.) Medicine. http://www.transfuzia.org/situacia-na-slovensku/medicina
-Report states that people can theoretically seek coverage for surgery performed in Czechia, but that they are not aware of anyone who had tried.
(2017) Trans healthcare lottery. p. 11, 28. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		-"In Slovakia, public insurance does not include trans healthcare in its catalogue, but in practice... hormonal treatment, hysterectony, orchiectomy, and bilateral adnexectomy are covered. With the lack of rules however, access to these services is not guaranteed (p.30)."
(2017) Trans healthcare lottery. p. 11. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		-"In Slovakia, public insurance does not include trans healthcare in its catalogue, but in practice... hormonal treatment, hysterectony, orchiectomy, and bilateral adnexectomy are covered. With the lack of rules however, access to these services is not guaranteed (p.30)."
(2017) Trans healthcare lottery. p. 11. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		-"Some people go to the Czech Republic for this procedure, which is largely reimbursed after an agreement with the insurance company."
(n.d.) Medicine. http://www.transfuzia.org/situacia-na-slovensku/medicina
-Report states that people can theoretically seek coverage for surgery performed in Czechia, but that they are not aware of anyone who had tried.
(2017) Trans healthcare lottery. p. 11, 28. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		-"In Slovakia, public insurance does not include trans healthcare in its catalogue, but in practice... hormonal treatment, hysterectony, orchiectomy, and bilateral adnexectomy are covered. With the lack of rules however, access to these services is not guaranteed (p.30)."
(2017) Trans healthcare lottery. p. 11. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		-Recent draft guidelines for trans healthcare rejected by government. "Medical professionals state they do not want to provide trans healthcare services, without the guidelines being adopted (p.128)."
(2022) ILGA annual review. p. 128. https://ilga-europe.org/files/uploads/2022/04/annual-review-2021.pdf-Access to GCT but no funding.
(2018) Trans and intersex equality rights in Europe. p. 78. https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf
-Virtually no, or no healthcare coverage.
-"In Slovakia, public insurance does not include trans healthcare in its catalogue, but in practice... hormonal treatment, hysterectony, orchiectomy, and bilateral adnexectomy are covered. With the lack of rules however, access to these services is not guaranteed (p.30)."
(2017) Trans healthcare lottery. p. 11. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf
(2010)Transgender persons' rights in the EU member states. p. 33. https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf		(2017) Trans healthcare lottery. p.16, 18. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf
-Diagnosis "required due to interpretation of law (p.10).
(2017) Psychiatry in legal gender recognition procedures in Europe. p.10-11. http://hlcmr.de/wp-content/uploads/2017/01/Psychiatry-in-legal-gender-recognition-procedures-in-Europe.pdf
-"In the case of "sex change" [the state] requires medical opinion to approve the change... [and] interprets the expression 'sex change' as triadic therapy with hormonal treatment, real life experience and surgeries leading to sterilization (p.33)."
(2010) Transgender persons' rights in the EU member states. p.33. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf		(2017) Trans healthcare lottery. p.16, 18. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf
-Diagnosis "required due to interpretation of law (p.10).
(2017) Psychiatry in legal gender recognition procedures in Europe. p.10-11. http://hlcmr.de/wp-content/uploads/2017/01/Psychiatry-in-legal-gender-recognition-procedures-in-Europe.pdf		See links in other cellsNEI-"Quite a few trans people are involuntarily excluded from the transition process if they are mentally ill... e.g. depression, have developmental disorders or autism spectrum disorders etc."
(n.d.) Transition. http://www.transfuzia.org/situacia-na-slovensku/tranzicia#je-na-slovensku-mozne-podstupit-tranziciu		-"Quite a few trans people are involuntarily excluded from the transition process if they are mentally ill... e.g. depression, have developmental disorders or autism spectrum disorders etc."
(n.d.) Transition. http://www.transfuzia.org/situacia-na-slovensku/tranzicia#je-na-slovensku-mozne-podstupit-tranziciu		(2017) Trans healthcare lottery. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf
-"Although one has to look around and see that just as men and women are not the same, they are not exclusively heterosexual... these attributes are often required of trans people. In the eyes of doctors... if your identity is clearly male or female, if you want to be perceived as a heterosexual man or woman..."
(n.d.) Transition. http://www.transfuzia.org/situacia-na-slovensku/tranzicia#je-na-slovensku-mozne-podstupit-tranziciu		-"If the doctor decides that you are not 'trans enough... they can completely block your access to healthcare (p.26)."
(2017) Trans healthcare lottery. p. 26. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf
-"Although one has to look around and see that just as men and women are not the same, they are not exclusively heterosexual... these attributes are often required of trans people. In the eyes of doctors... if your identity is clearly male or female, if you want to be perceived as a heterosexual man or woman..."
(n.d.) Transition. http://www.transfuzia.org/situacia-na-slovensku/tranzicia#je-na-slovensku-mozne-podstupit-tranziciu		1
(2017) Trans healthcare lottery. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf"
-"Although one has to look around and see that just as men and women are not the same, they are not exclusively heterosexual... these attributes are often required of trans people. In the eyes of doctors... if your identity is clearly male or female, if you want to be perceived as a heterosexual man or woman..."
(n.d.) Transition. http://www.transfuzia.org/situacia-na-slovensku/tranzicia#je-na-slovensku-mozne-podstupit-tranziciu		NEI-"Refugees and asylum seekers are entitled to necessary healthcare--i.e., also to consultations with general practitioners, vaccinations, or parts of the care for chronic diseases."
(n.d.) https://bratislava.sk/en/bratislava-for-ukraine/healthcare		NEINEINEI18 (w/o parental or public authority consent)
-Could not confirm anything else.
(2017) Access to transgender hormone therapy. https://fra.europa.eu/de/publication/2017/mapping-minimum-age-requirements-concerning-rights-child-eu/access-transgender-hormone-therapy
74
TGEU Confirmation (score)000011001110010611100NEI01111NEINEINEINEI41NEI01802
75
Slovenia
76
TGEU Confirmation (sources)-Can be covered under Slovenian health insurance (ZZZS).
(n.d.) t-handbook for transfeminine people. https://transakcija.si/t-prirocnik/tf/?path=%2Fposegi		-Only in the case of necessity before vaginoplasty
(n.d.) t-handbook for transfeminine people. https://transakcija.si/t-prirocnik/tf/?path=%2Fposegi		-Does not appear to be
(n.d.) t-handbook for transfeminine people. https://transakcija.si/t-prirocnik/tf/?path=%2Fposegi		-Could not absolutely confirm, but appears to be.
(n.d.) t-handbook for transfeminine people. https://transakcija.si/t-prirocnik/tf/?path=%2Fhormoni		-Could not absolutely confirm, but appears to be.
(n.d.) t-handbook for transmasculines. https://transakcija.si/t-prirocnik/tm/?path=%2Fhrt%2Fo_hrt		(n.d.) t-handbook for trans masculinities. https://transakcija.si/t-prirocnik/tm/?path=%2Fposegi%2Fhisterektomija
(2018) https://www.lgbti-era.org/sites/default/files/pdfdocs/Report%20on%20Legal%20Gender%20Recognition%20in%20the%20Western%20Balkans%20and%20Turkey.pdf		(n.d.) T-handbook for trans masculinities. https://transakcija.si/t-prirocnik/tm/?path=%2Fposegi%2Fzgornja_operacija(n.d.) T-handbook for trans masculinities. https://transakcija.si/t-prirocnik/tm/?path=%2Fposegi%2Fspodnja_operacija-Not stated explicitly, but appears so.
(n.d.) t-handbook for transfeminine people. https://transakcija.si/t-prirocnik/tf/?path=%2Fposegi		(n.d.) t-handbook for trans masculinities. https://transakcija.si/t-prirocnik/tm/?path=%2Fposegi%2Fhisterektomija(n.d.) T-handbook for trans masculinities. https://transakcija.si/t-prirocnik/tm/?path=%2Fposegi%2Fspodnja_operacija-"Trans persons who are insured can access all health services including trans-specific health services for free (p.22)."
(2018) https://www.lgbti-era.org/sites/default/files/pdfdocs/Report%20on%20Legal%20Gender%20Recognition%20in%20the%20Western%20Balkans%20and%20Turkey.pdf		-Can be covered under Slovenian health insurance (ZZZS).
(n.d.) t-handbook for transfeminine people. https://transakcija.si/t-prirocnik/tf/?path=%2Fposegi		(n.d.) t-handbook for transfeminine people. https://transakcija.si/t-prirocnik/tf/?path=%2FposegiNEI
Could not confirm		(2018) https://www.lgbti-era.org/sites/default/files/pdfdocs/Report%20on%20Legal%20Gender%20Recognition%20in%20the%20Western%20Balkans%20and%20Turkey.pdf
(2017) Trans healthcare lottery. p. 13. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf
-"It is up to individual doctors to decide whether to refer transsexual clients to specialists who then decide on the appropriate sex reassignment process. The treatment is free of charge (p. 33)."
(2010) Transgender persons' rights in the EU member states. p. 33. https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf
(2010) https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf		https://transakcija.si/t-prirocnik/tf/?path=%2Fhormoni%2Fpogoji
(2018) Trans and intersex equality rights in Europe: A comparative analysis. p.78. https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf
-Diagnosis implicitly required (p.10).
(2017) Psychiatry in legal gender recognition procedures in Europe. p.10-11. http://hlcmr.de/wp-content/uploads/2017/01/Psychiatry-in-legal-gender-recognition-procedures-in-Europe.pdf		https://transakcija.si/t-prirocnik/tf/?path=%2Fposegi
(2018) Trans and intersex equality rights in Europe: A comparative analysis. p.78. https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf
-Diagnosis implicitly required (p.10).
(2017) Psychiatry in legal gender recognition procedures in Europe. p.10-11. http://hlcmr.de/wp-content/uploads/2017/01/Psychiatry-in-legal-gender-recognition-procedures-in-Europe.pdf		See links in other cellsAs per respondent(2021) Transgender people during the covid-19 epidemic. p.51. https://legebitra.si/wp-content/uploads/2019/08/TransBuddy-REPORT.pdf
-Discussed slow progress of care.
(2021) Case report-Adolescent with autism and gender dysphoria. https://www.frontiersin.org/articles/10.3389/fpsyt.2021.671448/full		(2021) Case report-Adolescent with autism and gender dysphoria. https://www.frontiersin.org/articles/10.3389/fpsyt.2021.671448/full
(2017) Trans Healthcare Lottery. p. 32-33. https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		-Lots of concern around need to determine non-binary people's sexuality and what this means for detransition.
(2021) Transgender people during the covid-19 epidemic. p.58. https://legebitra.si/wp-content/uploads/2019/08/TransBuddy-REPORT.pdf"		-Particularly around concern that they will detransition and need to protect them from themselves.
-Seen as a manifestation of borderline personality disorder?
(2021) Transgender people during the covid-19 epidemic. p. 51, 57-58, 72. https://legebitra.si/wp-content/uploads/2019/08/TransBuddy-REPORT.pdf		1
-Did not find explicit reference, but based on following report this seems likely.
(2021) Transgender people during the covid-19 epidemic. p. 51 https://legebitra.si/wp-content/uploads/2019/08/TransBuddy-REPORT.pdf		-Aylum seekers only guaranteed access to emergency health care.
(2021) AIDA Country Report Slovenia. p. 78. https://asylumineurope.org/wp-content/uploads/2022/05/AIDA-SI_2021update.pdf		-Presumably receive healthcare on the same terms as citizens-Repeated mention of treating patient for obesity and relation to gender identity. Did not mention that this affected progress of treatment, but respondent stated that is does.
(2021) Case report-Adolescent with autism and gender dysphoria. https://www.frontiersin.org/articles/10.3389/fpsyt.2021.671448/full		NEI(n.d.) Transition of minors. https://transakcija.si/t-prirocnik/tranzicija-mladoletnih-oseb/(n.d.) Transition of minors. https://transakcija.si/t-prirocnik/tranzicija-mladoletnih-oseb/
77
TGEU Confirmation (score)1101111111111NEI12211003-6 months211111NEI1NEI60<1811805
78
Spain
79
TGEU Confirmation (sources)-All procedures here are only available in some regions and not others.
(2021) Experience of trans women in your profocess medical transition. https://felgtb.org/wp-content/uploads/2021/01/experienciamujerestransProcesoTranscionMedica.pdf		-Could not confirm. However, existing publications mentioned for other procedures did not specify this.(2020) New care models for transgender people in the Spanish health system. https://www.researchgate.net/publication/347927932_New_care_models_for_transgender_people_in_the_Spanish_Health_System_demands_controversies_and_reflections
(2012) Organization of healthcare for transsexual persons in the Spanish national health system. https://www.researchgate.net/publication/221688222_Organization_of_healthcare_for_transsexual_persons_in_the_Spanish_national_health_system		(2017) Trans healthcare lottery/ https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf(2017) Trans healthcare lottery/ https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf(2012) Organization of healthcare for transsexual persons in the Spanish national health system. https://www.researchgate.net/publication/221688222_Organization_of_healthcare_for_transsexual_persons_in_the_Spanish_national_health_system(2012) Organization of healthcare for transsexual persons in the Spanish national health system. https://www.researchgate.net/publication/221688222_Organization_of_healthcare_for_transsexual_persons_in_the_Spanish_national_health_system-Could not confirm either way. Went with respondent's assertion. Some sources do specify "genitoplasty", which is non-specific, but could include this.
(2012) Organization of healthcare for transsexual persons in the Spanish national health system. https://www.researchgate.net/publication/221688222_Organization_of_healthcare_for_transsexual_persons_in_the_Spanish_national_health_system		-Presumed yes, based on performance of vaginoplasty and span of other procedures.
(2020) New care models for transgender people in the Spanish health system. https://www.researchgate.net/publication/347927932_New_care_models_for_transgender_people_in_the_Spanish_Health_System_demands_controversies_and_reflections
(2012) Organization of healthcare for transsexual persons in the Spanish national health system. https://www.researchgate.net/publication/221688222_Organization_of_healthcare_for_transsexual_persons_in_the_Spanish_national_health_system		(2012) Organization of healthcare for transsexual persons in the Spanish national health system. https://www.researchgate.net/publication/221688222_Organization_of_healthcare_for_transsexual_persons_in_the_Spanish_national_health_system(2020) New care models for transgender people in the Spanish health system. https://www.researchgate.net/publication/347927932_New_care_models_for_transgender_people_in_the_Spanish_Health_System_demands_controversies_and_reflections-"The public healthcare system guarantees trans-specific healthcare for minors [PB and HRT] (p. 56)."
(2017) Overdiagnosed but underserved. p. 56. https://tgeu.org/wp-content/uploads/2017/10/Overdiagnosed_Underserved-TransHealthSurvey.pdf		NEI-"Feminizing genitoplasty (p.207)"
(2012) Organization of healthcare for transsexual persons in the Spanish national health system. https://www.researchgate.net/publication/221688222_Organization_of_healthcare_for_transsexual_persons_in_the_Spanish_national_health_system		NEI-Access to GCT and funding, without conditions.
(2018) https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf
-Vastly different depending on region. Report here is an amalgamation of all of Spain. Specifically, "granting access and health coverage for trans people is delegated at the discretion of each autonomous region to a centralised service unit (p. 55)."
(2017) Overdiagnosed but underserved. https://tgeu.org/wp-content/uploads/2017/10/Overdiagnosed_Underserved-TransHealthSurvey.pdf
-Explicitly not included in Spanish National Health Care Service, but instead covered by a number of autonomous regions.
(2015) The Legal Status of Transsexual and Transgender Persons in Spain
-Out of date, but provides table with procedures carried out by each unit/autonomous region.
(2012) Organization of healthcare for transsexual persons in the Spanish national health system. https://www.researchgate.net/publication/221688222_Organization_of_healthcare_for_transsexual_persons_in_the_Spanish_national_health_system		Mixed
-Required in some regions and explicitly not required in others. However, amongst the latter, many providers (e.g. endos) will still require a supplementary mental health assessment.
-Precedent set that individuals who cannot receive care in their region due to it's nonexistence must receive funding for it in another region.
(2017) Trans healthcare lottery. p.17-18, 38 https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		Mixed
-Required in some regions and explicitly not required in others. However, amongst the latter, many providers (e.g. endos) will still require a supplementary mental health assessment.
-Precedent set that individuals who cannot receive care in their region due to it's nonexistence must receive funding for it in another region.
(2017) Trans healthcare lottery. p.17-18, 38 https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		Mixed
-Required in some regions and explicitly not required in others. However, amongst the latter, many providers (e.g. endos) will still require a supplementary mental health assessment.
-Precedent set that individuals who cannot receive care in their region due to it's nonexistence must receive funding for it in another region.
(2017) Trans healthcare lottery. p.17-18, 38 https://tgeu.org/wp-content/uploads/2017/12/TGEU-trans-healthcare-lottery.pdf		As per respondent
-This seems overly optimistic.
-Waitlist for surgery in public clinics 6-8 years.
(2017) Overdiagnosed but underserved. p.60. https://tgeu.org/wp-content/uploads/2017/10/Overdiagnosed_Underserved-TransHealthSurvey.pdf		-On the basis of Autism at least
(2020) Legal gender recognition in the EU: The journeys of trans people towards full equality. p. 130, 144. https://ec.europa.eu/info/sites/default/files/legal_gender_recognition_in_the_eu_the_journeys_of_trans_people_towards_full_equality_sept_en.pdf		(2020) Legal gender recognition in the EU. p. 144. https://ec.europa.eu/info/sites/default/files/legal_gender_recognition_in_the_eu_the_journeys_of_trans_people_towards_full_equality_sept_en.pdf-Could not confirm, though some of the citations here suggest this may be the case and the heterogeneity of approaches from different GICs suggests this is plausible.-"Non-binary people usually cannot access trans-specific healthcare due to a prevailing binary medical model (p. 54)."
(2017) Overdiagnosed but underserved. p. 54, 59. https://tgeu.org/wp-content/uploads/2017/10/Overdiagnosed_Underserved-TransHealthSurvey.pdf		1
-People feel forced into a gender binary
(2017) Overdiagnosed but underserved. p. 62. https://tgeu.org/wp-content/uploads/2017/10/Overdiagnosed_Underserved-TransHealthSurvey.pdf		-Access to HRT in principle. Presumption that an individual has registered.
(2017) Current migration situation in the EU. p 15. https://fra.europa.eu/sites/default/files/fra_uploads/fra-march-2017-monthly-migration-report-focus-lgbti_en.pdf		-No information. Healthcare assumed to be available to refugees on the same terms as citizens.-Could not confirm, though noted study did indicate that high BMI was a risk factor in HRT for trans women (did not specify excluding these individuals). Nevertheless, indicated yes because respondent indicated it was and because BMI limits for trans surgeries exist widely.
(2022) Clinical practice guidelines for transsexual, transgender and gender diverse minors. https://www.sciencedirect.com/science/article/pii/S2341287922000783		-Judgement call. Could not find references supporting this except below, which indicates they can begin or continue HRT after meeting with endo. On the other hand, this presumes a waiting period to see the endo and says nothing of surgery etc.
(n.d.) https://www.prison-insider.com/en/compare/es/be?profiles%5B0%5D=49763&profiles%5B1%5D=29230;		-In at least some regions
(2022) Clinical practice guidelines for transsexual, transgender and gender diverse minors. https://reader.elsevier.com/reader/sd/pii/S2341287922000783?to. ken=6F0C64C59C789D1B0E58A62312FB171395086A79AB70BF016FD7ADE48C5F33A98F0551AEB026ACBEB1061ACD88B8D919&originRegion=eu-west-1&originCreation=20220911205416
-"Puberty blockers are available to youth, dependent on differnet legislation in each autonomous region (p. 54)."
(2017) Overdiagnosed but underserved. p. 54. https://tgeu.org/wp-content/uploads/2017/10/Overdiagnosed_Underserved-TransHealthSurvey.pdf		(2017) Access to transgender hormone therapy. https://fra.europa.eu/en/publication/2017/mapping-minimum-age-requirements-concerning-rights-child-eu/access-sex-reassignment-surgery
(2015) The Legal Status of Transsexual and Transgender Persons in Spain. p.268. https://drive.google.com/file/d/1jVTPnP_F_SBgYVl4cu8Je6XVWChnI-k9/view?usp=sharing
80
TGEU Confirmation (score)101111111111NEI1NEI12211113-6 months21111001051Tanner 221619
81
Sweden
82
TGEU Confirmation (sources)As per respondents(2015) Trans health care. https://www.rfsl.se/en/organisation/vard-for-transpersoner/transvaard/(2015) Trans health care. https://www.rfsl.se/en/organisation/vard-for-transpersoner/transvaard/(2015) Trans health care. https://www.rfsl.se/en/organisation/vard-for-transpersoner/transvaard/(2015) Trans health care. https://www.rfsl.se/en/organisation/vard-for-transpersoner/transvaard/(2015) Trans health care. https://www.rfsl.se/en/organisation/vard-for-transpersoner/transvaard/(2015) Trans health care. https://www.rfsl.se/en/organisation/vard-for-transpersoner/transvaard/(2015) Trans health care. https://www.rfsl.se/en/organisation/vard-for-transpersoner/transvaard/(2015) Trans health care. https://www.rfsl.se/en/organisation/vard-for-transpersoner/transvaard/(2015) Trans health care. https://www.rfsl.se/en/organisation/vard-for-transpersoner/transvaard/(2015) Trans health care. https://www.rfsl.se/en/organisation/vard-for-transpersoner/transvaard/-In the case where it is approved.
(2021) https://lgbtalliance.eu/four-requests-to-improve-healthcare-for-trans-people/
(2015) Trans health care. https://www.rfsl.se/en/organisation/vard-for-transpersoner/transvaard/		(2015) Trans health care. https://www.rfsl.se/en/organisation/vard-for-transpersoner/transvaard/(2015) Trans health care. https://www.rfsl.se/en/organisation/vard-for-transpersoner/transvaard/(2015) Trans health care. https://www.rfsl.se/en/organisation/vard-for-transpersoner/transvaard/"full range of procedures (including gender surgery)"
(2018, EC report) Access to GCT and funding, with conditions. https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf. See supplemental information
(2021) https://www.frontiersin.org/articles/10.3389/fendo.2021.717914/full		https://www.rfsl.se/en/organisation/vard-for-transpersoner/transvaard/
-A diagnosis of gender dysphoria is required for upper body surgeries and transsexualism for lower body surgeries (p.81).
(2018) Trans and intersex equality rights in Europe: A comparative analysis. https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf
(2010) Transgender persons' rights in the EU member states. p.33. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf		-A diagnosis of gender dysphoria is required for upper body surgeries and transsexualism for lower body surgeries (p.81).
(2018) Trans and intersex equality rights in Europe: A comparative analysis. https://ec.europa.eu/info/sites/default/files/trans_and_intersex_equality_rights.pdf
(2010) Transgender persons' rights in the EU member states. p.33. https://www.europarl.europa.eu/RegData/etudes/note/join/2010/425621/IPOL-LIBE_NT%282010%29425621_EN.pdf		See links in other cellsAs per respondents
(2022) Ilga Report. https://ilga-europe.org/files/uploads/2022/04/annual-review-2022.pdf
(2021) https://ilga-europe.org/files/uploads/2022/04/annual-review-2021.pdf
-New policy has reduced gender clinics from 7 to 3.
(2021) "The queues for gender-affirming care must be shorter" https://www.dagensmedicin.se/opinion/debatt/koerna-till-konsbekraftande-vard-maste-bli-kortare/		-Recommends intensive investigation for autistic and ADHD clients (children).
(2022) Support, investigation and hormone treatment at gender incongruity in children and young people. https://www.socialstyrelsen.se/globalassets/sharepoint-dokument/artikelkatalog/kunskapsstod/2022-2-7774.pdf		-Recommends against treatment where intellectual disability is present (p.54).
(2022) Support, investigation and hormone treatment at gender incongruity in children and young people. p. 54. https://www.socialstyrelsen.se/globalassets/sharepoint-dokument/artikelkatalog/kunskapsstod/2022-2-7774.pdf		(2020) Legal gender recognition in the EU. p. 163. https://ec.europa.eu/info/sites/default/files/legal_gender_recognition_in_the_eu_the_journeys_of_trans_people_towards_full_equality_sept_en.pdf
-Implication.
(2017). Sexual health among transgender people in Sweden. p. 323. https://www.researchgate.net/publication/315998325_Sexual_health_among_transgender_people_in_Sweden		-Recommends Dutch Protocal and states that "an urgent issue is to clarify under which conditions young people with non-binary gender identity cna be offered anti-puberty treatment... in the context of research (p. 54)."
(2022) Support, investigation and hormone treatment at gender incongruity in children and young people. p.54. https://www.socialstyrelsen.se/globalassets/sharepoint-dokument/artikelkatalog/kunskapsstod/2022-2-7774.pdf
-"For non-binary persons younger than 18 years, the health care is limited."
(2015) Trans health care. https://www.rfsl.se/en/organisation/vard-for-transpersoner/transvaard/		0
-Not specifically		-Trans healthcare not considered "care that cannot be delayed" and those without a residence permit are not entitled to it. Respondent does indicate that those who are already on HRT can get continuation of care, which is consistent with some other countries. Same questions/concerns around legitimacy of where HRT came from (DIY?) and proving it.
(2017) Current migration situation in the EU. p. 14. https://fra.europa.eu/en/publication/2017/current-migration-situation-eu-lesbian-gay-bisexual-transgender-and-intersex
(n.d.) Transgender asylum seekers outside of the healthcare system. https://program.stockholmpride.org/en/events/157/transgender-asylum-seekers-outside-of-the-healthcare-system		-No data/citations on treatment of trans refugees or evidence that they are treated differently than Swedish citizens but gone with respondent's answer.-No evidence one way or another. Put yes because respondent indicated it was and because BMI limits for trans surgeries exist widely.NEI(2022) Updated recommendations for hormone therapy for gender dysphoria in young people. https://www.socialstyrelsen.se/om-socialstyrelsen/pressrum/press/uppdaterade-rekommendationer-for-hormonbehandling-vid-konsdysfori-hos-unga/18
-New guidance recommends that HRT should not occur before 18 except in exceptional circumstances and "within the framework of research." No definition of what might constitute such circumstances.
(2022) Support, investigation and hormone treatment at gender incongruity in children and young people. p. 54. https://www.socialstyrelsen.se/globalassets/sharepoint-dokument/artikelkatalog/kunskapsstod/2022-2-7774.pdf
(2022) Updated recommendations for hormone therapy for gender dysphoria in young people. https://www.socialstyrelsen.se/om-socialstyrelsen/pressrum/press/uppdaterade-rekommendationer-for-hormonbehandling-vid-konsdysfori-hos-unga/
(2022). The right to healthcare related to gender transition. http://www.vikerkaar.ee/archives/28042
-Only available within the framework of clinical trials.
83
TGEU Confirmation (score)11011111111111114211001-3 years01111111NEI70Tanner 311803
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100