EU countries clash with WHO over trans rights and access to healthcare

Almost half of the EU – 12 of its 27 member states – don’t follow World Health Organisation guidelines for recognition of trans identities, according to a new health map published by TGEU, an umbrella non-profit advocating for the rights and wellbeing of trans people.  

The WHO agreed in 2019 to reform its classification to eliminate trans identities from its mental disorder category.  

The health organisation changed its International Classification – which serves to record and report health and health-related conditions globally- for its 11th edition, to “reflect modern understanding of sexual health and gender identity”. 

This update redefined gender identity-related health, replacing “outdated diagnostic categories” like “transsexualism” and “gender identity disorder of children” with “gender incongruence of adolescence and adulthood” and “gender incongruence of childhood” respectively.  

The WHO’s objective with these changes was to ensure that transgender individuals could access gender-affirming healthcare and appropriate health insurance coverage for these services. 

Despite these updates by the global health agency, TGEU’s maps shows that 12 EU countries – Austria, Croatia, Czechia, Estonia, France, Germany, Greece, Hungary, Lithuania, Poland, Slovakia, Sweden – use the formal diagnosis of “transsexualism” under the previous classification. Five countries – Belgium, Ireland, Italy, Portugal and the Netherlands – use “gender disphoria” Finland, Romania and Slovenia use both classifications.  

Only Malta, Denmark, and eight regions of Spain – for which data is available – do not require a psychiatric diagnosis as a condition to access specific healthcare. 

TGEU warns that this requirement contributes to stigma and hinders access to trans-specific healthcare. “Slow implementation of depathologisation implies that trans-specific healthcare is not based on informed consent and individual decision-making but is entirely contingent on a diagnosis,” states the 2024 map. 

Trans people face significant challenges in receiving trans-specific healthcare that is accessible, affordable, respectful, and of high quality, according to a report published by the Council of Europe earlier this month, which also estimates that at least 27% of trans people in Europe fail to access specific healthcare.  

The World Health Organisation is expected to publish new guidelines on trans-specific healthcare in 2025, which will aim to provide recommendations to member states on how to address the issue.