Transgender adolescents in Europe: reality and support

Changing your gender on official documents, obtaining medical care and receiving hormones without humiliating procedures or fear for your life continue to be challenging for minors in Europe who want to begin their transgender transition.

In an impressive achievement, Alex (not his real name) was able to access hormone replacement therapy two months before his 18th birthday. He became the youngest French person to convince his clinic to provide him with specialized health care related to his gender identity.

Alex realized the need for gender transition a little over a year ago. “It was a defining moment in my life. I graduated from high school, went to university, and my voice started to change by the end of the first semester. It was a relief and happiness. I realized that I could try to live without people knowing that I was trans.” -male identity,” recalls the young man.

In France, it is possible for minors to undergo gender-affirming therapy, including the use of puberty blockers or hormone replacement therapy (HRT). However, most medical institutions require a mandatory psychiatric evaluation, a process that can take several years.

For Alex, thanks to the support of his parents, the process was relatively quick. However, not everyone is so lucky.

“I recently spoke with my endocrinologist, and she told me that the clinic stopped the program I was using because there weren’t enough doctors willing to work with us,” he says. He also adds that now the wait to see a doctor can be up to a year, while for him the wait was only a month.

Dramatic twist: What happened to LGBTQ+ rights in Europe? 

Different parts of the European Union are witnessing mixed movements on LGBTQ+ rights. Some countries are passing progressive gender laws, while others are seeking to tighten restrictions, especially for trans teenagers.

In February 2023, for example, Spain took an important step towards respecting self-determination of gender by allowing individuals over 16 to self-identify their gender on official documents. During the same period, Sweden introduced a ban on hormone therapy for people under 18 years of age, except in rare situations.

Finland scrapped a sterilization requirement for transgender people, while Croatia discussed possible tightening of rules on access to gender-affirming therapy and extending restrictions to those over 21.

However, alongside these changes, Europe has seen a horrific increase in violence against the LGBTQ+ community in the past year. Transgender people have become a particularly vulnerable group. ILGA, Europe’s largest LGBTQ+ rights organisation, stresses that this is not just about physical attacks, but also about the rise in suicides caused by hostility in society. This phenomenon requires immediate attention and action from society and legislation.

The year 2022 has seen terrible events involving violence against the LGBTQ+ community in various countries. In Germany, a transgender man was killed during a pride parade. A trans woman was brutally attacked in the center of Tallinn. In Georgia, a cisgender woman whose gender identity matched her biological sex was targeted by criminals but was mistaken for a trans man.

In addition, there were at least two attacks on LGBTQ+ bars: in Oslo, two people were killed and 20 more were injured; in Bratislava, the tragedy claimed the lives of two people.

ILGA-Europe’s Executive Director, Evelyn Paradis, expressed concern about the growing hostility and intolerance towards the LGBTI community, not only in countries with clear hostility and intolerance, but also in those that have traditionally been tolerant of them. According to NGOs, in Ireland, Spain, Norway, Poland, Great Britain and Switzerland there is an increase in hatred towards trans people.

Medical procedures in Ireland: Why is this a concern?

In Ireland, as well as in Hungary and Poland, the law allows you to receive gender reassignment therapy from the age of 17, but in practice this has proven virtually impossible. In addition, Ireland stands out among 11 European countries that support the principle of “gender self-determination”. In the independent part of the island there is a simplified procedure for changing gender in official documents.

However, the realization of these rights faces serious obstacles in the form of an ineffective health care system and a lack of specialists. The wait for hormone therapy can be up to seven years, which effectively means that many people fail to begin their transgender transition until adulthood. This situation highlights the need to improve access to health care and support for the LGBTQ+ community in Ireland and other countries with similar challenges.

“Irish young people and their parents find themselves in situations where they are forced to seek medical treatment abroad, or even order medicine online without proper medical supervision, which poses a serious threat,” said Moneen Griffith, chief executive of LGBTQ+ youth organization BeLonG To in Ireland.

She also highlights that before the UK left the European Union (Brexit), Irish citizens made extensive use of UK clinics under the Treatment Abroad Scheme (TAS), which allowed them to seek medical treatment in other EU countries with full reimbursement through national insurance.

Spain: Decentralization and its consequences for the country

The situation for young people in Spain looks completely different. Last February, the country passed a law that significantly expanded the rights of LGBTQ+ people. This means that improved conditions have become available for transgender citizens to change their gender on official documents. Previously, this was only possible after two years of hormone therapy and a psychiatric evaluation, with a diagnosis of gender dysphoria included in the medical record.

According to the NGO Transgender Europe, Spain ranks second in Europe after Malta in terms of access to trans health care. Uge Sangila, president of the FELGTBI+ association, emphasizes that in most autonomous communities of the country, young people can easily receive qualified care, starting with a referral from their family doctor. Moreover, schoolchildren have the opportunity to easily change their names in school registers.

However, there are regions where the situation is not so rosy. For example, in Castile and Leon, which is partly controlled by the far-right political party Vox, access to health care is not guaranteed. Uge Sangil notes that everything depends on the will of a particular endocrinologist, and one should not rely solely on the goodwill of medical workers.