Gender Care in Austria

In 2018, the Constitutional Court ruled that a third option (divers/inter/offen/kein Eintrag) must also be available on birth certificates.

Legal framework

In 2018, the Constitutional Court ruled that a third option (divers/inter/offen/kein Eintrag) must also be available on birth certificates. Changing the registered sex is possible through an administrative procedure.

Clinical care

The main centres are in Vienna (AKH) and Innsbruck. Access is provided through multidisciplinary teams, and waiting times apply.

The procedure in practice

Austria does not have self-identification. Anyone wishing to change their registered sex must submit an application to the civil registry and provide an expert report. This report must show that the person’s sense of belonging to the other sex is enduring and is not expected to change. Surgery is not a requirement; that condition was abolished following a ruling by the highest administrative court. The third designation made possible by the Constitutional Court in 2018 is intended for people with a variation in sex development (intersex) and requires medical evidence.

Treatment recommendations

The Ministry of Health published recommendations for the treatment pathway for gender dysphoria, with a separate version for children and adolescents. They require a multidisciplinary assessment, with psychiatric, psychological and psychotherapeutic diagnostics preceding physical treatment. Social health insurance covers hormones and surgeries when the indication has been established in accordance with these recommendations.

German-language guideline

In 2025, a joint guideline for children and adolescents with gender dysphoria was published for Germany, Austria and Switzerland. Austrian professional associations contributed to it. The guideline maintains the option of puberty blockers and hormones following careful case-by-case assessment, and has been criticised by doctors who believe the evidence for these treatments is too weak. See also Germany and Switzerland.

Comparison

Austria has not independently conducted a systematic review of the evidence for treating minors, as Finland, Sweden and England have. Legally, the country is more restrictive than Germany and Switzerland, both of which have introduced a form of self-identification. Critical voices in the Austrian debate include the parents’ group Elterninitiative ROGD Österreich and the organisation EGGÖ, which opposes self-identification.