Gender Care in Spain

In February 2023, Spain passed the Ley para la igualdad real y efectiva de las personas trans.

Ley Trans (2023)

In February 2023, Spain passed the Ley para la igualdad real y efectiva de las personas trans. The law allows people to legally change their sex designation based on self-identification from the age of sixteen, without a medical assessment, and includes additional provisions for young people aged fourteen to sixteen.

Clinical care

Gender care in Spain is provided through regional Unidades de Tratamiento de Identidad de Género (UTIG). Access and waiting times vary considerably between autonomous regions.

Debate

The draft law sparked public debate, including within the governing coalition and among feminist organisations, about the implications for minors' access to changes in sex registration. The parent organisation Amanda was also among the critical voices.

How the procedure works

The applicant reports to the civil registry and must confirm the application at a second appointment within three months. No diagnosis, treatment or witnesses are required. Young people aged fourteen and fifteen need their parents' assistance, while children aged twelve and thirteen require the court's permission. The law also bans conversion therapy and introduces measures to combat discrimination at work and in education. Information on other countries' experiences with self-identification is available at transbeleid.nl.

The coalition's internal struggle

The law was a project of the Ministry of Equality under Irene Montero of Podemos. Within the socialist PSOE, a faction around former Deputy Prime Minister Carmen Calvo opposed self-identification. Feminist organisations feared consequences for sex-based services and policies, such as shelters, sport and the law against gender-based violence. Opposition parties PP and Vox voted against the law and referred it to the Constitutional Court.

Regional differences

Spain is highly decentralised, and almost every autonomous region has its own rules for healthcare and education. At the end of 2023, the Madrid region amended its regional law and once again introduced an assessment by an expert for minors before medical treatment can begin. Other regions retained more permissive arrangements. As a result, waiting times and the range of services vary considerably by region. See also Portugal and the overview of policies by country.