Gender-Affirming Care in Switzerland

Since January 1, 2022, people in Switzerland have been able to change their legal gender and first name by making a declaration at the civil registry office, without a medical assessment or surgical procedure.

Legal framework

Since January 1, 2022, people in Switzerland have been able to change their legal gender and first name by making a declaration at the civil registry office, without a medical assessment or surgical procedure. Minors need additional consent.

Clinical care

Gender-affirming care is provided at university hospitals, including those in Zurich, Bern, Lausanne, and Geneva. Care is covered by basic health insurance when there is an established medical indication.

The declaration at the civil registry office

The rules are set out in the Swiss Civil Code. Anyone aged sixteen or older makes the declaration independently; those under sixteen need the consent of their legal representative. The procedure involves a small administrative fee. The choice is limited to male and female: at the end of 2022, the Federal Council decided not to introduce a third gender designation.

Zurich calls for nationwide rules

In the canton of Zurich, the number of surgeries on minors increased. In early 2024, Health Director Natalie Rickli called on hospitals to exercise the utmost restraint. In July 2025, she asked the federal government to examine a ban on irreversible surgeries for minors and to allow puberty blockers only as part of research. The claim that demand for gender-affirming care among young people in Switzerland is declining, as reported by a Swiss newspaper based on figures from a single Zurich clinic, is disputed; transbeleid.nl discusses those figures. The canton itself introduced new quality requirements, including an interdisciplinary committee that assesses every indication, as well as scientific oversight of care. The association AMQG-AUFG, founded by parents in 2021, is seeking an alternative to the affirmative model.

German-language guideline

The joint guideline for children and adolescents with gender dysphoria, published in 2025 for Germany, Austria, and Switzerland, leaves open the possibility of puberty blockers and hormones following an individual assessment. The guideline is controversial, including among Swiss psychiatrists. See also Germany and Austria, and for countries that have taken a different approach, Sweden and Finland.