Spain: Health Care For All!



The International Gay and Lesbian Human Rights Commission (IGLHRC) forwards this action at the request of Identidad de Genero (Gender Identity), an organization advocating for the rights of transgender people in Spain. The action protests the refusal of the Public Health Department to provide medical assistance at a public facility to a transgender person--in defiance of a judicial verdict mandating them to do so.

IGLHRC urges IMMEDIATE support for transgender people's basic rights to health care and human dignity in Spain. Below is a sample letter circulated by Identidad de Genero (the Spanish original is followed by a translation by IGLHRC), as well as background information.


Please copy the letter found below, visit (the web page of the Valencia Public Health Department) and send the text. WE STRONGLY SUGGEST YOU SEND THE SPANISH ORIGINAL. And please send a brief message to Identidad de Genero at, letting them know that you have sent the letter.

Note: If you have trouble accessing the Health Department web page, please send the letter to Identidad de Genero and they will forward it.

SAMPLE LETTER- Spanish original:

Al saber que la sentencia de una Sra. Juez de Alicante, que reconoce el derecho a ser atendida por la Sanidad Pública que corresponde a la ciudadana J.B.A., transexual, va a ser recurrida por la Consellería de Sanitat, quiero expresar mi protesta por el carácter involutivo de tal decisión, si se mantuviere, dado que está en desacuerdo con las recomendaciones de la comunidad médica internacional y del mismo Parlamento Europeo.

La decisión de mantener tal recurso no podrá ser entendida más que como un paso atrás en el Estado Español, en esta materia, ya que en febrero de 1999 el Parlamento de Andalucía aprobó la atención pública a las personas transexuales y en abril del mismo año el Congreso de los Diputados aprobó por unanimidad de todos los grupos parlamentarios unas líneas políticas que conducían en esa dirección y que ahora se ven flagrantemente frustradas.


(your name, address and organization)

English translation:

I have learned that the verdict by a judge in Alicante, recognizing the right of transsexual/transgender citizen J.B.A. to receive treatment at public medical facilities, will be appealed by the Public Health Office (Conselleria de Sanitat). I want to express my protest. Such a decision --if the Conselleria continues to seek legal recourses against recognizing J.B.A.'s rights-- goes against recommendations issued by the international medical community as well as by the European Parliament itself.

A decision to pursue the appeal will only be understood as a step backward on the part of the Spanish State. The Andalucia Parliament passed a law granting access to treatment in public facilities to transsexual/transgender people on February 1999, and the national Parliament unanimously passed political guidelines pointing in the same direction on April 1999. The Conselleria's attitudes flout these progressive moves.



Sex-reassignment surgical procedures and related treatments are legal in the Spanish State. Yet public hospitals routinely refuse to treat transgender people wishing to pursue such procedures.

This flies in the face of a growing body of European precedent. In 1989, 1989 the European Parliament adopted a resolution calling on all member States of the European Union to "enact provisions on transsexuals' right to change sex by endocrinological, plastic surgery, and cosmetic treatment, on the procedure, and banning discrimination against them." It specifically urged that States ensure the provision --"as a minimum"--of:

  • psychiatric/psychotherapeutic differential diagnosis of transsexualism, by way of help with self-diagnosis;
  • a consultation period; psychotherapeutic assistance and support; information on the change of sex; medical examinations;
  • hormone treatment combined with a trial in everyday life, i.e. living the role of the new sex for at least one year;
  • surgery after approval by a board of experts consisting of a medical specialist, psychotherapist and possibly a representative nominated by the person concerned;
  • legal recognition; change of forename; change of sex on birth certificate; and identity documents;
  • psychotherapeutic and medical aftercare.

In the same year, the Parliamentary Assembly of the Council of Europe--a different body embracing a broader range of European States--passed Recommendation 1117, which called on States to ensure the amendment of civil status papers for post-operative transsexuals, and to ensure that "all discrimination in the enjoyment of fundamental rights and freedoms is prohibited in accordance with Article 14 of the European Convention of Human Rights."

These instruments were non-binding; but they carry the moral weight of democratic European institutions behind them. Spanish national and provincial authorities have ignored them. Only in Andalucia have sex-reassignment procedures recently have been included in public health service provisions--and facilities there are now crowded by transgender people from other regions of the country demanding treatment. The Valencia public health system's refusal to include sex reassignment procedures among its services aggravates discrimination and increases the marginalization of transgender people in society, family, and the labor market. IGLHRC supports the demand--by both local NGOs and European institutions--that all aspects of sex reassignment procedures be included in Spanish public health systems.

Note: Alicante, Castellón and Valencia are the three provinces which constitute the autonomous Valencia Community (Comunidad Valenciana o Pais Valenciá). The Spanish State includes 19 autonomous communities and 50 provinces.