Reports from multidisciplinary medical teams constitute a guarantee for minors seeking gender self-determination
The requirement of a multidisciplinary medical diagnosis of gender dysphoria does not violate fundamental rights
The approach of the draft bill is not adequate to protect the interests of minors under 16 years of age who lack sufficient maturity or whose transgender situation is not stable.
The CGCOM endorses the special distinction in this draft bill between gender dysphoria and intersex conditions, with a depathologizing approach to comprehensive healthcare for intersex people.
EThe General Council of Physicians (CGCOM) states, with regard to the so-called Trans LawThe reports from multidisciplinary medical teams constitute a guarantee for minors seeking gender self-determination, and this aspect should be included in the legal framework. Providing minors with assistance from specialized multidisciplinary medical teams throughout the gender self-determination process would reduce the risk of the desire for transsexuality not persisting and the psychological and physical risks associated with an accelerated gender transition.
The draft legislation outlines the procedure for changing one's registered gender in three age brackets: those over 16 years of age can change their gender on their own and without additional requirements beyond their free will, except for a three-month reflection period; minors between 14 and 16 years of age will need the permission of their legal representatives, and the law stipulates that minors between 12 and 14 years of age who wish to change their gender must provide a judicial report.
Based on a legal, ethical, and professional analysis, the General Council of Official Medical Associations (CGCOM) considers that requiring a multidisciplinary medical diagnosis of gender dysphoria cannot be deemed to violate fundamental human rights. Therefore, it understands that the draft bill's proposal, which would allow individuals aged 14 to 16 to request a change to their registered sex designation with no conditions other than the assistance of their legal representatives, is not adequate to protect the best interests of minors within that age range who lack sufficient maturity or whose transgender status is not yet stable.
The CGCOM's recommendation aligns with the legislation of Germany, Belgium, Denmark, Ireland, Italy, Luxembourg, Norway, Portugal, the United Kingdom, and Sweden, where conditions such as legal age, authorization from legal representatives, or judicial intervention for minors, or a medical report describing the situation, are required. The proposed Spanish legislation diverges from these European approaches by requiring only the express consent of the individual concerned.
The medical corporation shares the opinion of the report promulgated by the Judiciary, which proposes extending the voluntary jurisdiction procedure from 12 to 17 years of age, which is the mechanism foreseen in the draft Trans Law but only for minors between 12 and 14. Consistent with this statement, it must be taken into account that medical interventions aimed at carrying out the transsexuality process require special caution in minors, given the irreversibility of many of the therapies necessary for the transsexualization process.
It is advisable to subject the exercise of the right to rectify the registered sex designation by minors under sixteen years of age to the conditions of “sufficient maturity” and “stability in the transgender situation,” in the same way that these conditions are required for minors between fourteen and twelve years of age. Furthermore, we believe that the appropriate course of action is for the verification of compliance with these conditions to be carried out in court, through voluntary jurisdiction proceedings.
It does not seem necessary or proportionate to separate the rectification of the sex designation from any evidence that, in one way or another, demonstrates a certain stability in the sexual identity freely defined by the person. Based on this precept, The General Council of Physicians recommends requiring a specialized multidisciplinary medical report as a key element of guarantee for the applicant..
The CGCOM wishes to express its a firm defense of the right of people not to be discriminated against on the grounds of sexual orientation, sexual identity, gender expression or sex characteristics, as set out in this law.
However, the configuration of a specific reinforced protection regime, independent and separate from the general protection regime, and even from the specific protection regime of other groups contemplated in this draft bill, determines the existence of certain and notable advantages that generate possible situations of discrimination in relation to the rest of the citizens and with other groups that already have or could be deserving of identical reinforced protection.
Finally, the corporation also expresses its support for the law regarding comprehensive healthcare for intersex people, which is expected to be carried out in accordance with the principles of autonomy, decision and informed consent, non-discrimination, comprehensive assistance, quality, specialization, proximity and non-segregation, from a depathologizing approach.
Madrid, 2 November 2022
