a ruleAccess to gender-affirming care

Whether an adult may lawfully obtain hormone therapy and gender-affirming surgery in a given jurisdiction, under what gate, and what the law says about minors. The rows below record access to CARE. They do not record legal gender recognition — changing a name or a marker on a document — which is a separate body of law that most comparative sources run together with this one.

The conflation is the first thing that defeats a reader, and it defeated most of the research behind this record. Germany's Selbstbestimmungsgesetz, Ireland's Gender Recognition Act 2015, South Africa's Alteration of Sex Description and Sex Status Act 49 of 2003, Hungary's 2020 amendment: all of these are about registers and documents. None of them governs whether a surgeon may operate. In many countries nothing governs that by statute at all, and the rule is a professional body's, an insurer's, or a clinical guideline's.

Türkiye is the exception that matters most here, because Türkiye is a destination. Article 40 of the Civil Code makes a court's permission a precondition of the surgery itself — over 18, unmarried, and holding an official health-council report from a training and research hospital — with a second court step afterwards for the register. One instrument, gating both. Whether it binds a foreign patient treated in a Turkish hospital is a question this project could not answer from anything it read, and that unanswered question sits underneath a substantial trade.

Britain's instrument runs the other way: it restricts a medicine rather than a procedure. The 2024 Order bars new private prescriptions of gonadotrophin-releasing hormone analogues for puberty suppression in under-18s, exempts adults, and leaves NHS supply alone. It carries no expiry and its first review is due before 1 October 2027.

The United States has no federal instrument for adults. United States v. Skrmetti, decided 18 June 2025, held that Tennessee's statute is not subject to heightened scrutiny and passes rational-basis review, and expressly did not decide the adult question. The count of state bans for minors comes from a tracker that publishes its own date and method: 26 states and one territory at 16 September 2026.

Inference — the single line in this table that speaks directly to a person arriving from elsewhere is Czech, and it is procedural: §§ 21 to 23 of Act 373/2011 contemplate an extract from medical records kept in another state, with a certified translation. Everything else in these statutes is written about residents, which means a traveller's position is usually a matter of what a clinic will do rather than what a law says.

What a row does not carry: waiting times, whether the care is funded, what a home country's clinicians will do with a patient who was treated abroad, and whether a document issued after surgery in one state is recognised in another. The last is the recognition question, and it is the one this record deliberately does not answer.

Where a row says no-data, the reason is in the row's note. Most of them are the same reason: the instrument named to this project was a recognition statute, a guideline, or a page that could not be read on this pass.

As of 17 September 2026 seven rows rest on an instrument or judgment that was read. Eighteen say no-data. Thailand and Türkiye are the two destinations in this table, and only one of them has a row this project would stand behind.