• Sweden edition
 

'Antiquated' sex op laws must change: report

Published: 30 Jun 2010 11:04 GMT+02:00
Updated: 30 Jun 2010 11:04 GMT+02:00

"The regulations are based on antiquated legislation. The consequences are that transsexuals who are married or have a registered partnership are forced to separate in order to change sex," said Karin Lindell, who led the board's external inquiry, in a statement on Wednesday.

The report also points out that transsexuals are also deprived of the right to freeze their reproductive cells.

Karin Lindell was commissioned by the board in July 2009 to examine the care afforded transsexuals and others who fulfil the medical definition of a gender identity disorder.

The report shows that patients often feel poorly treated on initial contact with the health authorities and observes that resources applied for evaluation, treatment and follow-up vary considerably across the country.

"The whole evaluation process takes at best two years. For patients, the long waiting times are psychologically taxing. Some who have the financial possibilities elect to seek care overseas instead," said project leader Linda Almqvist.

Transsexual people often experience that they are born in the wrong body and seek the assistance of the healthcare services to realign their physical attributes. This can be achieved either through hormone treatment or through surgery.

Organizations representing gay, bisexual and transsexual people have long argued that often inconsistent healthcare services do not cater fully to their needs and complained over the lack of consistent nationwide information over available care alternatives.

The number of people applying for sex reassignment surgery is increasing.

For thirty years it averaged at about 12-15 people per year until 2003, when it began to climb, and there are now around 50 operations conducted in Sweden each year.

According to legislation passed in 1972, to undergo a sex change operation a person must be over 18-years-old, a Swedish citizen, be sterilized and unmarried.

The board states that the legislation is based on outdated societal values and is not consistent with EU Commission recommendations issued in 2009, which stipulate that sterilization should not be required for legal sex change.

"The requirement to be unmarried and sterilized is antiquated and should be removed. The situation of transsexuals can also be improved by care-givers taking their responsibility to cut waiting times," said Karin Lindell.

In order to establish a person's gender a psychiatric examination must have been completed before an application can be submitted to the Health and Welfare Board's legal council for confirmation.

Following the confirmation of a new gender the transsexual person is issued with a new personal identification number (personnummer) and are then able to elect to undergo sex reassignment surgery.

The board now proposes a slew of new measures to ease the process.

It is recommended that local health authorities should coordinate regionally with specialist teams allocated to supervise care, as well as a national care programme, the pooling of existing knowledge, and improved patient information.

"The Health and Welfare Board welcomes proposals which can improved conditions for transsexuals," said health and welfare board director-general Lars-Erik Holm.

Holm added that that he believed that few Swedes were still aware of the continued practice of forced sterilizations.

"This is a dark chapter in Swedish history, and it must stop," he said.

Peter Vinthagen Simpson (news@thelocal.se)

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Your comments about this article

15:12 June 30, 2010 by Åskar
Sorry, but I just don't understand why a person undergoing a sex change would want to retain hir gonads. To my mind sterilisation seems THE essential part of the process.
22:50 June 30, 2010 by inallsincerity
@Askar, it's more complicated than that and it is certainly not THE essential part of the process. Transsexuality is much more complex and nuanced than made-for-TV documentaries and day time talk shows make it out to be. There is not only one way to be transgender, and gender dysphoria is experienced on a spectrum. Some folks have it worse than others, so to speak. As a result it requires individualized treatment-- there is not a one-size-fits-all solution.

Sometimes dysphoria can be adequately treated with hormones or some minor surgeries and a full genital reconfiguration is not necessary.

Some folks might need the surgeries but are unable to have them due to other conflicting health problems.

Also, you have to realize that female to male transsexuals also exist. Many view the removal of their ovaries which are hidden away in the abdomen and silenced by testosterone injections as simply an unnecessary surgery and who wants to go around having unnecessary operations?

There is also simply a legal/moral issue here. Since when does the government get to step in and make laws about the bodies of its citizens? The status of one's genitals is their own private business. That very private business becomes extremely public via this person number business. If you're opening a bank account for a woman or checking her ID at a bar, you have absolutely no right to know what kind of operations she has or has not had, but if she has the wrong person number you are immediately informed. And you might be a jack ass who thinks transsexuals are sickos and should all be shot and therefore are going to be horribly rude to her when all she wants to do is open a bank account or buy a beer.
07:51 July 1, 2010 by Makaveli
Wonder whats next...Humans trying to change to other species (trans-species). Maybe from humans to apes. Hope am not around by the time that happens.
09:55 July 1, 2010 by Nemesis
Sterilisation as a requirement in law to gain rights. Whoever came up with that one, should be named publicly. I wonder if they proposed any other groups be sterilised.

I see they are still ignoring there EU and international legal agreements as well. Setting the age limit for sex change at above 18, is a breach of the United Nations Declaration on the Rights of the Child, amongst quite a lot of other treaties that Sweden has signed up to. Appears to be a case of do as I say, not as I do. The hypocrisy is noted. Transsexuals could sue Sweden in the European courts for that one and win easily.

Also ensuring that a person is declared to have a mental illness before getting there rights, is a breach of almost every human rights standard that exists.

As for if a person is married or not. That is none of Socialstyrelsen's business. As long as two people are consenting adults, there relationship is no one else's business. I think transsexuals, should sue them for coming up with that one. They would win in the European courts without a problem.
10:38 July 1, 2010 by Danielle_A
This is a huge gain for Sweden! For a country that has been great about same-sex relationships since the late 1980s, there was a lot of catching up to do in this department. While these suggested changes will not be a 'fix all', it certainly is a huge step in the right direction.

As a transgender woman from America who is married to a Swedish husband, I can say that I was certainly thankful to transition in the US where in the very capitalist health care system, I could pick and choose my doctors/therapists/psychiatrist and was not forced into a 'gender clinic' that was ignorant. As I have come to understand the Stockholm clinic to be, it is quite regressive and stuck with many ideas about sex and gender from the 1960's that do not reflect modern reality of gender. They have an 'All or Nothing" attitude and "One size fits all" approach to treating transgender and transsexual people --that is, everyone should want to have sex reassignment surgery, regardless of their underlying medical conditions, beliefs, or personal feelings about their bodies.

I have heard of several people who have been forced to have unnecessary surgeries (removal of ovaries or full out sex reassignment surgery) simply because they were told they would no longer be treated with hormones or allowed to change identity documents if they did not. Such methods as others have pointed out are absolute and flagrant violations of people's human rights. This is even further complicated if you are not a Swedish citizen and have no desire to be one.. they simply kick you out of the clinic or demand you get citizenship and have surgery etc.. to continue care. It's quite draconian!

As an activist and therapist I have worked with colleagues from the US to do some "educating" with professionals of the Stockholm clinic to push for a removal of the sterilization portion of the law and found the doctors/psychiatrist there to be very sympathetic but very Swedish in their "It's the law, we have to follow it" though they knew it to be a violation of human rights.

I was sorely disappointed in the treatment of Transsexual people in Sweden when I arrived and I have to say for a country that regards itself as liberal, progressive, egalitarian and open, it was honestly quite a shock to my system! While the treatment of me as a woman is FAR better in Sweden, interacting with the health care system has been a nightmare. As a Left Party/Green party supporter and socialized medicine enthusiast it turned my stomach to know that, if I had been in Sweden when I was 16 and transitioning from male to female I would have been out of luck! In this one regard, parts of the US medical system have been doing a better job and I'm thankful that I have connections in the US where I can go get medical care and not even have to deal with the Swedish systems drama.

I am glad to see Sweden catching up so I can brag to my friends back home about how awesome it is again!
11:30 July 1, 2010 by Nemesis
@ Danielle_A

Transsexuals are being killed regularly in the US, with a lot forced to work as sex workers due to massive discimination. Also the majority of clinicans in the USA oppose under 18's having hormones and the present health organisation for transseuxal people is a bunch of bigoted nazi's.

When someone in Sweden is as backward as the US citizens who live in Toronto are treating transsexual people, complain about Sweden then. Until then no one in Sweden comes close to the level of bigotry that pass's for experts in the USA.
21:57 July 1, 2010 by USA Is Number 1
Nemesis,

What you say about the US is not unique to the US, and it's not even representative of the US. Practices vary from state to state in the US and doctor to doctor in the US too. Approaches to minors is understandably cautious since minors who make choices as minors may come to realize that those choices are not ones they would make as an adult who is then more aware and not subject as much to the whims of parental type of authorities.

At least in the US there is no ridiculous national law calling for forced sterilization as a condition of such care or a requirement to be a citizen of the country to get such care.
00:16 July 2, 2010 by inallsincerity
@Makaveli Pat Robertson said gay marriage would lead to sex with ducks. There is a nice youtube video about it. Sounds right up your alley.
08:42 July 2, 2010 by Nemesis
@ USA Is Number 1

Wrong.

In the USA, they have some of the most backward practices in the western world for transsexuals. Quite a few third world countries and most ex-communist countries are more advanced in that area, than the USA.

As for minors, it has been proven with proper screening as in Netherlands and Germany that they can be put through it young. Those people usually blend into society and actually do better on average than the average citizen.

In those countries that reject them, such as the USA, they usually end up thrown on the street and have to prostitute themselves so as to support themselves.

The USA is one of the few countries that refuses to sign up to the United Nations Convention on the Rights of the Child.
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