'Antiquated' sex op laws must change: report

The Swedish Health and Welfare Board (Socialstyrelsen) has called for an end to the requirement that all those seeking to change gender must be single and sterilised in a new report which argues that existing legislation is out of date.

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The board states that the legislation is based on outdated societal values and is not consistent with EU Commission recommendations issued in 2009, which stipulate that sterilization should not be required for legal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