Results of the <strong>Legal</strong> <strong>Survey</strong> In this survey of the States' provisions for trans people, we accessed previous surveys, documents printed or on the internet, <strong>and</strong> word of mouth if it was verifiable. It is impossible to say if this survey is completely accurate, there are a few States in the EU where it is still impossible to get any information. It might well be that there has been no legal response to trans people in those States, <strong>and</strong> if that is the case, this is highly detrimental to trans people <strong>and</strong> contributes to their exclusion <strong>and</strong> violation of their rights.
25 April 2008 Public Funding for Gender Reassignment Treatments Psychotherapy Thirteen (13) 33 of the twenty seven (27) EU Member States provide funding for psychotherapy, which is not limited to a mental Health Evaluation of the patient. Most trans people benefit considerably from around ten psychotherapy sessions, <strong>and</strong> the World Professional Association for <strong>Transgender</strong> Health (WPATH formerly HBIGDA) highly recommends it as productive care for the well being of the patient. Some countries occasionally provide for it, notably Austria <strong>and</strong> Italy, both countries where as yet there is no form of legal recognition of the trans person's new gender; <strong>and</strong> Denmark, Finl<strong>and</strong> <strong>and</strong> the Netherl<strong>and</strong>s who do provide legal recognition of some form. The notable exception is the UK where psychotherapy is not funded, despite most other treatments being available on the National Health Service (NHS). The reason for this is the high cost of psychotherapy <strong>and</strong> the fiscal limits of the NHS. Hormone replacement therapy With the exception of Italy, nearly all of the seventeen (17) countries 34 for which we have information publicly fund Hormone Replacement Therapy. Hair removal Only two (2) countries, Germany <strong>and</strong> Sweden, provide public funding for hair removal. This is a real disappointment in that facial <strong>and</strong> perineal hair removal is essential in order to successfully live as a woman <strong>and</strong> to go on to successful genital reassignment by vaginoplasty. The cost of hair removal by electrolysis will be around €6-7,000, <strong>and</strong> by laser treatment (which does not scar the face) it would be around €9-12,000. This greatly exceeds the cost of breast augmentation <strong>and</strong> is similar to the cost of full genital surgery. Surgery to alter secondary sex characteristics Six (6) countries 35 fund breast augmentation surgery for trans women, in contrast trans men are much better supported with sixteen (16) 36 countries publicly funding bilateral mastectomies <strong>and</strong> fifteen (15) 37 funding hysterectomies. Surgery to alter primary sex characteristics (the genitals) Thirteen (13) States 38 fund vaginoplasty for trans women, <strong>and</strong> a similar figure provide phalloplasty for trans men. The exceptions to providing both treatments are Latvia where vaginoplasty is available <strong>and</strong>, surprisingly, the Czech Republic where vaginoplasty is not offered but phalloplasty, which is 4 to 5 times the cost, is reimbursed. However, when doing such a survey it is not possible to assess the quality of the treatments provided, <strong>and</strong> it may be that in the Czech Republic or other 33 Belgium, Bulgaria, Czech Republic, Estonia, Germany, Latvia, Lithuania, Luxembourg, Malta, Pol<strong>and</strong>, Portugal, Spain, Sweden. 34 Austria, Belgium, Bulgaria, Czech Republic, Denmark, Finl<strong>and</strong>, France, Germany, Irel<strong>and</strong>, Latvia, Malta, Netherl<strong>and</strong>s, Pol<strong>and</strong>, Portugal, Spain, Sweden, United Kingdom. 35 Austria, Belgium, Finl<strong>and</strong>, France, Germany <strong>and</strong> Portugal. 36 Austria, Belgium, Bulgaria, Czech Republic, Denmark, Finl<strong>and</strong>, France, Germany, Italy, Latvia, Lithuania, Netherl<strong>and</strong>s, Pol<strong>and</strong>, Portugal, Sweden <strong>and</strong> United Kingdom. 37 Austria, Belgium, Bulgaria, Czech Republic, Denmark, Finl<strong>and</strong>, France, Germany, Italy, Lithuania, Netherl<strong>and</strong>s, Pol<strong>and</strong>, Portugal <strong>and</strong> Sweden <strong>and</strong> United Kingdom. 38 Austria, Belgium, Denmark, Finl<strong>and</strong>, France, Germany, Italy, Latvia, Lithuania, Netherl<strong>and</strong>s, Portugal <strong>and</strong> Sweden <strong>and</strong> United Kingdom.
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