Lithuanian Minister of Health: Gender Reassignment Legislation Is A Challenge

On March 23rd, 2017 the Government of the Republic of Lithuania placed two Lithuanian ministries, i.e. the Ministry of Health and the Ministry of Justice, under obligation to prepare legal acts that would enable gender reassignment procedure in Lithuania. Aurelijus Veryga, the Minister of Health of the Republic of Lithuania, claims that it will be “difficult to implement due to the lack of experts specializing on this issue”.

“Since such an obligation has been placed, we will be obliged to fulfill this request. It seems to me that we will need to consult with experts and professionals. I believe that this legislation will represent a very difficult issue and a complex challenge. It is certainly not an easy question but, of course, the judgement by the ECtHR must be implemented and the State must fulfill this obligation without further questioning. However, this issue raises many questions – is it only an issue of establishing the procedure or is it also an issue of covering it [through the health insurance fund],” commented the Minister of Health.

The Ministry of Health and the Ministry of Justice are required to submit the draft proposals on “providing treatment for persons with gender identity disorder” by September, 2017. The Cabinet of Ministers has reached this decision after reviewing the 2016 Activity Report by the Representative of the Government to the European Court of Human Rights (ECtHR).

Aurelijus Veryga, the Minister of Health, explained that it is still unknown what services could be covered through the public health insurance fund for the persons seeking gender reassignment procedure in Lithuania.

“For me – as a professional of mental health – it is a very interesting discussion. It is being told that it is not a mental disorder. If it is not a disorder and we do not consider it to be a disease then what we are treating with this procedure? What is the goal of this kind of treatment? If a person is not satisfied with his/her appearance, wants to change it, and do something about it, is it really a treatment of a disease? And must the State pay for it? Or should it be seen as, for example, procedures of plastic surgery? If a person is not satisfied with his/her appearance, where is the limit?” rhetorically claimed the Minister of Health.

Moreover, he stressed that if such procedures were to be legislated, it would not necessarily mean that it would be readily available in Lithuania.

“There are many procedures which are not performed in Lithuania, because, for example, there are no professionals able to do it. To only legislate on this procedure does not mean that it will be provided right away, because, I think, there are no surgeons and other specialists in Lithuania who would be able to perform these surgeries or would know how to perform them correctly. It is one thing to legislate on the procedure, but it is another thing to make it available,” explained Mr. Veryga.

Rita Grumadaitė, the adviser to the Minister of Justice Milda Vainiutė, told that the Minister of Justice believes that gender reassignment procedure “should be regulated by a separate law”. In that case, the Parliament of the Republic of Lithuania would vote on the issue.

Despite the fact that the Lithuanian Civil Code (Article 2.27) foresees the individual right to go through gender reassignment procedure, the enabling legislation has never been adopted. In 2007 the European Court of Human Rights (ECtHR) in the case L. v. Lithuania concluded that this legal gap constitutes a violation of the Article 8 of the Convention (i.e. the right to respect for private life). In 2014 the Committee of Ministers of the Council of Europe transferred this case to the enhanced supervision procedure, because the Lithuanian authorities continue to disregard their international obligations in the field of human rights for transgender people.

Currently the legal gender recognition in Lithuania can be sanctioned only by the national courts after the accomplishment of the gender reassignment surgery, which is currently not available within the framework of the Lithuanian health care system. To put it in other words, the Lithuanian State imposes impossible-to-fulfil requirements upon its transgender citizens with the view of obtaining legal gender recognition.

“There is no procedure, no order, no funding. Currently there are no practical ways of solving this problem, so the right to go through gender reassignment procedure just does not exist in Lithuania,” explained Karolina Bubnytė, representative of the Government at the European Court of Human Rights (ECtHR).

Sex change is legally an improper term. The term to be used is recognition of gender identity. Everybody would probably agree that technically we cannot change sex. In this case we are referring to gender as a social category,” commented the representative of the Government to the European Court of Human Rights.