On March 6, 2026, LGL formally notified Minister Vladislav Kondratovič of a systemic problem, where an F64.0 diagnosis leads to automatic rejection, despite a stable mental health record and a successful term of military service with the same diagnosis on record.
Trans persons seeking work in regulated professions constinue facing systemic barriers. The letter argues that current practice is incompatible with EU case law, World Health Organization standards, and norms already enshrined across the majority of EU member states.
The latest specific case that prompted the letter: in March 2026, the Vilnius Central Medical Expert Commission (CMEK) declared a trans man unfit for police service solely on the basis of the ICD-10 diagnosis F64.0 (gender identity disorder) appearing in his medical record, despite specialists confirming stable psychiatric and psychological health. Critically, the same individual had previously completed successful service in the Lithuanian Armed Forces as a professional soldier, including during the period when the F64.0 diagnosis was already on record, and was never referred to a repeat military medical review on that basis.
The presence of diagnosis F64.0 / HA60 in medical records does not describe a dangerous or unstable psychiatric condition. It is an identity characteristic, not a disorder. — From LGL’s letter to the Minister of the Interior, 6 March 2026
WHO depathologised gender identity
LGL’s letter reminds the Ministry that in 2019 the World Health Assembly adopted the revised International Classification of Diseases (ICD-11), in which gender incongruence is no longer classified as a mental or behavioural disorder. ICD-11 entered into force in 2022. Lithuania, as a WHO member state, is bound by the objectives and principles of this reclassification. The current CMEK practice, i.e. using the ICD-10 diagnosis F64.0 as an automatic disqualifier, perpetuates a medical paradigm the international community has formally abandoned.
EU case law clearly protects trans workers
The letter surveys the Court of Justice of the EU’s (CJEU) growing case law on trans persons’ rights in employment. The landmark 1996 ruling in P v S and Cornwall County Council (C-13/94) was the first CJEU case directly concerning a trans person in employment, establishing that dismissal related to gender reassignment violates the equal treatment principle. More recently, the 2025 ruling in Deldits v. Magyarország (C-247/23) held that public authorities must correct gender data in official registers and that requiring proof of surgical intervention is disproportionate and violates the right to private life under the EU Charter. The pending judgment in Shipov (C-43/24), where the Advocate General issued his opinion in September 2025, is expected to further strengthen member state obligations, with a ruling anticipated in early 2026.
LGL also invokes Directive 2000/78/EC, which prohibits discrimination on grounds of sex across all aspects of employment. Occupational requirements must be genuine, essential, and proportionate. Automatic disqualification by diagnosis alone, without any individual functional assessment, does not meet this threshold.
LGL’s five proposals to the Ministry of the Interior
- Review CMEK fitness criteria: move from automatic diagnosis-list disqualification to individual functional psychiatric and psychological assessment in line with ICD-11 standards.
- Issue methodological guidelines for CMEK and the Police Department on assessing trans persons, grounding decisions in actual health status rather than the presence of a diagnosis.
- Establish a clear appeals and independent re-assessment mechanism for candidates rejected on the basis of a diagnosis.
- Ensure consistency between military and police health assessment frameworks: engage the Ministry of National Defence on harmonised standards so that the same diagnosis does not produce different outcomes across services.
- Organise a working meeting with foreign experts and representatives from member states already applying the individual functional assessment model.
International practice: individual assessment is the norm
The letter surveys practice across five countries. The Netherlands has admitted trans persons to both the police and military since 2014, applying functional health criteria rather than diagnostic exclusions. Germany’s Federal Police and state forces, France’s Police Nationale, and the UK’s Metropolitan Police all apply individual health assessments. In Finland, where the Gender Recognition Act entered into force in 2023, the F64.0 diagnosis is explicitly not listed among the factors affecting fitness-for-service classification: a direct application of the individual functional model. In 2025 the Finnish government additionally proposed amendments to the Conscription Act to ensure equal treatment for serving personnel regardless of gender status.
“Across all of these countries, one principle is constant: what matters is not the presence of a diagnosis, but functional capability, mental and physical health stability, and the ability to carry out service duties,” the letter states.
An inconsistency between the military and the police
LGL highlights an institutional paradox at the heart of the case: Lithuania’s Armed Forces allowed the same individual to serve with an F64.0 diagnosis on record throughout his service and never referred him to a repeat medical board on that basis. Yet the police treated the identical diagnosis as an automatic bar. This inconsistency, LGL argues, reveals that the systemic disqualification has no rational foundation even within Lithuanian institutional practice itself, the individual’s own record of successful service already disproves any presumption of automatic unfitness.
LGL has proposed a working meeting between the Ministry of the Interior, the Police Department, CMEK representatives, and invited foreign experts to examine best practice and develop concrete methodological solutions. The organisation says it is ready to coordinate international expert participation at a time convenient for the Ministry.
