Ces Urol 2025, 29(4):197-205 | DOI: 10.48095/cccu2025026

Gender reassignment in the Czech Republic – legislative framework and medical aspects

Adam Novák, Marcela Fontana, Lucia Strhárska, Ladislav Jarolím

Urologická klinika 2. LF UK a FN Motol, Praha

Major statement: The article summarizes the medical, legal, and psychosocial aspects of gender conversion in the Czech Republic. It describes diagnostics, hormonal and surgical therapy, legislative changes effective from July 2025, and emphasizes the need for multidisciplinary, long-term, and respectful care.

Summary: Gender dysphoria currently represents an important medical, legal, and social issue, closely linked to fundamental human rights and freedoms. In the Czech Republic, the process of gender transition is embedded in the legal system, with its conditions and procedures defined primarily by the Civil Code, the Act on Specific Health Services, and related decrees. Until recently, the key legal requirement was surgical transition (specifically procedures leading to infertility), without which it was not possible to complete the official gender change in the civil registry. Although this topic is gaining attention, it remains controversial and burdened with prejudices, stereotypes, and legislative ambiguities. From a medical perspective, the process of gender transition involves comprehensive multidisciplinary care, starting with psychological and sexological assessment, followed by hormone therapy, and culminating in surgical procedures that alter primary and secondary sex characteristics. Care is concentrated in specialized centers and requires long-term interdisciplinary collaboration. The aim of this paper is to present the current legal framework of gender transition in the Czech Republic, highlight its problematic aspects, and at the same time provide an overview of medical procedures and standards of care for individuals with gender identity disorder.

Keywords: gender dysphoria – gender-affirming surgery – legislation – transgender

Received: October 8, 2025; Revised: November 26, 2025; Accepted: November 26, 2025; Published: December 29, 2025