From self-management to depathologisation: the evolution of transgender health care and rights in Spain between 1970 and 2020

Abstract

Even though transgender people continue to experience violence and discrimination in many aspects of life, there has been progressive recognition of their experiences and demands in recent decades. This article analyses the process of claiming civil rights and the evolution of health care for transgender people in Spain, from the mid-1970s to the present day, paying particular attention to the narratives of key actors involved. To this end, three socio-historical periods are identified: (1) the travesti period (the mid-1970s to the early 1990s), characterised by strong social and institutional transphobia and resulting self-care practices; (2) the transexual period (mid-1990s to the 2000s), when demands for health care were institutionalised under a pathological medical model; and (3) the transgénero or trans period (2010s until the present) when identity and bodily autonomy have been re-claimed through a socio-cultural prism that has denounced pathologisation. At each stage, political, social and economic factors intervened at both national and international levels to trigger an ongoing negotiation between transgender movements and dominant social institutions, all within a changing universe of social values.

Keywords:

• Transgender
• transsexuality
• civil rights
• health care
• (de)pathologisation
• Spain

Disclosure statement

No potential conflict of interest was reported by the author.

Notes

1 Throughout this paper, ‘transgender’ and ‘transgenderism’ are used as umbrella terms to include people who reject the gender assigned to them at birth, regardless of whether they wish to undergo normalised medical treatment to express the opposite gender (specifically called transexuales [‘transsexuals’] in the Spanish context), or whether they reject biomedical treatment and are critical of gender binaries and dichotomies.

2 WPATH was originally named the Harry Benjamin International Gender Dysphoria Association.

3 For an overview of the stigmatisation and punishment of sexual and gender dissent during the Spanish dictatorship see Huard (2014), Mira (2004) and Ugarte Pérez (2008).

4 For a more detailed analysis of the travesti in Spain see Coll-Planas and Missé (2015), Guasch (2011), Guasch and Mas Grau (2014), Mérida-Jiménez (2016), Peralta and Mérida Jiménez (2015), Pierrot (2006), Platero (2011), Soley-Beltran and Coll-Planas (2011).

5 The Catalan association was created after the murder of a transgender woman called Sonia.

6 Before Law 3/2007 was passed, the power to decide whether to grant a legal change of sex fell to judges who used to request, following jurisprudence established by the Supreme Court, sexual reassignment surgery (Bustos 2008).

7 At present these are called Unidades de Identidad de Género (Gender Identity Units).

8 See Council of Europe (2011), European Parliament (2011) and the Yogyakarta Principles (2007).

9 In Catalonia, the 11/2014 Act seeks to guarantee the rights of lesbians, gays, bisexuals, transgender and intersexual people and to eradicate homophobia, biphobia and transphobia.

Additional information

Funding

Financial support for the copy-editing of this article was provided by the Faculty of Geography and History of the University of Barcelona.