Across The Big Pond

In many ways Europe is ahead of us in Trans rights but in other they lag behind.

Their military have trans service members but in some they lag behind, in some country you still need to see a therapist to transition.

What is the approach across Europe to transgender identity?
Euro News
By Anne Fleischmann  & Luke Hurst
August 8, 2019

Germany’s first openly transgender politician has called for the abolition of the country’s Transsexuellengesetz ('transsexual law'), which she describes as degrading.

Tessa Ganserer, who sits in the Bavarian state parliament as a member of the Alliance 90/The Greens political party, has not yet had her gender change officially recognised.

The country's 1981 law stipulates those wanting to change their first name and gender must talk to psychologists and a judge.

"I do not think that any human being, any state and certainly any judge has the right to determine the sex of another human being," Ganserer told the DPA news agency.
[…]
In Europe, 33 countries require a mental health diagnosis before identity documents can be adapted, which are shown on the below map in red.

Countries where this is not required are marked in blue and countries that do not offer reliable gender recognition procedures are shown in grey.

There are still some states here in the U.S. where they require surgery before you can change your gender markers and I think two states do not allow you to change your birth certificates.

Being transgender no longer on WHO's list of 'mental illnesses'
The World Health Organisation (WHO) removed transgender health issues from its list of mental illnesses in 2018 — a move welcomed by the transgender community.

It is now called "gender incongruence" and was reassigned to a new category: Category 17 — conditions related to sexual health, which also includes paedophilia and exhibitionism.

I don’t like the company we have been put in.

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Over in Ireland they are fighting for humane healthcare.

'It pens people in': The challenges of accessing transgender healthcare in Ireland
Transgender people speak of the challenges of transitioning in Ireland.
The Journal.ie
By Sarah Gallagher
August 11, 2019

Long waitsA psychiatrist’s referral to a gender endocrinologist was vital for Justin [A trans man], as he could not legally access hormones in Ireland without first seeing an endocrinologist. There are currently three endocrinologists in Ireland who will prescribe hormone replacement therapy to adults.

All three require patients to undergo psychiatric evaluation, with a diagnosis of gender dysphoria, before they will treat them.

Justin said that while seeking the referral, the waiting list for Prof Donal O’Shea, a
Loughlinstown-based endocrinologist, increased from about 14 months to about three and a half years.
[…]
“For some people that’s the right thing to do because the level of distress and dysphoria is immediately reprieved… and then for others who do that, the outcome is disastrous,” he said.

O’Shea said that for some who access treatment elsewhere, there is no improvement to their dysphoria, distress and mental health problems. “So our job is to make sure that the people who [transition] be truly better through transitioning.”

Okay where did he get his data that there is no improvement when we transition?

They want to go to the “informed consent” model…

Informed consentThe informed consent model of transgender healthcare is advocated by transgender individuals and activists across Ireland. Under this model patients would make their own decisions around hormone replacement therapy, with full awareness of potential risks, without psychiatric evaluation.

O’Shea does not support informed consent because of the amount of people who want to de-transition under the model elsewhere. “The informed consent model is leading to a surge in reversal surgeries… and when you’ve got a surge in presentation of any condition you’ve got to look at being even more careful.”
[…]
O’Shea does not support informed consent because of the amount of people who want to de-transition under the model elsewhere. “The informed consent model is leading to a surge in reversal surgeries… and when you’ve got a surge in presentation of any condition you’ve got to look at being even more careful.”

Again where did the doctor get his information?

The Informed Consent Model of Transgender Care: An Alternative to the Diagnosis of Gender Dysphoria
Journal of Humanistic Psychology
By Sarah L. Schulz First
December 13, 2017


Abstract
Historically, researchers and clinicians have viewed the transgender experience through a narrow diagnostic lens and have neglected to acknowledge the diverse experiences of those who identify as transgender. Currently, under the mainstream treatment paradigm, in order to be deemed eligible for gender transition services, transgender clients must meet criteria for a diagnosis of “gender dysphoria” as described in the DSM-5. An alternative to the diagnostic model for transgender health is the Informed Consent Model, which allows for clients who are transgender to access hormone treatments and surgical interventions without undergoing mental health evaluation or referral from a mental health specialist. This model shows promise for the treatment and understanding of the transgender experience outside of the lens of medical pathologization.
[…]
Conclusion
Instead of viewing transgender identity as an individual, disordered experience of identity, it is important to acknowledge the social and cultural factors that influence transgender identity development outside of the lens of medical pathologization. To this end, a shift in the clinical approach to transgender care is necessary in order to remove the distress narrative from the center of the transgender experience, and allow for a more nuanced understanding of gender variance than what the diagnostic model offers. The Informed Consent Model of transgender care shows promise in not only alleviating barriers to accessing treatment, but also for allowing a narrative of transgender experience to emerge outside of the distress narrative that is at the core of the diagnostic model. Not only might this contribute to the depathologization of gender variance in the psychological and medical fields, but it may also help us shift toward a larger culture of equal rights and protection for individuals with nonnormative gender identities and expressions.