In recent years, laws regulating the rights of trans people have evolved unevenly across the globe. While some countries have consolidated models of gender self-determination and access to healthcare, others have taken steps backward by rolling back regulations or limiting essential treatments. The result is a fragmented global map that tends toward polarization, where the level of protection largely depends on the country of residence. In 2025, trans laws have seen both progress and setbacks worldwide.
Spain, for example, following the approval of the Law for the Real and Effective Equality of Trans People (Law 4/2023), is positioned among the most protective legislative frameworks. However, comparison with other European territories, the United States, and Latin America reveals a complex landscape, full of contradictions between legal advances, social resistance, and barriers to real access to rights.
What is gender self-determination?
Gender self-determination is the right of a person to have their gender identity legally recognized by the State. This legal recognition makes it possible to officially change one’s name and sex based solely on self-declaration, without the need for a medical diagnosis or documentation proving hormonal treatment or surgery.
Gender self-determination in Spain
Spain’s 2023 trans law recognizes gender self-determination without the need for medical reports. This represents a major step forward and has positioned the country as a benchmark in trans rights, allowing people of different ages to align their legal documentation with their identity in a simpler way.
However, certain social challenges persist, largely due to the lack of regulatory development. For example, access for migrant trans people to updated documentation creates practical vulnerability. Recent administrative decisions such as the inability to recognize non-binary identities in certain procedures how that legal equality does not yet guarantee operational equality. Likewise, the current situation within Spanish prison systems is still far from fully respecting gender identity.
The gap between the law and everyday reality remains one of Spain’s greatest challenges.
Gender self-determination in Europe
In Europe, the landscape is heterogeneous. Some countries are advancing in legal recognition, while others are experiencing setbacks or complex judicial disputes.
The United Kingdom currently exemplifies this tension: although a labor tribunal recently ruled that allowing trans women to use women’s changing rooms does not contravene regulations, other court rulings have created uncertainty around the legal definition of “woman.” This has polarized public debate and begun to rebuild social barriers that were once thought dismantled.
Most European countries provide some form of legal recognition of gender identity, but access to specialized medical treatments continues to be marked by inequality, long waiting lists, and territorial disparities.
United States: more restrictions than progress
The U.S. context is characterized by a deep divide between states. While some territories have upheld decisions restricting public coverage of gender-affirming surgeries or limiting hormone treatments, others have seen federal courts intervene to guarantee the continuity of therapies when interruption would cause significant clinical harm.
Access to healthcare, legal documentation, and protection against discrimination varies enormously depending on the state of residence. This scenario makes the United States one of the countries with the greatest internal disparity in trans rights.
Latin America: progress and deep inequalities
Latin America presents a highly dual reality. On the one hand, some of the world’s most progressive legislative advances have been achieved. On the other, deep social inequalities, lack of access to healthcare, and high levels of violence against trans people persist.
Pioneering Latin American countries in gender self-determination
Argentina continues to be an international benchmark thanks to its 2012 Gender Identity Law, based on gender self-determination and the right to access medical treatments without judicial oversight. Uruguay and Chile have followed similar paths, guaranteeing legal recognition of identity and protection against discrimination.
In these countries, legislation is strong, but implementation largely depends on the availability of healthcare resources, professional training, and institutional willingness at the local level. In Argentina, for example, the community reports setbacks and insufficient social implementation of the law.
Limitations in access to surgery and specialized care
Although legislation in some countries allows access to gender-affirming surgeries, the reality is that public healthcare systems often face long waiting lists, a lack of specialized centers, or a shortage of professionals experienced in different types of trans surgery. As a result, many trans people in the region seek these treatments in countries with highly specialized private care, such as Spain.
Contexts with structural barriers
In other Latin American countries, especially in Central America and the Caribbean, legal recognition of gender self-determination is very limited or nonexistent. In some cases, there is no gender identity law at all, healthcare for trans people is marked by exclusion, and institutional violence is frequent.
The lack of clear legal frameworks makes it difficult both to access documentation and to receive medical care with proper guarantees.
A region marked by violence
Latin America remains one of the regions with the highest rates of violence against trans women and non binary people. Despite legislative advances, social vulnerability continues to be a central factor, especially for young people expelled from their homes or trans migrants.
The importance of social context for trans people
The existence of protective laws does not, by itself, ensure social acceptance or effective access to rights. Institutional discrimination, economic precarity, labor exclusion, and lack of healthcare resources continue to affect thousands of trans people worldwide.
Moreover, lack of awareness of this reality often leads society itself to violate rights that have already been achieved.
In countries such as Spain, social awareness has enabled trans people to live their identity from an early age, with growing understanding from families with trans children, schools, and socio-healthcare centers.
In other countries particularly in Latin America there is still a long way to go in terms of social education.
Spain: an advanced country
International comparison shows that Spain clearly belongs to the group of countries with the greatest legal protection and access to basic rights, as well as major advances in legal gender change. Compared to restrictions in the United States or ambiguous judicial debates in the United Kingdom, the Spanish model stands out for its clarity and for explicitly recognizing gender identity within one of the most advanced legal frameworks in the world.
At the social level, Spain is also among the countries most respectful of trans realities. Although practical implementation of the trans law must still improve to avoid territorial or administrative inequalities, the country has become an international reference for many trans people, especially those from Latin America seeking specialized medical care and a safer social environment.
The global trans reality in 2025
Laws can guarantee rights such as gender self-determination, but social acceptance and everyday protection depend on broader factors.
Internationally, the visibility of the trans community continues to grow, but so do hostile discourses in certain political contexts. In this sense, 2025 has become a year in which trans rights are firmly at the center of public debate, and where the defense of diversity takes on crucial importance.
In a world where progress coexists with setbacks, the future lies in consolidating strong legal frameworks that guarantee gender self-determination, developing inclusive public policies, and fostering a social culture that respects the diversity of identities.
Have you considered traveling to Spain for trans surgery? Contact the IM GENDER team and we will explain how to do it.
