The number of applications in the Czech Republic for gender reassignment has more than tripled over the past ten years, and was at its highest in 2024, when 296 people applied, according to data from the Ministry of Health.
The data reflect the number of applications processed, not the number of completed legal or surgical gender changes.
Since 2012, there have been more than 1,900 applicants for gender reassignment, with more than 60% of the requested changes from female to male.
As the number of applications increases, so does the number of cases in which the procedure is denied by a commission. There were nine such cases in 2024, and seven in 2025.
A Prague court is currently hearing the case of a person who underwent gender reassignment surgery, but is suing doctors for CZK 17 million over a misdiagnosis that led to the surgeries.
In 2024, the Constitutional Court repealed the castration requirement for those changing their legal gender, which made the Czech Republic one of the last countries in Europe to abolish this condition. Now, all that is required is a diagnosis from a sexologist, a process that typically takes six to twelve months.
Doctors must also inform the patient of the associated risks. “As part of diagnostic procedures, the diagnostic phase assesses the person’s desire to live and be accepted as a member of the opposite sex, as well as the permanence and consistency of the incongruence between the gender they experience and the sex assigned at birth,” stated the Ministry of Health last year in its gazette, in which it amended the process.
Before the Constitutional Court’s ruling took effect in July 2025, those applying to change their legal gender were required to submit an application for review by a special commission of the ministry. Under the new rules, this procedure is necessary only if they wish to have plastic and other gender-affirming surgeries covered by public health insurance. According to insurance companies, the cost is approximately CZK 100,000.
After review by the commission, these people may undergo the removal of breasts, penis, testicles or uterus, or, conversely, the creation of organs using plastic surgery.
According to experts, the number of diagnosed gender identity disorders is rising even faster than the number of requests for gender reassignment surgery. While doctors recorded 225 such cases in 2013, the figure rose to 989 in 2023, according to data from the ministry last year. Of these, 80% were categorised as ‘transsexualism’, which is considered an outdated term by patient organisations, who prefer the term ‘gender dysphoria’.
In 2023, the most likely to seek professional help for this issue were people aged 15-19 (370), 20-24 (186), and 25-29 (90). 52 people in their 30s, 46 in their 40s, and 13 in their 50s experienced gender dysphoria between their biological sex and gender identity. Two individuals in their late 60s and early 70s received the diagnosis, as well as 21 young people aged 10-14.
