Athens, March 7, 2023
Subject: «Question of 27 MPs on the ban on prescribing hormones for trans persons»
The Greek Transgender Support Association (GTSA), is a voluntary non-governmental organization that promotes the rights and freedoms of trans, gender-diverse, and LGBTQI+ persons in general, with this press release, informs about a question submitted by 27 members of parliament regarding the ban on prescribing hormones for trans persons.
Specifically, on March 6, 2023, the following question was submitted by 27 SYRIZA MPs:
Athens, March 6, 2023
To: The Minister of Health
Topic: “To allow the required prescription of medication for transgender people.”
The medicinal product ARVEKAP is administered for a number of medical indications, such as prostate cancer, endometriosis, induction of ovulation in the case of in vitro fertilization, breast cancer and finally in indications of early puberty. Nevertheless, as is also the case in most other cases in which a medicinal product has medical value to be administered outside of the prescribed indications, doctors prescribe this medication for the hormone therapy of persons who encounter a discrepancy between their innate anatomical, biological sex and the expressed, desired gender (transgender persons). With this hormone therapy* transgender persons are facilitated in changing their secondary sex characteristics to be more in congruence with how they experience their gender.
According to complaints that have come to the light of the public, individual cases and NGOs of the LGBTI+ Community, this medicine can no longer be prescribed for hormone therapy of transgender persons, without the cause of this development being known. However, the medicinal product ARVEKAP (active ingredient triptorelin) is prescribed off-label for persons on hormone therapy, while the product remains certified and available in the EU. This medicine works as a hormone inhibitor/blocker and cannot be replaced by another with the same effect (e.g. generic), while its prescription ban for transgender persons who are on hormone therapy and use it, or could use it, means the mandatory use of other preparations that do not have exactly the same action, increasing the possibility of complications and burdening their health.
The dissociation of externals from the psychological characteristics of gender (transsexualism*), as long as it lasts in time, compromises the very honor of the person as fundamental right, being forced to reveal the difference in social environments that often do not tolerate it. The granting of access to hormone therapy medical products which affirms their gender, moreover, is based on the principle of the social rule of law. In particular, in view of its guaranteeing mission as regards the protection of fundamental rights in article 25, paragraph 1, of the Constitution, the State should express social policy in the context of safeguarding the social autonomy of the human being, as well as securing the right of access to related medical procedures.
Following these, the Minister is asked
1. What is the reason that for the first time doctors are unable to prescribe ARVEKAP for hormone therapies of transgender persons?
2. Has he been informed of the intensifying complaints?
3. How will he intervene to resolve the problem that has been created?
4. Is it the government’s intention to implement the 2019 conclusion of the Working Group for the Healthcare Coverage of Transgender Persons of the Ministry of Health and cover transgender persons hormone therapy?
The questioning members of parliament
Markou Kostas, Agathopoulou Irini, Anagnostopoulou Athanasia (Sia), Avlonitis Alexandros Christos, Vagena Anna, Vardakis Sokratis, Giannoulis Christos, Dritsas Theodoros, Zachariadis Konstantinos, Igoumenidis Nikolaos, Thrapsaniotis Manolis, Mamoulakis Charalambos, Bakadima Fotini,Balafas Yiannis, Barkas Konstantinos, Notopoulou Aikaterini, Xanthos Andreas, Papadopoulos Athanasios (Sakis), Poulou Panagiou, Skourletis Panagiotis, Sirmalenios Nikolaos, Tzoufi Meropi, Filis Nikolaos, Fotiou Theano, Hatzigiannakis Miltos, Christidou Ralia, Psychogios Georgios»
Although the term used in the Members’ question, “transsexualism”, is an outdated, stigmatizing term, which has absolutely no basis, as it has been removed from the relevant classification list ICD-11 of the World Health Organization, from 2018 , as well as the term “hormone therapy”, is an outdated term and the more neutral “gender affirming hormones” should be used instead, as noted in the question of the 27 MPs, the specific medicine can no longer be prescribed for gender affirming hormones of transgender/trans persons, but without knowing the cause of this development. However, the medicinal product ARVEKAP (active ingredient triptorelin) is prescribed off-label for persons on gender affirming hormones, while the preparation remains certified and available in the EU.
The Greek Transgender Support Association (GTSA), had made public since February 18, 2023 , the controversial issue of the ban on the prescription of hormones to transgender/trans persons, a fact particularly serious for the health of these persons, as the abrupt cessation of gender transition creates serious health problems.
In particular, the abrupt cessation of gender affirming hormones creates serious problems such as osteoporosis, an increase in diabetes b’, cardiovascular diseases, as well as psychosomatic consequences such as depression, intense anxiety, or even increased chances of suicide.
Trans persons, according to all international research, often live in conditions of limited access to the workplace or exclusions, in short, in conditions of extreme poverty, therefore their participation in access to medication (gender affirming hormones) is a necessity. In fact, not only should there be full access to the prescription and the present problem solved, but precisely because trans persons live in conditions of extreme poverty, this should happen with insurance coverage with zero participation.
The GTSA, on February 28, submitted to the Minister of Health, Mr. Plevris, as well as to the Deputy Minister, Ms. Gaga, as well as to the General Secretary of Public Health, Ms. Agapidaki, a detailed full Memorandum (Prot. No. 584/28.02.2023), regarding the issue that arose from mid-January, with the ban on the prescription of GnRH agonists (specifically triptorelin) with a diagnosis of F64.0, with which it called on the Ministry to take all the necessary actions, in order to immediately remove the specific obstacle concerning prescription of the above medicine.
In addition, on this occasion, the GTSA emphasizes once again the necessity of taking legislative or other measures that will ensure equal access of trans, gender-diverse, intersex and LGBTQI+ persons in general to the health sector without discrimination.
In particular, we call on the Ministry of Health to proceed in cooperation with other possibly co-competent Ministries in the following necessary amendments:
1. Legislation that provides for full access of trans persons to health services without discrimination and stigmatization on grounds of gender.
2. In the amendment of the law of equal treatment so that trans persons are included in the provisions of equal treatment in the field of health and social security.
3. In amending the code of Medical Ethics to include gender identity and sex characteristics.
4. In the complete de-psychiatrizationof gender identity following modern developments (ICD-11).
5. Full insurance coverage of gender reassignment procedures.
6. The removal, where it exists in laws, of the mandatory examinations, especially when it is foreseen that they will be done with the assistance of the police.
7. The provision for transgender persons with immigrant/refugee status.
The GTSA continues its struggle until the necessary institutional framework is created that will ensure safe, equal, inclusive and non-discriminatory access to health for all trans, gender diverse and LGBTQI+ persons in general.
THE BOARD OF MEMBERS
GREEK TRANSGENDER SUPPORT ASSOCIATION
15 ViktorosUgo, 10437, Athens
Trans Day Reception & Empowerment Center: Evangelistrias 6, Kallithea Athens, 17671
Tel. 210.9210 697 & 698 753 9741
Office hours for the public: Tuesday & Thursday – 12.00-20.00
firstname.lastname@example.org – email@example.com