Gender reassignment

Information on gender reassigment, including definitions, and an overview of relevant policy and legislation.

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Gender reassignment is the term used to describe transitioning from one gender to the other (EHRC, 2011).

The Equality Act 2010 defines a person as having the protected characteristic of gender reassignment if the person is proposing to undergo, is undergoing or has undergone a process (or part of a process) for the purpose of reassigning the person´s sex by changing physiological or other attributes of sex.

The UK Government Equalities Office quick start guide to gender reassignment notes that the process of gender reassignment may involve different stages, such as change of name and title, through to surgical intervention. Gender reassignment surgery is recognised as the appropriate treatment for gender dysphoria.

NHS Health Scotland’s Dimensions of Diversity report defines ‘transgender’ (or trans) as an umbrella term in Scotland which covers not only transsexual men and women (who are protected under the gender reassignment characteristic) but also cross-dressing and transvestite people, intersex people (people born with chromosomal abnormalities or ambiguous genitalia) and polygender/androgyne people.

A useful glossary of terms can be found in Press for Change’s Legal Survey and Focus on the Transgender Experience of Health Care.

Scottish Government Evidence Reviews
The Scottish Government have published a series of Equality Evidence Reviews, to inform the development of the public sector’s equality outcomes. The reviews explore available evidence about the scale and severity of issues faced by people with protected characteristics including gender and lesbian, gay, bisexual and transgender.


There is no reliable information on the number of transgender people in Scotland (Dimensions of Diversity, Sex and Gender (3.12)).

GIRES estimates that in the UK, the number of people aged over 15 presenting for treatment for gender dysphoria is thought to be 3 in 100,000. This would equate to approximately 150 per annum in Scotland. In developing a new Gender Reassignment Services Protocol, NHS Health Scotland and its partners completed a scoping exercise which found this number to be slightly higher, approximately 200 per annum.

The median age for transitioning is 42, although those who are treated for gender dysphoria recall experiencing gender variance from a young age.

Press for Change´s European survey of transgender people’s experiences of health care anticipate that the ratio of trans women to trans men is nearing 1:1 across Europe as the trans population grows exponentially.

The Press for Change study raises the problem of the criteria by which the population is measured: ‘Those who have had surgery? Those who are on hormone replacement therapy? What about trans people who do not seek medical diagnosis and treatment?’


The Scottish Government’s Gender Reassignment Protocol sets out the procedures for gender reassignment which may be provided on the NHS.

NHS Inform has further information on NHS Scotland gender reassignment services.  

The Christie Commission Report, the NHS Healthcare Quality Strategy, and Equally Well are all policies relevant to this population group. For further information, visit our policy page.


The Equality Act 2010 came into force in October 2010 and provides a legal framework to protect the rights of individuals and advance equality of opportunity for all. There are nine protected characteristics’ under the Act – including gender reassignment.

The Gender Recognition Act 2004

The Gender Identity Research and Education Society (GIRES) explains that under the Gender Recognition Act, transsexual people who experience severe gender variance, and have medical treatment for the condition, may apply to the Gender Recognition Panel (GRP) for a Gender Recognition Certificate (GRC). The GRC then entitles them to recognition of the gender stated on that certificate ‘for all purposes’.

European Court of Human Rights

The European Court of Human Rights (ECHR) has established a positive duty that States provide for the possibility of undergoing surgery leading to full gender reassignment. Depending on an individual transsexual person’s wishes and needs, they should have access to hormone treatment, gender reassignment surgery or other medical interventions, such as lasting hair removal and voice training.

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Updated April 2015

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