Transgender persons

What is the difference between ‘intersex’ and ’transgender’?

People often distinguish between physical intersex and transgender persons. Intersex persons suffer from a medical condition, they are people born with a reproductive or sexual anatomy and/or chromosome pattern that is not typically male or female. English speakers refer to it as ‘DSD’ or ‘Disorder of Sexual Development’. Specifically, it refers to people who have the physical characteristics of both sexes. This manifests itself in their primary or reproductive sexual organs. 

People with this medical condition are not transgender persons. As described earlier, ‘transgender’ refers to the inwardly experienced gender identity, expression or behaviour. ‘Transgender’ is not a medical condition but is a term derived from psychology. 

Medical gender reassignment therapy

Belgian law accepts gender reassignment therapy for transgender people. This makes it medically possible to reconcile a person's physical body with their lived gender identity. Hormone treatments and surgery can be part of this sex-change therapy. 

In practice, one can start hormone therapy from the age of 16. For effective sex surgery, the age limit depends on what one wants. Surgery to reduce or completely remove the breasts can be done from the age of seventeen, but other sex-changing surgeries are only possible from the age of eighteen. 

Whether sex-change therapy is ultimately allowed is a medical decision made by a doctor. No one can force a doctor to perform the acts. In other words, there is no right to gender reassignment surgery.

Legal sex change

From 1 January 2018, transgender people can change their gender through a relatively flexible administrative procedure, also the conditions to legally change their gender have become more flexible (Art. 135/1 old Civil Code).

Any adult or emancipated minor who has the conviction that the gender stated in his birth certificate does not correspond to his internally experienced gender identity may declare this to the registrar of births, marriages and deaths. 

The transgender person must present a signed personal statement at his declaration stating two things:

• First, that he is convinced that the gender mentioned in his birth certificate does not correspond to his inner lived gender identity. 
• In addition, he must also declare that he wishes the administrative and legal consequences of an adjustment of the registration of gender in his birth certificate.

Thereafter, the transgender person appears before the official for a second time within three to six months.

What happens to the parentage of children already born after gender reassignment surgery?

The parentage of children already born remains as it was after the legal gender reassignment. This means, for example, that a trans man will remain legally the mother of the already-born children. A trans woman will remain the legal father of the children already born.