Press Release from HAS: Gender Transition — HAS Publishes First Recommendations on Medical Care for Adults
- La Petite Sirène
- Jul 22
- 4 min read
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Press Release – Posted online 18 July 2025 – HAS (French National Authority for Health)
Important in the press release
Recommendations to come for minors
In the absence of sufficiently robust data and consensus, the HAS has chosen to address the issue of individuals under the age of 18 separately. After establishing the framework of the subject, it will begin developing recommendations regarding minors at the start of 2026.
18 July 2025
At the request of the Ministry of Health, the Haute Autorité de Santé (HAS) has published the first part of its recommendations regarding the support and medical care of transgender individuals seeking to undertake a gender transition. This first section focuses on people aged 18 and over. Aimed at healthcare professionals, these recommendations seek to standardize practices and ensure safe, high-quality care. They place particular emphasis on welcoming, listening to, and informing the individuals concerned, to enable informed decision-making. HAS will later develop best practice recommendations concerning minors.
A transgender person is someone who lives or identifies in a gender different from the one assigned at birth. Questions of gender may lead someone to pursue a transition process, which can include various steps: social, administrative, and medical. The latest version of the International Classification of Diseases (ICD-11), published in 2018, classifies gender incongruence under “conditions related to sexual health,” meaning it is no longer considered a mental, behavioral, or neurodevelopmental disorder. In France, transition-related care is covered by national health insurance under the category of long-term conditions outside the standard list (ALD hors liste). The number of people followed under this category for “gender identity disorders” stood at just over 22,000 in 2023, a figure that has been increasing in recent years.
Today, access to quality care remains highly uneven across the country. Many transgender individuals experience medical neglect, exposing them to risks such as forgoing treatment, self-medication, depression, or anxiety disorders that can, in some cases, lead to suicide. According to a recent study, one in five transgender people suffers from depression. Discrimination—highlighted in the most recent framework decision of the Defender of Rights—adds to these challenges, leading to increased risks of violence (especially in public spaces) and social insecurity (employment difficulties, access to housing, etc.). In the face of these issues, which reflect a significant public health concern, professionals often lack clear guidelines.
In this context, the Ministry of Health tasked HAS in 2021 with developing recommendations to improve the support and medical care of transgender individuals. After a process involving 128 experts in total, HAS is now publishing the first part of its recommendations, which concern adults seeking to undergo a gender transition.
These recommendations aim to provide healthcare professionals with clear guidance on medical practices, while respecting the diversity of individual journeys. They outline the various aspects of care: hormone prescriptions, surgical interventions, psychological support, and other services. HAS also provides two accompanying documents: a summary aimed specifically at general practitioners and a factsheet outlining the implementation of care pathways.
Receiving transition requests without stigma and offering tailored support
Depending on the individual situation of the transgender person beginning a medical transition and their stage of reflection, needs will vary. For this reason, HAS recommends that care be personalized and that psychosocial support be adapted throughout the process. The goal is to promote the person’s autonomy and help them identify and articulate informed choices, in line with the principle of self-determination. It is essential to welcome individuals without judgment or preconceived notions about their gender identity and needs, including using the name and pronoun they request. Gender identity should not be subject to a specific psychiatric evaluation.
Given the diversity of situations and needs, HAS recommends comprehensive, multidisciplinary care provided by a healthcare team. The recommendations are aimed at a broad range of professionals: general practitioners, endocrinologists, psychiatrists, psychologists, fertility and reproductive specialists, gynecologists-obstetricians, urologists, plastic surgeons, occupational health physicians, and social workers.
HAS recommends that general practitioners be the first point of contact for any healthcare request and coordinate care throughout the transition process. They may monitor a prescription and, if trained, initiate gender-affirming hormone treatments. The recommendations emphasize the importance of the initial consultation with the general practitioner or another first-contact professional.
Clarifying requests for hormone prescriptions and surgery
Prescribing hormones to those who request them may help improve quality of life. A personalized evaluation of benefits and risks is recommended, particularly assessing risk factors (vascular, oncological, cardiac, etc.). Regarding surgical care, HAS recommends responding to the surgical requests of transgender individuals. It underscores the need to provide clear, honest, and appropriate preoperative information on surgical options, associated risks (short- and medium-term), and the irreversible nature of some procedures, for which a reflection period is required. This is to ensure the person gives informed consent.
HAS also calls on public authorities to strengthen the initial and ongoing training of healthcare professionals, structure the provision of care, and implement a territorial organization that meets the needs for support and medical and surgical care of transgender people.
Recommendations to come for minors
Due to a lack of sufficiently robust data and consensus, HAS has decided to address the issue of individuals under 18 separately. After defining the scope of the subject, it will begin developing recommendations for minors in early 2026.
[1] Elaborée par l’Organisation mondiale de la santé, la classification médicale des maladies (CIM) constitue la norme internationale pour l'évaluation de l'état de santé. La 11e version (CIM-11) a été publié en 2018, approuvée par l’Assemblée mondiale de la santé en 2019 et est entrée en vigueur en 2022.
[2] Effectif, prévalence et caractéristiques des bénéficiaires d’une ALD – 2023, Assurance maladie
[3] Konrad and Kostev, Increased prevalence of depression, anxiety, and adjustment and somatoform disorders in transsexual individuals, 2020
[4] 64 % des personnes transgenres en France ont déclaré avoir subi une discrimination liée à leur identité de genre dans les 12 mois précédents selon une enquête publiée en 2023 par l’Agence européenne des droits fondamentaux (FRA)
[5] Décision-cadre 2025-112 du 16 juin 2025 relative au respect de l’identité de genre des personnes transgenres
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