Health care for transsexual and gender variant people in spain: history and evolution
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Introduction: The aim of this article is to analyze the chronological set up and evolution of the health care for transsexual and gender variant people in Spain.
Method: A descriptive study was performed based on published literature related to health care for transsexual persons in Spain, and on information provided directly by the professionals of the established gender units or emergent gender teams of the different autonomous communities.
Results: The first Spanish historic medical document dates from XV and XVI centuries. In modern times, in private practice, the first vaginoplasty surgeries were performed in 1983 and the first phaloplasty in 1989. In public hospitals, from 1986, there are isolated clinical records of psychology, psychiatry and/or endocrinology attention, despite the absence of legal support. The creation of public multidisciplinary gender units began in the Community of Andalucía (1999), and then were also established in Madrid, Cataluña, Aragón (2006), Asturias (2007), País Vasco, the Communities of Valencia and Canary Islands (2008), Navarra (2010) and Castilla and León (2014). In the 5 last years, changes in health care models are produced in parallel with the pressure made by activists asking for gender self determination and decentralization.
Conclusions: In the last 20 years, multidisciplinary gender units have been progressively developed in several Spanish communities, achieving levels of quality, in spite of the limited resources and the inequalities between communities. In the last years, new models of attention have been established that differ between communities and from the models and guidelines existing in our European environment countries.
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