States must ensure trans and gender-diverse persons' right to health

March 31, 2025

Washington, DC—On the International Transgender Day of Visibility, the Inter-American Commission on Human Rights (IACHR) calls on States to prevent and prohibit discrimination based on gender identity and expression in the health care system. States must act and take all measures necessary to guarantee comprehensive healthcare services that address the needs of trans, non-binary and gender diverse persons.

Across the region trans and gender-diverse persons' access to healthcare services is severely limited due to the lack of recognition of their gender identities in their identification documents; pathologizing perspectives that consider them as mentally ill; and the high rates of violence and discrimination due to prejudice. Because of institutional discrimination, mistreatment, and harassment, many trans and gender-diverse persons fear seeking services and avoid health centers, which increases their vulnerability and health risks.

As noted in IACHR's Trans persons and their ESCER report, health systems in the region don't generally recognize trans persons' gender identities. The nonrecognition of their identities means that trans persons are often referred to in public by a name and gender that does not correspond with their gender identity, which results in distress and feelings of discrimination. Lack of inclusive healthcare facilities, for example, those without gender-neutral bathrooms can be unsafe spaces for trans persons. Moreover, exclusionary restrooms can exacerbate the risk of anxiety and depression, low self-esteem, and have serious health consequences for the urinary tract or renal system.

The lack of appropriate training of the medical personnel results in trans persons being denied services or treatments that are perceived as exclusive to cisgendered men or women. Trans persons, also, face challenges such as hormone shortages and the high costs of gender affirming care not covered by the public health system.

In a 2024 public hearing, the Commission was informed that transmasculine persons face great obstacles in accessing health services, due to a lack of information and attention protocols. For example, medical staff are not trained to offer adequate gynecological or endocrinological treatments to trans men and often refuse these services.

In many States, due to structural discrimination factors, trans women are amongst the most affected groups by HIV, compared with the rest of the adult population; non-binary and gender diverse persons remain invisible in public health policies, official data and statistics.

Ensuring the right to health is a State obligation established by different Inter-American legal instruments. The has indicated that the right to health is closely linked to the right to life and personal integrity. States are responsible for constant regulation of the provision of services, both public and private. Furthermore, States must provide available, acceptable, adaptable and accessible services.

The IACHR calls States to develop and implement a comprehensive legal framework against discrimination in healthcare settings, develop protocols for the provision of healthcare care with a gender and sexual diversity approach, and to invest in the adequate training of medical professionals to attend the needs of trans and gender diverse persons. Furthermore, States must guarantee the legal recognition of trans persons' gender identity, as this is essential when accessing healthcare and other economic, social, cultural and environmental rights.

The IACHR reaffirms its commitment to working with States and civil society, through technical cooperation, in the promotion, protection and fulfilment of the human rights of trans and gender diverse persons, including access to their economic, social, cultural and environmental rights.

The IACHR is a principal and autonomous body of the Organization of American States (OAS), whose mandate is derived from the OAS Charter and the American Convention on Human Rights. The Inter-American Commission is responsible for promoting human rights observance in the region and serves as an advisory body to the OAS in this area. The IACHR comprises seven independent members, elected by the OAS General Assembly in their personal capacity, not representing their countries of origin or residence.

No. 064/25

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