Since the European Court of Human Rights’ earliest decisions on legal gender recognition, strategic litigation has driven many major advances. More recently, rulings by the Court of Justice of the European Union on freedom of movement and non-discrimination have further strengthened these gains. TGEU’s 2026 Trans Rights Map also found that national court decisions are increasingly driving progress in trans rights, particularly where legislative and policy advances are stalled or reversed.

Trans-specific healthcare is an exception and is comparatively less litigated at the European level. Trans people across the EU face significant barriers in accessing trans-specific healthcare. Enforcing their rights to healthcare is further complicated by administrative refusals, unclear national regulations, and national court rulings that remain largely unknown. At the same time, interest is growing in using legal tools to advocate for improved access to trans-specific healthcare, and in how courts across the region handle such cases.