THE road to sex reassignment covers some very difficult terrain, ranging from hormone treatment and possibly surgery, to social stigma and discrimination. But in many European countries those wanting to have the reassignment legally recognised face extra challenges. Citizens of Malta, Ireland, Denmark and Norway can simply tell authorities their decision. Elsewhere the process requires judicial consent or even the diagnosis of a mental disorder. Switzerland, Greece and 18 other, mostly eastern European, countries have a final hurdle: sterilisation. Why is this the case?

The requirement for sterilisation has dark echoes of eugenics. In the early 1970s Sweden became the first country in the world to allow transgender people to reassign their sex legally. It enforced a strict sterilisation policy though, on the grounds that such people were mentally ill and unfit to care for a child. (Indeed the World Health Organisation still lists “transsexualism”, which it describes as “a desire to live and be accepted as a member of the opposite sex”, as a mental and behavioural disorder.) The nationwide eugenics programme ended in 1976 after 42 years, but sterilisation remained a condition for sex reassignment until 2013; it had already spread to other countries when they started tackling the same issue.

Amnesty International estimates that the European Union is home to around 1.5m transgender people (those whose gender identity differs from their biological sex). Though Europe is widely seen as progressive on LGBT rights, transgender rights specifically still lag. Read more via the Economist