The Interterritorial Council of the National Health System has approved the beginning of the process to create a center specialized in the care of trans people and people with diverse sexual development. A historic decision that seeks to repair years of inequality in access to health.
A milestone in healthcare: the first reference center for trans people
The State takes a firm step towards more inclusive care. The Ministry of Health, with the support of the autonomous communities, has approved the creation of the first Center, Service or Reference Unit (CSUR) specifically aimed at trans people and people with diversity in sexual development.
Although specialized units already exist in some regions, this would be the first center with national recognition. The objective: to guarantee decent, specialized health care without discrimination, adapted to the real needs of the group.
What does this new center entail?
The Ministry’s proposal contemplates comprehensive care from a human rights approach. The center will not only offer surgical interventions for complex cases, but will also be able to provide consultations and follow-up when specific referral criteria are met.
The autonomous communities now have the responsibility of proposing hospitals that can be accredited as CSUR. Aspects such as:
- Previous experience in caring for the trans community.
- The technological capacity and minimum volume of activity.
- Specific training of healthcare teams.
- Coordination with psychosocial and community resources.
- And most importantly: respect for gender self-determination and non-pathologization.
A historical debt to the LGTBIQ+ community
The figures support the urgency of this measure. A recent study by the Carlos III Health Institute reveals that 40% of trans people feel that their medical staff does not know how to treat them. Even more alarming: 10% have confronted professionals who consider being trans an illness.
This lack of knowledge is not just a symbolic barrier, but a real obstacle. About 10% of the group avoids starting hormonal treatments for fear of rejection or discriminatory treatment. The impact on mental health is evident: the probability of being diagnosed with anxiety and depression skyrockets among trans and non-binary people, compared to the general population.
The minister speaks clearly: “We will not medicalize what is not a disease again”
Mónica García, Minister of Health, has been blunt. At a press conference, he stressed that the new centers will avoid any approach that involves medicalizing or pathologizing trans identities. The minister insisted that this measure is not only technical, but also ethical and political: it is about guaranteeing care with guarantees, resources and prepared professionals.
And what is left to do?
Although this progress is significant, there are still open questions. How will equal access be guaranteed if only one national reference center is enabled? What happens to patients who cannot travel outside their community? And how will it be ensured that the principles of respect and non-discrimination are truly complied with?
It’s a step forward, yes. But also a reminder that the path to truly inclusive healthcare is still under construction.
📌 Critical perspective: centralization or barrier?
Although the creation of a CSUR for trans people is a necessary measure, it is not exempt from debate. Centralizing care in one or a few centers can be counterproductive for those who live far away or have limited resources. Furthermore, although principles such as non-pathologization are established, their effective application will depend on the actual training of personnel and sustained political will. What if this new center, instead of being a replicable model, becomes the exception that proves the rule?
Other topics addressed in the Interterritorial Council
In the same session, other relevant measures were discussed:
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Financing of new places in Medicine: the Ministry will invest almost 27 million euros to expand university training in medicine, covering 1,783 places for the 2025-2026 academic year.
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Advanced Therapies Plan Update: access to treatments such as gene or cell therapies (including academic CAR-T) is expanded, which allow diseases such as certain types of cancer to be addressed with innovations developed within public hospitals.
