R v the former Yugoslav Republic of Macedonia

The applicant in this case is a young transgender man who wishes to undergo gender reassignment surgery. The applicant found it impossible to obtain adequate medical assistance in Macedonia due to the absence of the requisite facilities but also due to the indifferent or even outright hostile attitude of medical professionals he met towards transgender people. He therefore decided to seek treatment abroad, in Serbia. There he received a gender dysphoria diagnosis and he started to undergo hormonal treatment. Since he could not afford the costs and in the absence of coverage from the Macedonian health insurance fund, he had to discontinue the treatment. He therefore found himself in an intolerable situation of limbo, due to the discrepancy between the gender marker included in his personal documents reflecting his sex at birth on the one hand and his male appearance and name on the other hand. He filed a request asking that he be issued with a new birth certificate reflecting his preferred gender, which the authorities rejected.

The applicant made two broad claims in his complaint lodged with the European Court of Human Rights, First, he complained about the absence in Macedonia of any meaningful procedures for legal gender recognition. This allowed public officials entitled to receive sex change requests to act arbitrarily, frequently on the basis of their own biased opinions towards transgender people. Second, the applicant complained about the implicit requirement that he undergoes genital surgery in order to be granted a gender marker change. This requirement, the applicant argued, was in breach of his human rights and lacking in any conceivable justification. Furthermore, the domestic authorities which heard his claims failed to give due consideration to his inability of undergoing the required surgical treatment due to lack of funds.

The applicant’s representative, Skopje-based lawyer Natasha Boshkova, working with the Macedonian NGO Coalition Sexual and Health Rights of Marginalised Communities Skopje, assisted by INTERIGHTS as advisor to counsel, submitted the application in this case to the European Court of Human Rights in June 2012.