The European Court of Human Rights judgment of June 12, 2025, in the case of T.H. v. Czech Republic addresses a matter concerning the legal recognition of gender identity for transgender persons, and more generally, the conflict between the right to respect for private life and the right to physical integrity.

The applicant, T.H., a Czech national, identifies as a non-binary (intergender) person and, while having undergone hormone treatments and cosmetic surgeries, refused to submit to gender reassignment surgery from male to female. However, such surgery was a mandatory requirement under Czech law to change the personal identification number in the national identity document.

Under Article 29 § 1 of the Czech Civil Code and Paragraph 21(1) of Law No. 373/2011 on healthcare services, relevant to the case at hand, recognition of gender change was conditional on completing a surgical intervention that entailed disabling reproductive function and genital reconstruction.

Starting in 2012, T.H. submitted numerous requests to national authorities to obtain a gender code change, but consistently faced refusals from the Ministry of the Interior.

These refusals were justified by the absence of the aforementioned legal requirement, namely the lack of medical certification attesting to the completed surgical intervention.

Domestic judicial remedies proved unsuccessful: in particular, the Prague Municipal Court in 2018 upheld that failure to undergo surgery constituted a legitimate ground for refusal.

The following year, the Supreme Administrative Court reiterated that Czech legislation was based on a binary and objective conception of gender, which reflected national legal and social culture.

Seized of the matter, the Czech Constitutional Court, in its plenary judgment No. Pl. ÚS 2/20 of November 9, 2021, rejected the request for annulment of the legislative provisions, stating that the sterilization requirement was necessary to ensure the reliability of civil registry records and that, on ethically sensitive issues, the State enjoyed a wide margin of appreciation in the absence of a unanimous European context.

Faced with these rejections, T.H. approached the European Court of Human Rights, arguing that Czech legislation violated his rights to physical and mental health and the right to respect for private life.

In the judgment under review, the Strasbourg Court delivered a particularly detailed analysis, clarifying that T.H. had not been subjected to forced medical interventions or sterilized against his will, but that domestic law had placed him before an insurmountable dilemma, forcing him to choose between recognition of his gender identity and protection of his physical integrity from invasive and irreversible procedures.

Referencing its established case law, the Court reaffirmed that Article 8 of the European Convention on Human Rights protects gender identity within the right to respect for private life and imposes on States a positive obligation to ensure rapid, transparent, and accessible procedures for legal gender recognition, based on the principle of self-determination.

In this perspective, the Court concluded that conditioning legal recognition on the obligation of sterilization constitutes a violation of Article 8, as it creates a disproportionate conflict between private life and the individual’s physical integrity.

While acknowledging that States have a certain margin of appreciation on morally complex issues, the Court specified that this margin significantly narrows when an essential dimension of personal existence and identity is at stake, as occurs in the case of transgender persons.

Furthermore, the Court referred to the evolution of Czech normative and jurisprudential framework: in particular, the subsequent plenary judgment No. Pl. ÚS 52/23 of April 24, 2024, by which the Constitutional Court changed its stance, recognizing that the sterilization obligation represented a significant interference with the decision-making autonomy and physical integrity of transgender persons, which proved highly disproportionate to the goal of legal certainty, thereby annulling the contested normative provisions and suspending their application until 30^th June 2025, to allow the legislature to intervene.

This jurisprudential shift demonstrates how the assertion of fundamental rights in the supranational context has had a direct impact on the internal review of national norms.

The relevance of the decision in question lies in the consolidation of a series of principles. First, it reaffirms that legal recognition of gender identity must occur through simple procedures based on self-determination.

In this context, the State’s margin of appreciation is reduced where fundamental personal rights are at play: in particular, the imposition – even indirect – of an irreversible sterilization intervention as a condition for gender identity recognition violates Article 8 ECHR.

Finally, the judgment emphasizes the duty of States to fulfil positive obligations by establishing normative systems that enable the full exercise of the right to gender identity.

Situated within the broader context of European and international human rights law, the judgment aligns with the recommendations of the Parliamentary Assembly of the Council of Europe (Resolution 2048/2015), the opinions of the Council of Europe Commissioner for Human Rights, the decisions of the European Committee of Social Rights, and the most recent orientations of the UN and WHO. The latter, through the ICD-11 classification, has excluded gender identity issues from the realm of mental disorders—confirming the shift from a medical and pathologizing paradigm toward recognition of personal dignity and autonomy.

Overall, T.H. v. Czech Republic represents a further step toward strengthening the protection of the right to legal recognition of gender identity within the European Convention system, resolving the conflict between self-determination and physical integrity in favour of maximum protection of individual dignity and freedom, and clarifying that the State’s margin of appreciation can never justify imposing invasive and impactful surgical practices on private life as a condition for legal gender recognition.

 

(Comment by Martina D'Onofrio)