14 Nov
2024
Changing legal gender with or without mandated sterilization - Impact on transgender health and earnings
Until 2013, Sweden required transgender people to undergo surgical sterilization before changing their legal gender. We analyze whether the removal of this requirement led to an increase in the number of legal gender changes. Additionally, we evaluate whether people who changed legal gender with versus without mandated sterilization had different mental health and labor market trajectories during their gender transition. Our analysis uses population-wide administrative data from 2006 to 2020, including information on legal gender changes, medical records, and socioeconomic characteristics. We find that, starting in the first quarter after the requirement was abolished, three to four times as many people changed legal gender, driven by younger people with worse labor market attachment. Approximately 32.6% of trans women and 55.2% of trans men chose not to have surgery when it was not mandated. Despite this, we find negligible differences in earnings, sick leave, or mental health trajectories between people who changed legal gender before and after the abolishment.