The End of an Impossible Choice: Removing Infertility as a Prerequisite for Legal Gender Recognition

Until 2013, transgender people in Sweden were required to undergo sterilization surgery and destroy stored reproductive cells before changing their legal gender marker, rendering them permanently infertile. Using population-wide administrative data, we document a threefold increase in yearly legal gender marker changes following the 2013 removal of these requirements. After the policy change, 30 percent of trans women and 56 percent of trans men opted out of sterilization surgery, leading to a one-week reduction in hospitalization days. Additionally, after fertility preservation legalization, 9.5 percent of trans women and 7 percent of men chose to store reproductive cells for future use.