Czech Trans Introduction

Created 2022-11-26
Updated 2024-02-29

So you've realized you're transgender and you live in Czechia. What are your options?

Here I've tried to summarize some of the information you'll need to get started with transition in Czechia on your own. I'd still recommend you search for a local community for moral support.

Social transition

When it comes to social transition our government at least doesn't care.

Officially no one should stop you from using a different name or pronouns than what's on your documents in social situations, however there is usually no standard mechanisms for handling this sort of stuff at school, workplace, or government institutions. Exceptions are usually large corporate workplaces which imported their LGBT+ programmes from their western parent company. How well or wrong things go for you will be very individual and hard to predict. Even today a lot of people in czechia are entirely unaware of our existence and or consider us just in theory, and almost nobody expects to actually meet a trans person in real life. You're probably going to be met with confusion, be prepared to explain yourself often.

In my own experience, people will assume a gender and stick with it, sometimes people will switch back and forth in confusion. Gendering myself through past tense is usually ignored. I haven't yet encountered anything worse than just misgendering from strangers for being trans, even if I believe it's pretty obvious. I have been confronted by assholes about rainbow symbols I have displayed publicly, but never about trans symbols.

If you want to change your legal documents to match your identity, you can change your name and gender marker but there are limitations.

Gender marker change requires surgical castration 1, that means any procedure from the list in 2 which prevents reproductive function, so at least bilateral orchiectomy for trans women and hysterectomy (including bilateral oophorectomy) for trans men. The surgery must be approved by the so-called "gender committee" (officially "Odborná komise pro provádění změny pohlaví transsexuálních pacientů"). To be approved by the committee you must have a referal from your sexologist and a diagnosis of "transsexualism" (F64.0 3) from a clinical psychologist, you must have been on HRT for 1 year and must have "lived in your desired gender role" for 1 year. You must not be in an active marriage / civil union and more rules apply if you've had children, see 4 for more details.

First name change is possible without medical transition. According to the law you can't change your name to a name that doesn't align with your official gender marker 5. So until you are allowed to change your gender marker you can only use a name that's also valid for your legal gender. Since 2023-07-01 there is now an official list of gender neutral 6 names, which are names valid for people with either gender marker, published by the ministry of interior which the registry office should accept automatically. If your chosen name is not on the list, you can still pay for an expert opinion 7 8 and use that, the registry office should then inform the ministry about this new neutral name and it should get added to the official list when it's next updated 9 (though that hasn't happened yet). For inspiration you can still use this larger unofficial list 10.

Last name change is also restricted, Czech language has pretty strict gramatical rules about gender inflection of names 11. Simplified rules are: no suffix in "Novák" or "-ý" suffix in "Černý" is considered the masculine form, suffix "-ová" in "Nováková" or "-á" in "Černá" is considered the feminine form and suffix "-ů" in "Nováků" or "-ých" in "Černých" is considered the neutral form. If your gender marker is "F" it should be possible for you to change your last name to the masculine form 12 13, if your gender marker is "M" you can only use the masculine and neutral forms. Beware that it's very uncommon for cis people to use the neutral form so you would be marking yourself as trans in your official documents.

Note that you're allowed to change your last name to any existing last name, not just a different gendered inflection of your current name. Transfeminine people especially can use this to change their name to a foreign name where the lack of gendered suffix doesn't stand out as much and makes it somewhat easier to pass.

There are two patways to changing your name. If you have a certificate from your sexologist stating you've begun your medical 14 transition you can declare your new name (both first and last) free of charge at any registry office 15 16.

If you don't have the certificate yet, you can still change your name but you have to visit the registry office according to your permanent residence, you have to submit a request stating the reason for the change, this costs 3000 CZK for each name separately 16. When you receive the decision about your name change some registry offices may want to make you wait for the appeal period to run out, this is an incorrect interpretation of the law, it is possible to sign it immediately as you're the only affected person and you can give up your right to appeal 17.

For the registry office visit you'll need your birth certificate and your ID 16. After the name change is processed you'll also have to pay standard fees for a new passport or driving license if you need them, old passport and driving licence expire with the name change. Replacement of your ID after a name change is mandatory and free of cost.

    7

    Jana Valdrová - Soudně znalecký posudek na jméno - informace a doporučení 2022 - as of 2022-11 Jana Valdrová is no longer able to provide expert opinions for medical reasons, if you need one use 8.

    9

    Směrnice Ministerstva vnitra č. j. MV-72740-32/VS-2023 ze dne 23. června 2023, k postupu matričního úřadu při zápisu rodově neutrálního jména in Věstník vlády pro orgány krajů a orgány obcí, Částka č. 5/2023. In the future this will be included in the law § 1e odst. 5 zákona č. 301/2000 Sb., o matrikách, jménu a příjmení - budoucí znění od 2027-01-01

    10

    Seznamy neutrálních jmen Jany Valdrové

    14

    Potvrzení o zahájení léčby pro změnu pohlaví Příloha 5 vyhlášky Ministerstva vnitra č. 207/2001 Sb.

Medical transition

In Czech republic your central point of contact is going to be a sexologist, while this doesn't make much sense they're the only doctor authorized to prescribe you HRT for transition reasons so if you want a HRT prescription or anything more from the medical system you're going to have to visit a sexologist.

The reality is that there are only a handful of sexologists who work with transgender people and an even smaller portion of them are any good. Even the good ones are likely to ask you very personal sexual questions which have nothing to do with your transition because it's in the description of their job.

Sexologist will refer you to a psychologist and/or psychiatrist, endocrinologist and possibly to a urologist/gynecologist, geneticist, general practicioner etc. Some sexologists require more specialist appointments and some less, some will be happy with any specialist consultant and some will require a specific one (even though the law states you have a free choice of medical provider).

Sexologists

I'll be listing all sexologists I have information about, basically all of this information is second hand from people who shared their experiences with me so take it for what it is, on the other hand it's all experiences of transgender people (mostly women) which is going to be better than general reviews online.

I've highlighted in green sexologists which I'd personally recommend people try. I'm going to be listing everyone I know about even if I wouldn't recommend people go there.

Petra Vrzáčková (Praha) TH Klinika, Atoda Medical - Probably the best sexologist in Czechia. She's accepting of non-binary people and of people who have previously self-medicated HRT. She is also the only sexologist who seems to actually read newer research about HRT and is prescribing according to modern best practices. Unfortunately she's very overloaded, since early 2024 she doesn't accept any new patients in either clinic.

Pavel Turčan (Olomouc) Centrum Mediol - Probably the second best sexologist in Czech republic. He's friendly and helpful and queer himself, though some may find his vocabulary a bit rougher. He's accepting of non-binary people and didn't make problems about people already being on DIY HRT. He seems to be full as of 2024 and is not accepting new patients. You may want to try Petr Kepič at the same clinic who we have vague reports of being also nice. Appointments are booked over email with the centrum mediol receptionist.

Pavel Tomeš (Plzeň) Sexuologie Plzeň - Another friendly and non-judgemental sexologist. We've pretty consistent reports of him being colder at the first appointment and being significantly more chill after. Most people who have come to him while on DIY HRT als o didn't have problems continuing until their prescription. At the time of writing you can get an appointment within 3 months, there's also an easy online form where you can check a date and book yourself instead of calling or writing emails.

Luděk Fiala (Plzeň) Sexuologie - FN Plzeň - We have a few good references with a warning that he may seem cold at the beginning and one really bad one, probably try Tomeš first. We've heard he refered to psychologist Černá who you should avoid and go to someone else.

Pavla Entnerová (Olomouc) Centrum Mediol - We have some nice and some mixed references about her, she might be delaying HRT unnecessary long. She's retired now and probably isn't accepting new patients, though we have some conflicting information about that.

Ivo Procházka (Praha) Sexuologický ústav VFN - He's one of the oldschool sexologists, and not in a good way. He's infamous for doing "physical exam" which isn't required but most people don't know that and will let him touch them. He also has a tendency to prescribe injectable estradiol and then make patients go to a doctor every week to get it injected, unlike better doctors who teach you how to inject yourself. He by refers people to Weiss for psychological evaluation and he directly writes the name on the referal so you might have problem going somewhere else if you don't ask in advance.

Hana Fifková (Praha) Soukromá ordinace Fifková - People have mixed experiences with her. She claims to specialize in care for transgender children but said some very unfavourable things especially about young trans boys, she seems to believe in the TERF nonsense "rapid onset dysphoria". However some people, especially older (not teens) trans women who are closer aligned with stereotypes, have reported good experiences with her.

Helena Daxnerová (dříve Reguli) (Brno) Soukromá sexuologická ordinace - She's been very strict about RLT and acting and dressing stereotypically for one's gender. She's delaying prescribing hormones with excuses and unnecessary specialist appointments. She tried to force people into taking antidepressives they didn't want. She left people on only high-dose Androcur without prescribing estradiol for over a year which is very unhleathy and nonsensical treatment. Avoid.

Martina Mikešová (České Budějovice) Nemocnice České Budějovice - We have only one reference. She had issues with DIY hormones, "young people not knowing what they want" (said to a 23 year old), requires RLT before prescribing HRT and will want at least one year of visits and waiting before prescribing HRT. Avoid.

Petra Sejbalová (Brno) FN Brno - Infamous for requiring a pletysmography exam which is completely unnecessary and dehumanizing. She consistently says awful things about trans people when she's interviewed somewhere. Avoid.

Psychologists

Again I'm going to try to list every psychologist I have some reference for, unlike sexologists there are a lot more of them and more seem to be sympathetic, but that also means we have fewer references for each of them.

Tomáš Kufa (Praha) Soukromá ordinace - A few good references. Recommended by Vrzáčková. Doesn't have issues with non-binarity. Waiting times may be longer.

Klára Borůvková (Trutnov) Page on znamylekar.cz - We've have several good references for her, nothing bad. At the start of 2022-11 the waiting times have been around 3 months.

Petra Sumcovová (Plzeň) Poliknika Plzeň Doubravka - Recommended by Tomeš. Waiting times at about 1-2 months. Prefers 2 sessions before giving an assessment required for HRT which might mean unnecessary waiting but maybe also possible to talk about it and get it sooner. Lately we've heard she has gotten more gatekeepy.

Petr Weiss (Praha) Sexuologický ústav VFN - He's pretty infamous in the Czech community. He's holding us back with his outdated views while he is probably the most often interviewed "trans specialist". He doesn't believe non-binary people exist. He doesn't seem to have many patients so you can get an appointment with him relatively quickly, which might be worth it if you're desperate and willing to play into stereotypes.

Jana Černá (Plzeň) contact directory - Both references we have have been bad. She's putting appointments off, misgendering, believes in stereotypical gender roles. Believes bisexuality is made up and a sign of sexual immaturity. Avoid.

HRT

Most sexologists in Czech republic, even the good ones, are prescribing HRT according to outdated medical information. Usually it's going to be some form of estradiol, oral Estrofem or injectable Neofollin in combination with Androcur.

One big problem is Androcur dosage. It is most commonly prescribed at 50mg (1 tablet) per day, that's way more than is necessary and only increases its negative effects and long term risks 19. You can try to talk to your sexologist about it, if you do please cite the source here or the studies it is citing, maybe we can help educate our doctors eventually. If they're not receptive or you're scared to even try talking about it you can just take the prescription as they're giving and adjust the dose down yourself. The 50mg tablet can be split into quarters with a pill splitter. Reasonable starting dose would be 1/4 of the pill (12.5mg) per day. After blood tests show sufficient testosterone suppression it can be lowered to 1/4 every other day (average 6.25mg per day) or even every third day (average 4.16mg per day), you can always adjust it back up if your tests come up with too high T.

Another problem is they almost never explain how to use the Estrofem tablets to get the most out of them. Some people are worried they got only prescribed 2 or 3 mg a day and that it's too little, however if used the right way this can be enough for many people. The "oral" estradiol tablets work best when taken sublingually or buccally, split into at least 3 or 4 doses spaced evenly throughout the day 20.