Our Ethical Framework for Gender-Affirming Surgery
You decide freely what changes you want from your surgery. We give you full, detailed information first, then ask for your consent.
The Legal Framework
Our approach is grounded in Spain's Law 4/2023, which recognizes trans people as equals. If you are non-binary, the law also protects your right to your own body shape.
Every request is assessed jointly by you, the surgeon and the anesthesiologist.
When We Operate
- 01The physical or emotional benefit justifies the risk involved.
- 02Your general health is suitable for the planned operation.
- 03You are certain about what you want.
- 04You understand and accept the risks.
- 05The doctor confirms at consultation that you have the legal capacity to decide.
- 06You give written agreement to the planned anatomical changes.
Patients Under 18
We operate from the age of 14. The young person gives written consent, as do both legal guardians, and the team makes sure they fully understand. This internal rule is stricter than Spanish law.
Non-Standard Requests
If your request is not a standard one, we begin with a physical and psychological assessment, followed by a one-to-one interview to understand your distress and your needs.
We then look at what is technically possible, the risks and the proposed technique. We weigh up its limits, including irreversibility, and make a clear estimate of the psychological benefit you can expect.
If these conditions are met, we go ahead with your surgery.
Irreversible Procedures
Nullification is the only irreversible procedure we perform. Before any decision is made, we always follow the same seven-step process.
01
An initial video call.
02
A diagnosis of gender dysphoria.
03
A one-to-one consultation.
04
An assessment of your risks and your understanding.
05
Full, detailed information, with particular emphasis on irreversibility.
06
A check that all the conditions are met.
07
Signing the anatomical changes form.
The decision is yours, made together with the surgeon and the anesthesiologist.
What We Put in Writing
- 01The anatomical changes form, signed by you and the doctor.
- 02The informed consent form, signed on every page.
- 03Your medical records at the center.
- 04Your medical history questionnaire, completed before surgery.
When We Decline to Operate
- 01A risk of serious complications or death that no physical or emotional benefit can justify.
- 02Hesitation or incomplete understanding.
- 03Being aged 13 or under.
- 04A minor without the verbal and written agreement of their legal guardians.
- 05Lack of legal capacity to make the decision.
- 06Disagreement about the planned anatomical changes.
Request Your First Consultation
We reply within 24 hours on weekdays, then see you for your first consultation by video call or in Madrid.