The petitioner shall: Ministry of Health of the Slovak Republic
Name of the petition:
Abolish the gender guidelines immediately, Prime Minister! –
It's quare: No.
Number of persons supporting the petition: approx. 22 000
Date of delivery: 24.03.2023
Date of equipment: 21.06.2023
Equipment: § 5 (6) of Law No 85/1990 Coll. on petition law as amended - not evaluated
Reason for equipment:
On 24.03.2023 was electronically, to the e-mail address of MZ SR: mzsr.podatelna@health.gov.sk delivered a submission marked as –Petition: Cancel the gender guidelines immediately, Prime Minister! together with the signing sheets in electronic form, in the form of a transmission by letter to the Office of the Government of the Slovak Republic (hereinafter referred to as "ÚV SR') dated 24.03.2023, marked "The Alliance for Family', Croatia 199, 900 81 Šenkvice - referral of the petition'. . The documents were submitted by the Chairman of the Alliance for Family and the person authorised to act with the public authorities via the mailbox of the ÚV SR. Petition presented on the e-portal Þ Sign it– around 22 000 citizens have so far supported. On 28.03.2023, the above documents were delivered to the Slovak Republic from the ÚV SR also in documentary form. MZ SR referral from OS SR designated as –Petition: Cancel the gender guidelines immediately, Prime Minister! together with the signing sheets in electronic form, and after assessing its material and formalities in the context of the provisions of Act No 85/1990 Coll. on petition law as amended (hereinafter referred to as the Act on Petitions) the submission was registered in the Special Report of the MZ SR Registry as petition under the sp. zn Pet 3/2023, which has the character of the application.
Since the petition received is in the nature of a request for cancellation of requested documents, the Ministry of the Slovak Republic, as a public authority responsible for its execution, is obliged to arrange for the petition in question pursuant to § 5 (6) of the Act on petition law, according to which, if it appears from the contents of the petition that the petition cannot be dealt with pursuant to § 5 (5) of the Act on petition law, the public authority responsible for the execution of the petition containing the request or proposal will assess its content and send a written reply together with the statement of reasons to the representative within the period under § 5 (5) of the Act on petition law. Pursuant to Article 5d (1) of the Law on Petitions, if the petition is supported by at least 10,000 persons, it will be discussed by the competent public authority with a representative and a petition committee for the whole territory of the Slovak Republic.
In accordance with the above provisions of the law on petition law of the Slovak Republic, as a public authority competent to deal with the petition submitted, he submitted the following reply to the representative. On the various points of the petition, we state:
The Minister Lengvarský signed the Expert Guideline of the Ministry of Health of the Slovak Republic on the unification of procedures for providing health care to change sex prior to the issue of a medical opinion on a person's sex change (hereinafter referred to as the "Guideline'). Minister Lengvarský has withdrawn from the Standards Committee arguably dissent member of the commission, and even though there remained considerable contradictions in the professional community, he signed on the last day in his capacity the standards that activated this guideline and are in clear contradiction with our highest legal standards, namely the Constitution of the Slovak Republic, the Family Act and other laws of the Slovak Republic.
- MZ SR does not register the conflicts of the professional community, because even before the approval of the standard procedure, several national and foreign professional companies, as well as the main experts of MZ SR, who are concerned with the issue, expressed their professional content.
The long-term Swedish study (one of the few cohort studies) provides very serious findings that do not confirm clear benefits after sex change. People with transsexualism have a significantly higher risk of mortality, suicidal behaviour and psychiatric morbidity than the general population, after sex change.
- the Swedish study referred to above is from 2011,
- the authors of the standard procedure have drawn on the sources listed in the standard procedure literature chapter
- there are many studies which, on the contrary, demonstrate that the transdition reduces the risk of suicide:
- Anthony N. Almazan and Alex S. Keuroghlian, -Association between Gender-Affirming Surgeries and Mental Health Outcomes,-- JAMA Surgery 156, no. 7 (January 2021): p. 611, https://doi.org/10.1001/jamasurg.20.0952.
- Greta R. Bauer et al., – Interventional Factors Associated with Suicide Risk in Transgender Persons: A Respondent Driven Sampling Study in Ontario, Canada,
- This Decision shall enter into force on the date of its adoption.
- Anthony N. Almazan and Alex S. Keuroghlian, -Association between Gender-Affirming Surgeries and Mental Health Outcomes,-- JAMA Surgery 156, no. 7 (January 2021): p. 611, https://doi.org/10.1001/jamasurg.20.0952.
In the 1970 ' s, Johns Hopkins University, the first U.S. medical center to engage in sex-change surgery, under the leadership of Dr. McHugh, launched a study comparing the results of transgender people who had undergone surgery with those who had not. McHugh said: - Most surgically treated patients were described as -satisfied with the results, but their subsequent psycho-social adaptation was no better than those who had not had the surgery. And so in Hopkins, we stopped doing sex-change surgery because we were producing a happy, but still troubled patient seemed to be an inadequate reason for surgical amputation of normal organs.
- With regard to human dignity and respect for the autonomy of people with transsexualism who are willing to consciously assume responsibility for the consequences of the transition, it is ethical to allow the legal recognition of the preferred genus without forced intervention in physical integrity. The right to the free development of the personal sphere is balanced by informed consent and professional psychotherapeutic accompanying, which precludes misdiagnosis.
The guidelines of the Ministry of Health and the standards signed by the former Minister of Lengvarski help deny biological reality and we therefore consider them to be incompetent. Regardless of the number of countries that jump into the wells of ideological propaganda, Slovakia does not have to jump behind them.
- This is a purely medical clinical standard practice for people undergoing transsexualisation. It was created by experts who are concerned with the issue. It is not an idea or a philosophical-religious expression. The standard procedure has a purely medical aspect.
This already activated guidance will make it practically possible for even in Slovakia, even if you do not intervene and if you do not abolish the guidelines and standards, you, Prime Minister, would also be co-responsible for spreading the social contagion of gender dysphoria among young people in Slovakia.
- in the context of hormonal therapy, it should be noted that, with GAHT (hormonal gender-confirming therapy) in AFAB (female at birth), testosterone treatment with its supraphysiological doses for cis-female and within the physiological levels for cis-male, in addition to virilizing influence, causes menstruation to stop, blocking in follicular maturation and ovulation, induces changes in the histology structure of the ovaries, induces long-term application of androgen receptors in the ovaries, prevents endometrial proliferation, causes uterine atrophy. The above causes that when taking GAHT, the chance of becoming pregnant is almost zero and if it occurs there is a very low likelihood of maintaining pregnancy. It is also important to note that a very high percentage of transgender men undergo hysterectomy (surgical uterine removal) of their own will due to non-conformity with menstrual bleeding and because the uterus is a symbol of the female family.
The family dysphoria belongs to the same family of mental disorders as other dysphorias. Dr. McHugh said: -- gender dysphoria -- the official psychiatric term for feeling that you are of the opposite sex -- belongs to a family of similarly disordered assumptions about the body, such as anorexia nervousness and physical dysmorphic disorder. His treatment should not be focused on the body, such as surgery and hormones, as well as anorexics fearing obesity are not treated by liposuction. Treatment should seek to correct the incorrect, problematic nature of the assumption and resolve the psychosocial conflicts that trigger it. Young people do their best in family therapy.
- According to MKCH 10, dg. F64.0 is characterized as a desire to live and be accepted as a member of the opposite sex, usually accompanied by a feeling of discomfort from their own anatomical sex or its inadequacy and desire for surgical and hormonal treatment that would reconcile the body of the patient with the preferred sex.
- Access to therapy means that therapy seeks to seek ways of reducing gender dysphoria so that the person concerned can find a meaningful life in his or her life situation in developing his or her gender identity.
- Adoption of Standards and renewal The guidelines do not violate MZ SR, but fulfil the principles of medical ethics. They respect the principle of benefience, as they help to reduce gender dysphoria and thus lead to an increase in quality of life and health.
As regards the legal assessment of the petition, we state that the right to petition is guaranteed in Art. 27 paragraph 1 of the Constitution of the Slovak Republic and given that this constitutional right is not listed among those who, within the meaning of Article 27 (1) of the Constitution, 51 The Constitutions of the Slovak Republic can be applied only within the limits of the laws which they implement, it can be assumed that the petitioning law is applicable directly from the Constitution of the Slovak Republic. However, since the right to petition is also governed by the law on petition law, it is also necessary to comply with that law when exercising it. The violation of the right of petition as a fundamental right can occur both in connection with the failure to fulfil the conditions laid down by the Constitution of the Slovak Republic and in the relevant provisions of the law on petition law.
We point out that the purpose of petitioning law is not to negotiate redress in public matters. The right to petition serves to alert public authorities to needs, interests or shortcomings faced by numerous interesting groups of the population in case their public authorities are not aware of them themselves. The petition is therefore a means of exercising fundamental law, but it is also an outlaw in itself1.
In matters of public or other common interest, each shall have the right to address, by itself or with others, national and local authorities with requests, suggestions and complaints. From a certain point of view, the right to petition can be attributed to the so-called communication nature, as it guarantees the possibility of contacting and submitting to the competent authorities of the State their requests, suggestions or complaints, and at the same time to expect an answer.
Petitions constitute a special, qualified case of freedom of expression, which is linked to the obligation of the public authority to respond to the content of the petition by its negotiation. In this context, the Constitutional Court stated: Thus, the right to petition acquires an informational dimension guaranteeing the petent an informal channel of communication, which will draw public authorities' attention to a problem of public or other common interest. Consequently, the right to petition shows, quite naturally, an implementation dimension consisting of the obligation of the public authority to investigate the petition, to arrange for it and to communicate the outcome of the equipment to the person designated in the petition for representation in contact with the public authority. However, the content of the petition law does not extend further to the types prescribed in the way the petition is dealt with or even to the only possible way of dealing with it. 2
According to Paragraph 1 (4) of the Law on Petitions: The petition must not call for violations of the Constitution, laws and legally binding acts of the European Union, denial or restriction of personal, political or other rights.
Coming out of Art. 7 (5) Constitution of the Slovak RepublicInternational treaties on human rights and fundamental freedoms, international treaties for which no law is necessary to implement, and international treaties which directly establish the rights or obligations of natural or legal persons and which have been ratified and declared by law shall prevail over laws.The Convention shall take precedence over the laws of the Slovak Republic, irrespective of the extent of the constitutional rights and freedoms conferred by them.
In interpreting Article 8 of the Convention, the ECtHR stated that the sphere of privacy to be protected includes gender identity or identification, name, sexual orientation and the sex life of the individual. In the context of transgender cases, he recognised the right to decide on his or her identity, while the freedom of a person to decide on his or her sexual identity constitutes one of the most fundamental components of the right to private and family life. Article 8 of the Convention therefore guarantees, in the light of the ECtHR's case law, the right of transgender people to personal development and to physical and moral security.
Article 40 of the Constitution Everyone has the right to health protection. On the basis of health insurance, citizens are entitled to free healthcare and medical devices under conditions laid down by the law. PArticle 51 (1) of the Constitution – Claiming the rights referred to in Art. 35, 36, 37 (1) 4, Art. 38 to 42 a Art. 44 to 46 This Constitution may be exercised only within the limits of the laws implementing those provisions.
According to § 4 §. 3 Act No. 576/2004 Coll. on health care, services related to the provision of health care and amending certain laws, as amended, according to whichThe Provider is obliged to provide healthcare correctly. Health care is provided correctly if all health performances are carried out to correctly identify the disease, ensuring early and effective treatment to cure a person or improve the condition of a person, taking into account current knowledge of medical science and in accordance with standard prevention procedures, standard diagnostic procedures and standard therapeutic procedures, taking into account individual patient status.–
With all this pointed out, a petition calling for the annulment of the Documents can mean interference with the right to respect for private life guaranteed by Article 8 of the Convention and the right to health guaranteed by Article 40 of the Constitution of the Slovak Republic, contrary to Paragraph 1 (4) of the Law on Petitions. On the basis of the above, a petition designated as "Petition: Cancel the gender guidelines immediately, Prime Minister! cannot be satisfied.
By sending a letter to the MZ SR informing the representative of the outcome of the execution of the petition designated as "Petition: Cancel the gender guidelines immediately, Prime Minister! considers MZ SR petition to be provided in accordance with § 5 (6) of the Act on petition law.
1Drgonec, J. Constitution of the Slovak Republic. Theory and practice. 2 recast and completed edition. Bratislava : C. H. Beck, 2019, p. 700
2 founding of the Constitutional Court of the Slovak Republic sp. zn. PL. ÚS 4/2016 of 10 May 2017
Place: In Bratislava– Date:26 June 2023