25/02/2026 | Writer: Oğulcan Özgenç
Hospital record systems do not allow hormone prescriptions to be issued under the F64 “transsexualism” diagnosis. The restriction, which has come into effect without any official regulation, risks effectively halting trans people’s access to treatment.
Photo: Serra Akcan / csgorselarsiv.org
Access to hormones for trans people has recently been severely restricted due to technical and administrative regulations in the health system. Now, the F64 “transsexualism” diagnosis used in hospital record systems is not being accepted for prescribing hormones. Physicians can enter the prescription into the system, but at the signing stage the system does not complete the process.
On 20 November 2024, on the Trans Day of Remembrance, the Turkish Medicines and Medical Devices Agency (TİTCK) introduced a regulation requiring e-prescriptions for hormone medications used by trans people in their gender-affirming processes. At the point reached today, this regulation, combined with technical system barriers, is effectively making access to hormones impossible.
It effectively means halting access to treatment
Ecmel Deniz from Kapsama Alanı stated that the inability to prescribe hormones under the “transsexualism” diagnosis in hospital systems means that F64 codes related to gender identity are being excluded by the system. Deniz emphasized that this is not merely a technical malfunction, saying:
“A diagnosis-based blockage through the e-prescription system effectively means halting access to treatment. If such a practice is not based on an official regulation, a publicly announced decision, or a legal ground, it means the administration is producing a de facto ban through its software infrastructure.”
Deniz also recalled that the F64 code used by trans people for hormone prescriptions is a category related to gender identity, noting that restrictions imposed through this code constitute discrimination.
Inability to prescribe under the F64 code locks the entire medical process
Stating that the practice more severely affects trans people whose identity has not yet been legally changed and who are in official transition processes, Deniz said:
“The F64 code is an official part of the transition pathway in terms of the psychiatry–endocrinology referral chain and board procedures. The inability to prescribe hormones under this code risks blocking not only access to medication but the entire legal and medical process.”
Deniz noted that if this practice is based on a change to the Health Implementation Communiqué (SUT), a TİTCK decision, or a Ministry of Health instruction, it should be publicly announced. In the absence of such a decision, leaving patients and physicians with the response “the system does not allow it” is unacceptable:
“The right to health of trans people cannot be left to administrative ambiguities, algorithmic blockages, or invisible decision-making mechanisms.”
A systematic war has been launched against trans+ people
Umut Derin from Muamma LGBTI+ Association stated that access to hormones for trans people is already difficult and costly. Derin said, “The main motivation is that trans people cannot access hormones free of charge in any way. They already cannot,” noting that current practices deepen this barrier.
Derin added: “This practice points to an aim far beyond merely making access to hormones more difficult,” and stated:
“A political, economic, and systematic war has been launched against trans+ people. It appears the main goal is to expand de facto practices that will make trans people’s medical processes more difficult and to construct a system that does not allow access to hormone therapy. Before officially introducing restrictions, they are implementing them in practice.”
Contrary to both the principle of equality and the state’s obligations
Lawyer Furkan Yurt from the Association for Social Policy, Gender Identity and Sexual Orientation Studies (SPoD) evaluated the inability to prescribe hormones under the F64 code from a legal perspective. Yurt stated that the practice constitutes a deliberate and selective blockage targeting trans identity.
Yurt recalled that the legal basis of the e-prescription system in Türkiye is Law No. 5510 on Social Insurance and General Health Insurance and the Health Implementation Communiqué (SUT) issued based on it. He stated that silently removing diagnosis-drug matches through the system without any official amendment in the legislation or communiqué clearly contradicts the principles of legal certainty and clarity of administrative actions:
“From a legal perspective, this situation represents an intervention carried out through the back door, without any official circular or amendment to the Health Implementation Communiqué (SUT). Preventing access to healthcare through a closed-circuit software update is entirely contrary to both the constitutional principle of equality and the state’s obligation to protect the health of its citizens. Turning an identity code into a barrier to treatment is an unacceptable example of algorithmic discrimination in a state governed by the rule of law.”
Tags: human rights, life, trans, lgbti
