Israel has lowered the minimum age for sex-change surgery from 21 to 18, and candidates will only have to prove they have lived for one year as the requested gender identity, instead of two years.

The minimum age is for approval; patients will still need to go abroad for the procedure due to a lack of expertise in Israel. It bears noting that the procedure is included in Israel’s “health basket” of subsidized treatments: it is considered a genuine health need, not cosmetic surgery.

The amended Health Ministry regulation was sent this week to the hospitals and health maintenance organizations.

The transgender community has complained for years about discrimination in the run-up to approval for sex-change operations, citing disdain for them at the hospitals’ sex-reassignment committees, let alone in the overall health system. The community complained of humiliations throughout the whole two-year process in the run-up to approval.

The authority to approve the surgery will be transferred from the sex-reassignment committees to a special committee including a psychologist, a psychiatrist, a urologist, an endocrinologist, a gynecologist and a representative of the transgender community.

Under the new system, the use of hormones will no longer be mandatory for undergoing the operation; the decision will be left to the special committee.

The committee will determine a candidate’s suitability for surgery and be responsible for diagnosis, follow-up, testing and assistance. Members of the committee will accompany the candidates to the operation. The committee also has the authority to reduce the one-year period for a given candidate.

The new regulation replaces one from 1986, but candidates will still need to go abroad; there have been no sex-change operations in Israel since September 2012.

"In Israel, operations for a sex change from a woman to a man are not performed due to a lack of medical skill for performing the operation," a senior official Health Ministry official, Prof. Arnon Afek, said in a letter to the HMOs. “At this stage there is no plan to perform these operations in Israel, and no forecast on when it will be possible to offer them.”