| Verified against primary record | |
| Eligibility restrictions | In 11 of 43 European countries surveyed, access limited to heterosexual couples with an infertility diagnosis, as at 31 December 2018[1] |
|---|---|
| Criminalising states | 65 UN member states, per the organisation maintaining the count (as-of date not stated)[2] |
| Records read | Survey publication and legal database summary, 30 September 2026 |
| Independently reported | |
| Measured travel | Partly measured for fertility care; not measured for gender-affirming care[3] |
| Bands apply only to the rows beneath them. The fertility figures are old and several of the laws they describe have since changed. No provider-supplied figures are used. | |
Medical travel for LGBTQ+ patients concerns journeys undertaken because a treatment, or eligibility for it, differs across a border. Two categories account for most of what can be documented: assisted reproduction, where national law sets who may be treated, and gender-affirming care, where provision is uneven and largely unmeasured. A third factor, the legal environment of the destination, bears on the journey regardless of its purpose.
Eligibility law in assisted reproduction
A survey by the European society for reproductive medicine, published in February 2020 with data accurate as at 31 December 2018, covered 43 European countries and found that 41 had statutory regulation of assisted reproduction, the exceptions being Albania, Bosnia and Herzegovina, Ireland, Romania and Ukraine. In 11 of the 43, access was limited to heterosexual couples with a diagnosis of infertility, which the survey states precludes treatment of single and lesbian women. Countries named in that group include Czechia, France, Italy, Poland, Slovakia, Slovenia, Switzerland and Turkey, with France then in the process of relaxing its legislation.[1] The society’s own summary describes Europe as a patchwork of local legislations.
It does not follow that the other 32 countries permitted such treatment. The survey reports only the restrictive group, and a country outside it may restrict access by other means. Only the figure of 11 of 43, with its date, should be used.
How much of this travel is counted
Cross-border fertility care is the one part of this subject with published proportions. A society fact sheet dated 1 January 2017 states that approximately 5 per cent of all fertility care in Europe involves cross-border patients, based on surveys over ten years, that almost 3 per cent of United States cycles in 2013 involved non-residents, and that 8.5 per cent of all fertility treatments in Spain in 2014 were provided to foreign residents, of which 66 per cent were egg donation.[4] No reference year accompanies the 5 per cent figure. The fact sheet also names legal restriction as the first of four reasons for travel, specifically citing access for single and lesbian women in France.[4]
The underlying measurement is a 2010 study covering 46 assisted reproduction centres in six countries, with patients completing questionnaires during one calendar month between October 2008 and March 2009, yielding 1,230 forms. Among those patients, 6.1 per cent overall were single women, rising to 43.4 per cent of the Swedish group and 16.4 per cent of the French; 9.7 per cent overall described themselves as homosexual or bisexual, rising to 39.2 per cent of the French group, 32.7 per cent of the Swedish and 21.3 per cent of the Norwegian. Legal reasons were given by 54.8 per cent of patients overall.[3]
That same study is the origin of the figure of 11,000 to 14,000 cross-border fertility patients a year, which circulates widely in medical travel writing. Its authors describe it as a minimum estimated number, and it is extrapolated from a one-month snapshot at 46 clinics in six countries in 2008 and 2009.[3] It is repeated far more often than it is dated or scoped, and it is an estimate rather than a count.
Gender-affirming care
The eighth version of the international standards of care for transgender and gender diverse health, published in 2022, records that many regions worldwide lack facilities dedicated to transgender care, and recommends that providers build networks to facilitate care that is not available locally. It notes that legal gender recognition is restricted or non-existent in much of the world, that provision may not be included in universal coverage or private insurance even where comparable procedures are covered for other patients, and that in many countries services are unavailable, difficult to access or unaffordable.[5] Its framing is about care being unavailable locally rather than about travel, and it quantifies no travel at all. No count or estimate of patients travelling internationally for gender-affirming care was found in the sources consulted.
The legal environment of the destination
The organisation that maintains the standard international record of laws affecting lesbian, gay, bisexual, trans and intersex people reports that 65 United Nations member states criminalise consensual same-sex sexual acts, that 7 prescribe the death penalty as a legal penalty, and that there are 5 more where there is no full legal certainty on the point.[2] The page carries no explicit as-of date, and its internal references point to a count current after June 2025; the total has changed repeatedly in recent years, so it should be re-checked rather than treated as fixed.
See also
- Medical travel for unavailable treatments, the wider category this sits within
- Elective medical travel, the planning category most of this travel falls under
- Self-funded medical travel, the usual payment route where coverage is refused
- Medical tourism and health equity, for who can act on a legal difference between countries
References
- European Society of Human Reproduction and Embryology. Europe moves towards complete statutory regulation of assisted reproduction but large variations still exist in how the legislation is applied. Published 6 February 2020; survey data accurate as at 31 December 2018. Verified against primary record: the society’s own publication of its survey, opened and read. Retrieved 30 September 2026.
- ILGA World. Pride Month: new ILGA World data and maps on laws affecting LGBTI people globally. Verified against primary record: publication by the organisation that maintains the count. No explicit as-of date is stated on the page. Retrieved 30 September 2026.
- Shenfield F, et al., ESHRE Taskforce on Cross Border Reproductive Care. Cross border reproductive care in six European countries. Human Reproduction, vol. 25, issue 6, June 2010; fieldwork October 2008 to March 2009. Independently reported: peer-reviewed study. Retrieved 30 September 2026.
- European Society of Human Reproduction and Embryology. Fact sheet: Cross border reproductive care. Dated 1 January 2017, with underlying figures from 2013 and 2014. Verified against primary record: institutional publication opened and read. Retrieved 30 September 2026.
- Coleman E, et al. Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. International Journal of Transgender Health, vol. 23, issue S1, 2022, DOI 10.1080/26895269.2022.2100644. Bibliographic details confirmed on the issuing body’s publication page. Independently reported: professional standards document; the publisher’s own full text was not reachable and the content summarised here was read from a third-party hosted copy. Retrieved 30 September 2026.
Sourcing note: the survey publication, the fact sheet and the legal database summary were opened and read on 30 September 2026. The figure of 11,000 to 14,000 cross-border fertility patients a year is reproduced only alongside its derivation, because it is an extrapolation from a one-month snapshot in six countries and is almost always repeated without that context. The count of criminalising states is given with the caveat that its source page carries no as-of date. The standards of care are summarised rather than quoted, because the publisher’s own text could not be reached and the wording was read from a copy hosted elsewhere; the citation itself was confirmed with the issuing body. Several of the national laws described here have changed since the data were collected.