Photo Credit: Miriam Alster/Flash90
Health Minister Nitzan Horowitz, August 3, 2021.

According to a Channel 14 report, outgoing Health Minister Nitzan Horowitz circulated a draft proposal instituting several radical policies under the noses of Israeli voters, calling for public funding for gender reassignment surgeries, including free breast removal surgeries for minors with the consent of their parents.

The draft was circulated by the medical division of the Health Ministry that was addressed to all hospital directors and the managers of HMO’s medical departments. It is signed by Dr. Hagar Mizrahi, head of the medical division at the health ministry. The draft was published on October 25 and requires a response from the addressees by November 16. This could mean that the content of the draft might be adopted by the ministry before a new coalition government is established.


The Health Ministry did not deny the report but responded: “The transgender population faces significant health disparities and a lack of access to gender adjustment services nationwide. In August of last year, a meeting was held involving the health minister, health ministry management, and representatives of the trans community, and the circulated draft in question is a continuation of that meeting, in conjunction with the initiative of the medical ombudsman of the health ministry. It has nothing to do with the date of the coming election.”

Except, of course, that the ministry had more than a year to issue the draft but chose to send it out under the radar, literally one week before the election. I could think of at least one reason for the lack of publicity (remember, only Channel 14, the “right-wing propaganda” channel covered it so far): Horowitz, the former Meretz chairman, didn’t want to alienate his party’s Arab voters. And many Jewish voters, come to think of it.

Protesters marched in support of the transgender community in Tel Aviv, July 22, 2018. / Miriam Alster/Flash90

The same draft also proposes allowing one to change one’s gender in the population registry (and consequently alter one’s ID card) only based on a statement, without having undergone the medical or surgical procedure to actually change one’s gender. On its face, this appears to permit any Israeli man to inform the Interior Ministry that he is now she, and she is he, thank you very much. It says so in so many words, according to the report:

“Giving permission to change the sex registration should not be conditioned on the performance of medical procedures for gender adjustment, including hormone therapy,” the draft reads. Also, a minor may also request to change his/her gender on their identity card, and “the opinion and wishes of the minor must be given status and attention.”

I checked (so you won’t have to), and it turns out that until 2015, changing the gender section in one’s ID card was only possible after genital surgery. However, in 2015, the health ministry issued a decree from the head of the medical administration determining that a person’s gender in their ID card can be changed even if he/she has not undergone surgery. All it takes is a certificate from the Committee for examining certificates of non-surgical sex changes, comprised of a clinical psychologist, a psychiatrist, and an endocrinologist. They issue a certificate indicating a sex change even without surgery, which the trans person goes to their local office of the interior ministry and, bam ­– they are no longer recognized by the state as what they were before.

Now, according to the health ministry’s hush-hush proposal, you won’t even have to share your story with the committee.


Regarding sex reassignment surgery, the draft emphasizes that a certificate issued by a clinic for gender adjustment “will be recognized by the HMOs for providing a financial commitment for gender reassignment treatments,” meaning those surgeries will be at least partially at the expense of the HMOs.

Stand aside, all other patients, we have some genders to reassign.

“If the committee is convinced of the informed consent of the applicant for gender reassignment surgery and there are no contraindications against the surgery, the applicant will be issued a certificate for gender reassignment surgery,” says the health ministry’s draft proposal.

Funding for surgeries will also apply to minors, with the consent of their parents, but at the age of 16-18 surgical treatments will be limited to the upper body.

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