A survey by the Federal Anti-Discrimination Agency (ADS) showed an overrepresentation of discriminatory experiences in the context of medical practice. Often it is reported that doctors and nursing staff deny the gender identity of trans* people. Furthermore, situations of conflicts arise for example when the gender identity is not being respected when allocating a hospital room. Besides that, trans* people report about difficulties with treatment by specialists, for example gynaecologists or urologists as those are often refer to a biologistic-medical idea of sex and gender. Due to a survey by the European Union Agency for Fundamental Rights (FRA) in 2019, Germany after Bulgaria, had the second highest number of experiences of discrimination relating to medical examination. With 40% the percentage of trans* people who have experienced discrimination is nearly twice as much compared to the survey of 2011. In 2019, the most reported disrespect of personal boundaries in medical context were inappropriate questions (25%) and ignoring specific needs (22%). For fear of experiencing discrimination or intolerance, 19% of the German interviewees decided against medical treatment.

Next to the discrimination against trans* people by medical staff, trans* people also face barriers in the process of surgical operation. Those can be an (important) part of the personal expression of trans* people. However, the access is limited due to structural barriers. The costs of 6,000 – 15,000 € for a surgical operation is just minimally covered by health insurances. The requirement of living conformably to one’s own gender identity in everyday life for multiple years can have an influence on the career choice and is perceived as degrading, as physical characteristics (e.g., breasts or beard) must be elaborately hidden. Furthermore, for a surgical operation, psychological reports are required and the trans* person, therefore, is dependent upon their assessment by experts. For this reason, 21% of the German trans* people decided to use surgical treatment in another EU country as stated by the European Union Agency for Fundamental Rights (FRA).

Structural barriers in the context of surgical operation also arise from discrimination against trans* people and heteronormativity which is rooted within society. The longstanding work of trans* activists led to a punctual simplification in the requirements for surgical treatment, for example the possibility, that hormone therapy can, in general , be prescribed by any qualified doctor. However, experiences of trans* people show that doctors still often refuse the prescription of hormones, even if it is just a follow-up prescription. At the same time, conservative political actors misuse reports of people who do not (fully) identify as trans* anymore to complicate surgical measures. This is criticised by trans* activist, as it denies the self-determination of trans* people and grounds the discriminatory argument that a gender identity as trans* just resulted from external pressure.