Act on Gender Autonomy No 80 /2019 as amended by Act No. 159/2019, No. 152/2020
and No. 154/2020

If mention is made in this Act of a Minister or Ministry without further specification as to thefield of competence, this shall be understood to mean the Prime Minister or the Prime
Minister´s Office, under whose auspices this Act is administered. Information on the divisionof responsibilities between ministries, laid down in a Presidential Decree, can be found here.

Chapter I
Objective and Definitions.
Article 1
Objective.
This Act provides for the right of persons to define their own gender, thereby aiming at
guaranteeing the recognition of their gender identity. The objective of this Act is also to guard
the rights of persons to physical integrity.
Article 2
Definitions.
For the purposes of this Act, the following definitions shall apply:
1. Gender (sexuality): A collective term, including, inter alia, sex characteristics, gender,
gender identity and gender expression.
2. Sex characteristics: Biological traits related to gender, such as sex chromosomes,
hormone function, gonads and genitals.
3. Gender expression: A personal social expression with regard to one’s gender.
4. Gender identity: The identification and definition of one’s gender.
5. Physical integrity: The absolute right to autonomy over one’s body and entitlement torespect for one’s right to life, security, freedom and human dignity.
[6. Atypical sex characteristics: Sex characteristics that fall outside traditional definitionsof sex characteristics as male or female, e.g. as regards functionality or appearance.] 1)
1)
Act 154/2020, Article 1.
Chapter II.
Right to Define One’s Gender.
Article 3
Right to Define One’s Gender.
For every person there is in place, in accordance with age and maturity, an unrestricted
right:
a. to define one’s gender,
b. to have one’s gender, gender identity and gender expression recognised,c. to develop one’s personality in keeping with one’s gender identity,
d. to physical integrity and autonomy concerning changes to sex characteristics.
Article 4
Right to Change the Official Gender Registration.
For every person there is in place the right from the age of [15] 1) to change one’s genderregistration in Registers Iceland. A request for such changes shall be submitted to Registers
Iceland. Alongside a change in gender registration, the applicant has the right to a namechange.
It is prohibited to make a surgical operation, medication, hormonal treatment or othermedical treatment, such as psychiatric or psychological therapy, a requirement for changing
the registration of gender.
A change pursuant to paragraph 1 entails the right of a person to obtain identity documentsthat are in keeping with the change, as well as documents pertaining to the education andemployment records of the said person.
The gender of a person shall be recorded in public registers and other public data in thesame manner as in Registers Iceland.
[Icelandic nationals residing abroad are entitled to change the registration of their genderand name pursuant to paragraph 1.] 2)
1)
Act 152/2020, Article 1. 2)Act 159/2019, Article 1.
Article 5
Changing the Gender Registration of a Child.
A child under the age of [15] 1) may, with the assistance of its guardians, change its official
gender registration.
A request for changing a child’s gender registration shall be submitted to Registers Iceland.
Alongside a change in gender registration, the child has the right to a name change. The
provisions of Article 4[(2) to (5)] 2) shall also apply to this provision.
A child that does not have the support of one or both of its guardians in changing its genderregistration may submit a request for a change of registered gender to an expert committee
pursuant to Article 9 and have the registration changed if the committee accepts the request.
A decision to change the gender registration of a child shall be taken with the interests ofthe child in mind and be in conformity with its will and the development of its gender
identity.
1)
Act 152/2020, Article 1. 2)Act 159/2019, Article 2.
Article 6
Neutral Gender Registration.
Neutral gender registration is permitted.
Public and private bodies that register gender shall provide for the possibility of registering
gender as neutral, inter alia in identity documents, forms and databases, and provide for aclear denotation of such registration. In passports, neutral gender registration shall always bedenoted with the letter X.
Article 7

Limited Authorisation to Change Gender Registration.
A change in gender registration pursuant to this Act and a simultaneous name change shall
only be permitted once, unless otherwise justified by special circumstances. A person again
requesting a change of gender registration shall provide a written submission to Registers
Iceland recounting the reasons for such a request.
[The restriction in paragraph 1 shall not apply to individuals under the age of 18.] 1)
1)
Act 152/2020, Article 2.
Article 8
Effect of a Changed Gender Registration on Legal Status.
When a child has changed its official gender registration, its legal status vis-á-vis a parent,
cf. Articles 4 and 5, will remain as it was prior to the change.
A persons who has had a change of official gender registration shall enjoy all legal rights of
the registered gender.
Every person is entitled to health care services in accordance with its sex characteristics,
irrespective of gender registration.
Rules that apply to a woman who carries and gives birth to a child shall also apply to aperson who carries and gives birth to a child after the gender registration has been changed.
Article 9[A committee of experts on changes to the gender registration of children and permanentchanges to atypical sex characteristics of children.]1)
The Minister will appoint a committee of experts on changes to the gender registration ofchildren [and permanent changes to atypical sex characteristics of children] 1) that will serve
for a term of four years at a time. The committee is comprised of three members. One of themembers shall be a paediatrician, appointed by the Directorate of Health, one shall be a
psychologist with child psychology as a field of expertise, appointed by the Icelandic
Psychological Association, and one shall be a lawyer with special knowledge in the field ofchildren’s rights, appointed by the Minister responsible for human rights issues.
The committee of experts makes its decisions pursuant to Article 5(3) [and Article 11a(6)].
1)
In assessing cases, the committee may obtain the opinion of other specialists, if necessary.
Members of the committee and specialists who have been consulted pursuant to this Article
shall handle matters of persons submitting their cases to the committee with the utmost
confidentiality.
A decision of the expert committee in accordance with Article 5(3) cannot be appealed to ahigher administrative authority, except for procedural reasons.
1)
Act 154/2020, Article 2.
Article 10
Recognition of Foreign Gender Registrations and Applicants for International Protection.
A ruling by a foreign court or the registration by a foreign competent authority of a change
in the registration of a person’s gender, as well as a name change, is fully recognised in
Iceland.
A person seeking international protection in Iceland may request that registration
certificates, cf. Article 34 of the Foreign Nationals Act No 80/2016, include the person’s
gender registration in accordance with the person’s gender identity, even if this does notcorrespond to the person’s identity documents from the home state.

Chapter III
Physical Integrity and Changes to Sex Characteristics.
Article 11
Physical Integrity.
Permanent changes to genitals, gonads or other sex characteristics of persons 16 years ofage or older are prohibited without their written consent. Furthermore, in cases involving
children aged between 16 and 18, an assessment is needed from the Child and Adolescent
Psychiatric Department team on gender identity ... 1) pursuant to Article 13, to confirm that it
is in the best interests of the child to perform the surgical operation. Permanent changes
include inter alia surgical operations, medication and other irreversible medical interventions.
Regarding exceptions from the principle in paragraph 1, the provisions of the Patients’
Rights Act apply.
Prior to making changes pursuant to paragraph 1, the person shall be provided with detailed
information on the planned treatment, including on progress, risks and benefits involved,
whether it will affect reproductive abilities, as well as information on other possible remedies
and the consequences of not acting at all. The person shall also be invited to seek second
expert opinion regarding the necessity of the treatment, free of charge. If treatment results indiminished reproductive capabilities or permanent infertility, the person shall be informed
about any possibilities of preserving gamete cells.
1)
Act 154/2020, Article 3.
[Article 11a
Children born with atypical sex characteristics.
Children born with atypical sex characteristics shall have the right to physical integrity inrelation to their sex characteristics and the right to receive the best health care available at any
given time. In implementing the Act, care shall be taken to respect their right to selfdetermination regarding personal matters.
Permanent changes to the sex characteristics of a child under the age of 16 born withatypical sex characteristics shall only be made in conformity with the will of the child, cf.
paragraph 6. However, if a child is unable to give its consent due to its young age or is forother reasons unable to express its will, the child’s sex characteristics may be changed if so
required for health reasons, following a detailed assessment of the need for such changes andof their consequences in the short and long term. Social, psychosocial and appearancerelated reasons shall not be regarded as health reasons. Permanent changes pursuant to thefirst and second sentence include inter alia surgical operations, medication and otherirreversible medical interventions.
When preparing a decision on permanent changes to a child’s sex characteristics for healthreasons pursuant to paragraph 2 without the child’s consent, the child shall be consulted to theextent possible in light of its level of maturity and in all cases once the child has reached theage of 12. Before a decision is made, every effort shall be made to establish the child’s
position and take account of its views in conformity with its age and maturity. A child, inconformity with its age and maturity, as well as its guardians, shall be provided with theinformation mentioned in Article 11(3). The guardians shall give their written consent. In thedecision-making process, the child and its guardians shall receive counselling and support
from a team on the issue of children born with atypical sex characteristics pursuant to Article
13a. In every case, a reasoned position shall be taken as to the possibility of postponing anypermanent changes until the child is able to give its consent, and deal with any health issues ina different and less invasive manner. Furthermore, the child and its guardians shall be invited
to seek expert opinion outside the team on the necessity of such treatment, free of charge.
Decisions pursuant to this Article shall be made on the basis of what best serves the child.
Preparations for the decision shall be recounted in the health record. The provisions Article
14(3) of the Health Records Act No 55/2009 shall not apply to information in the healthrecord regarding any permanent changes to a child under the age of 16. The child’s guardiansshall explain to the child as soon as it is mature enough to understand it that permanentchanges have been made to its sex characteristics.
In cases where the child is unable to give its informed consent due to its young age or is forother reasons unable to express its will, the following shall apply, notwithstanding paragraph
2, to any permanent changes made to the sex characteristics of a child under the age of 16born with atypical sex characteristics, if these entail a surgical operation on account of a shorturetha (hypospadias) or medication for micropenis:
1. General rules shall apply to an assessment as to whether a surgical operation or
medication is necessary, such as the Patients' Rights Act, with the derogations arising fromthis paragraph.
2. The aforementioned permanent changes to sex characteristics shall not be performed
unless a detailed assessment of possible advantages and consequences in the short and longterm has been undertaken, including the consequences of not performing a surgical operationor providing medication or postponing it until the child can express its will, cf. paragraph 6.
3. The provisions of paragraphs 1, 3, 4 and 7 shall apply to such permanent changes.
In cases other than those discussed in paragraphs 2 and 5, permanent changes to the sex
characteristics of a child under the age of 16 born with atypical sex characteristics shall only
be made in conformity with the will of the child and its level of gender identity, and always
with the best interests of the child in mind. A child, in conformity with its age and maturity, as
well as its guardians, shall be provided with the information mentioned in Article 11(3). In thedecision-making process, the child and its guardians shall receive counselling and support
from a team on the issue of children born with atypical sex characteristics pursuant to Article
13a. This is conditional upon the consent of the guardians and the committee of experts
pursuant to Article 9 for the changes. The conclusion of the committee shall be based on
establishing the child’s views regarding the change pursuant to procedures adopted by thecommittee. Despite the aforementioned, hormonal treatment is authorised to trigger puberty
without the consent of the experts committee, with due respect to the general rules on
establishing the child’s views.
Health care professionals who provide treatment that permanently changes sex
characteristics of children pursuant to this Article shall enter information on the treatment into
the health record and provide the Director of Health with information on the number andnature of surgical operations and medication and the age of those who undergo thesechanges.] 1)
1)
Act 154/2020, Article 4.
Article 12Landspítali Team on Gender Identity and Changes to Sex Characteristics.
Landspítali University Hospital shall have a team of experts on gender identity and changes
to sex characteristics, appointed by the CEO of the hospital. The team shall beinterdisciplinary and composed of professionals with relevant knowledge and experience. The
team may call on other experts for consultations and collaboration in order, among otherthings, to secure knowledge of the social aspects of gender identity. The provisions of the Act
on Health Care Professionals shall apply to the rights and obligations of health care
professionals [pursuant to this Article, Article 13 and Article 13a].
The team provides its clients, 18 years and older, with information, counselling andtreatment in accordance with the needs of each and every one. The team also provides therelatives of clients with information and counselling.
The team adopts its rules of procedure which shall be in conformity with recognised
international rules of procedure. … 1)
The Minister responsible for health care services may lay down in a regulation moredetailed provisions on the tasks and services of the team.
1)
Act 154/2020, Article 5.
Article 13[Child and Adolescent Psychiatric Department Team on Gender Identity.]1)
The Landspítali Child and Adolescent Psychiatric Department has a team of experts ongender identity ... 1) appointed by the CEO of the hospital. The team shall be interdisciplinary
and composed of professionals with relevant knowledge and experience. The team may callon other experts for consultations and collaboration in order, among other things, to secureknowledge of the social aspects of gender identity.
The Child and Adolescent Psychiatric Department team provides treatment for children
under the age of 18 who experience discrepancy between their gender identity and the gender
allocated to them at birth, in accordance with the needs of each person and provides theirguardians with support and counselling. ... 1) Furthermore, the team assesses whether it would
best serve a child between the ages of 16 and 18 to undergo permanent changes to genitals,
gonads or other sex characteristics, cf. Article 11.
The team adopts its rules of procedure which shall be in conformity with recognised
international rules of procedure. The Minister responsible for health care services may lay
down in a regulation more detailed provisions on the tasks and services of the team.
1)
Act 154/2020, Article 6.
[Article 13a
Team on the issue of children born with atypical sex characteristics.
The Minister responsible for health care services appoints a team of experts on the issue ofchildren born with atypical sex characteristics. The team shall be interdisciplinary andcomposed of professionals with relevant knowledge and experience. The team is authorised tocall on other experts for counselling and cooperation purposes, e.g. in order to ensure that
health reasons are separated from social, psychosocial and appearance-related reasons that
may come into play in the assessment of permanent changes to sex characteristics.
The team provides children under the age of 16 born with atypical sex characteristics andtheir families with information, counselling and treatment in conformity with individual needs
and will otherwise fulfil the obligations provided for in Article 11a. The team shall guide its
clients to appropriate peer-to-peer counselling of people with atypical sex characteristics andtheir representative associations. The team provides services in cases where atypical sex
characteristics have been permanently changed, as well as in cases where no changes havetaken place or have been postponed.
The team adopts its rules of procedure which shall be in conformity with recognised
international rules of procedure. The Minister responsible for health care services may laydown in a regulation more detailed provisions on the tasks and services of the team.] 1)
1)
Act 154/2020, Article 7.
Article 14
Participation of the Icelandic Health Insurance.
Persons covered by the Act on Health Insurance are entitled to make use of the services ofteams pursuant to Articles 12, [Article 13 and Article 13a].
1)
Act 154/2020, Article 8.
[Article 14a
Right to appeal.
If, pursuant to Article 12, Article 13 or Article 13a, the team rejects an application fortreatment entailing a change to sex characteristics, this may be appealed to the Directorate of
Health. If the committee of experts pursuant to Article 9 rejects to give its consent pursuant to
Article 11(6), this may also be appealed to the Director of Health. Decisions of the Directorate
of Health may be appealed to the Ministry of Health.] 1)
1)
Act 154/2020, Article 9.
Chapter IV
Miscellaneous provisions.
Article 15[Fines, etc.]1)
Violations of Article 4(3), point 1 of Article 6(2) and Article 9(3) of this Act and of
regulations issued by virtue of it are punishable by fines, unless a more severe punishment
applies pursuant to other laws. Fines shall be paid to the Treasury.
A legal entity can be fined pursuant to the rules of Chapter IIA of the General Penal Codefor violations of the provisions of paragraph 1 and of rules issued by virtue of it.
[The limitation period for claims for damages established due to violations of this Act where
the injured party is under the age of 18 shall start on the day the injured party reaches the ageof 18. No claims may be established on the basis of Article 11a(4), third sentence.] 1)
1)
Act 154/2020, Article 10.
Article 16
Authorisation to issue regulations.
The Minister may issue a Regulation on the implementation of this Act in further detail, forinstance on requirements regarding data provided pursuant to Article 10(1), and on the workof an expert committee on changes in the gender registration of children pursuant to Article 9,inter alia regarding in which cases the child protection committee should be notified in thecourse of expert committee’s work.
Article 17
Entry into force.
This Act shall enter into force immediately.
…
Notwithstanding the provisions of paragraph 1, the parties responsible for registering gender
have 18 months from the entry into force of this Act to modify the registration sheets, forms,
identity papers and such pursuant to Article 6(2).

Article 18
Amendments to other acts. …
Transitional provisions.
[Within three years of the entry into force of Article 11a, the Minister will appoint aworking group to review the provision with respect to practical experience and developmentof research and knowledge and best practice in the field of human rights. In particular, thegroup must assess Article 11a(5), including whether the provision should be deleted. The
working group shall submit its proposals to the Minister as soon as possible after it
commences its work.
The group shall be comprised of a paediatric surgeon, a paediatric endocrinologist, a childpsychologist, appointed by the Minister of Health, a representative of Intersex Iceland, a
representative of Samtökin ‘78, the National Queer Association of Iceland, a sexologist
appointed by the University Level Collaboration Committee, an ethicist appointed by
University of Iceland‘s Center for Ethics and two lawyers, one with expert knowledge ofchildren’s rights issues and the other with expert knowledge of human rights, appointed
without nomination, as well as a chairperson, appointed without nomination.] 1)
1)
Act 154/2020, Article 11.