Albania Quietly Approved Hormone Therapy Guidelines for Trans Adults. Religious Leaders Are Pushing Back.
A new Health Ministry clinical guideline sets out the first formal framework for trans hormone treatment in Albania. Muslim and Christian leaders are calling it a moral threat; the government calls it overdue clinical guidance.
Albania’s Ministry of Health and Social Protection has approved the country’s first formal clinical guideline on hormone treatment for transgender people — a quiet bureaucratic order that has turned into one of the more pointed religious-versus-state disputes in the region this year.
The directive, issued as Order No. 304 in late April, sets out medical criteria, clinical procedures and monitoring requirements for hormone therapy to be offered at QSUT, Tirana’s main university hospital, and funded through public resources. It applies to adults, and to adolescents aged 16 and over with medical approval and family consent. Until now, Albania — like most of the Western Balkans — had no codified clinical pathway for trans healthcare at all; patients seeking hormone therapy navigated an informal, inconsistent process shaped as much by which doctor they happened to find as by any national standard.
Where the pushback is coming from
The response arrived not from parliament but from Albania’s Interreligious Council, which brings together representatives of the Albanian Orthodox Church, the Catholic Church, the Evangelical Brotherhood and the Muslim Community. The Council issued a public statement calling on the government to disclose the scientific and medical basis for the guideline and to open it to broader professional consultation, arguing that a change of this nature required more institutional transparency than a ministerial order provided.
Individual religious figures went further. Ardit Hoxhllaku, the Mufti of Vlora, called the policy “unacceptable from an Islamic perspective” and said it contributes to the “moral and social deterioration” of society. Mirel Mazelli, imam of the Pogradec Mosque, said the guideline “conflicts with human nature and divine guidance.” The Council’s underlying substantive point — that Albanian law still has no dedicated legal framework governing gender identity recognition, medical criteria or treatment standards for trans people — is also, notably, a point LGBTQ+ advocates in Albania have made for years, though toward the opposite conclusion: that the gap needs to be closed with rights protections, not left open as grounds to block care that already has a clinical basis.
The government’s response
Deputy Minister of Health and Social Protection Eugena Tomini pushed back on the framing directly, clarifying that the document is a clinical guidance framework rather than a binding final protocol. She said it was developed using international clinical practices and the recommendations of a multidisciplinary specialist team, applies strictly to the target adult population under existing law, and requires informed individual consent at every step. In other words: this is medical guidance for a treatment that clinicians in Albania were already, in practice, sometimes providing — not a new legal status or a change to who can access care.
Why this matters beyond one ministerial order
Albania has spent the past several years positioning LGBTQ+ rights progress as part of its EU accession case, from its 2010 anti-discrimination law to benchmark discussions around partnership recognition tied to Cluster 5 negotiations. A hormone therapy guideline is a small, technical step by comparison — but it’s also one of the only concrete, funded healthcare frameworks for trans adults anywhere in the Western Balkans, a region where most countries still offer nothing comparable. That combination — genuine, if modest, institutional progress, met immediately by organized religious pushback framed around morality rather than medicine — is a pattern familiar to anyone who has watched LGBTQ+ policy move through the region: forward motion rarely goes uncontested, and the contest itself often becomes the more visible story.
For now, the guideline stands as issued. Whether the Interreligious Council’s call for “transparency” turns into sustained political pressure to walk it back — or fades the way similar objections to Albania’s 2023 draft Gender Equality Law eventually did — will say a lot about how durable this kind of incremental healthcare progress actually is in a country still writing its rules for trans recognition from scratch.
Sources: Euronews Albania; Euronews Albania; OrthoChristian.com.
