‘If you don’t know people, you can’t really know how things work.’

Athens, Greece — A trans woman was found dead in Thessaloniki two days ago and two separate transphobic attacks in Athens have made the news this year. The culture of violence and threats on trans people in Greece are intensifying while they face challenges accessing healthcare.

Trans people in Greece have no map to navigate their healthcare access within the current system. There is no clear entry point, and no guarantee that the next step will lead anywhere stable.

Sadie’s story is one of many, a brief view into the barriers that exist in the medical system but one that cannot be told without acknowledging the broader climate in which trans lives in Greece are lived.

“I had to figure it out myself by then. And most things in my transition, I’ve had to figure out on my own, to be honest.”

For Sadie, a 27-year-old trans woman living in Athens, this was the reality she had to navigate: fragmented information, uneven access, and a system that only partially exists. Advice from friends, a bit of luck and trial and error in finding the right doctor, unexpected disruptions, like medication costing up to 200 per dose, suddenly being taken off insurance coverage and a constant requirement for patience.

The system does not disappear. It is still there, in fragments: insurance codes, prescriptions, psychiatrists, endocrinologists, legal procedures that exist on paper but cost money and require expertise to navigate. It is a process of trial and error, a continuous search for information, resources, and occasionally luck. The right piece of advice at the right time can mean avoiding months of delay or unnecessary hardship. Community knowledge becomes essential: what you read, who you meet, what they tell you and what you are told along the way by the people that you are made to meet through this process.

In Sadie’s case, that guidance was minimal in the beginning.

“Back in the day, I don’t think I received much guidance,” she says. “I don’t think many people really helped me.”

There were exceptions. One person stands out in her memory, a trans woman.

“She gave me some small guidance. Nothing extreme.”

“I don’t hold that against anyone,” she says. “If you don’t know people, it’s not possible.”

Now, she is on the other side of that equation. When younger trans people reach out to her, she responds eagerly to offer the information and share her experience.

“That’s why I actually like it now when younger trans people come and talk to me and ask how you do this or that, and I share information openly, about doctors and all that stuff, and, you know, legal things and surgery things.

Because it’s something I feel I didn’t have, and I think it fucking sucked that I didn’t have it. And I’d like to be able to provide it to other people, because it’s a kind of strange situation, and that information isn’t properly structured anywhere, as it should be, I think.”

In Greece, gender-affirming healthcare is not entirely absent. Hormones exist. Doctors exist. Legal pathways exist. What does not exist is a system. Instead, care is distributed across disconnected points, what Sadie jokingly calls “side quests”: a web of private psychiatrists, endocrinologists, informal networks, and inconsistent insurance coverage. There is no centralized pathway, no standardized protocol, and of course no guarantee of access.

The result is that for a person seeking this kind of healthcare, their experience is shaped less by institutional support than by informal networks, personal finances, and individual persistence. Although all these services are theoretically accessible, there is no standardized pathway guiding trans people through the process. Access frequently depends on finding the “right” doctor through community recommendations, enduring long waiting periods in the public sector, and navigating or avoiding discriminatory and pathologizing treatment.

According to research, many trans people describe approaching hospitals and clinics with fear, while mental health services, although functioning in practice and legally required as a prerequisite for proceeding with medical transition, are often experienced as inconsistent, leading some individuals to abandon public healthcare altogether in favor of private providers despite the financial burden.

Surgical procedures remain almost entirely excluded from public coverage and are commonly classified as cosmetic interventions …