The FAA/CAMI imposes certain testing requirements on transgender pilots, listed in the Guide for Aviation Medical Examiners under Item 41 (G-U System), subheading "Gender Identity Disorder".

Is the FAA the only authority that has these requirements, or do other countries have similar policies?

EDIT: the link above is broken but I think there might be value leaving the old URL in case people want to try to get there on archive. The updated reg is at https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/app_process/exam_tech/item48/amd/gd/

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    $\begingroup$ Also, transgender persons are not as widely accepted in many countries as they are in the USA. I wouldn't be surprised if most countries didn't even consider this. $\endgroup$
    – Keegan
    Dec 2, 2014 at 3:21
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    $\begingroup$ @kjmccarx And in the USA, being transgender means you get described as having a "disorder", made to undergo psychiatric testing and assumed to be abusing/misusing substances. If only every country were so accepting! $\endgroup$ Dec 2, 2014 at 9:23
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    $\begingroup$ The European Association of Social Anthropologists makes searching for European answers surprisingly difficult! Oh, and for anyone who wants to read an incredibly offensive article of how the FAA was dealing with this in 2009 see page 6 of this article: faa.gov/other_visit/aviation_industry/designees_delegations/… $\endgroup$ Dec 2, 2014 at 11:53
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    $\begingroup$ @DavidRicherby at the danger of getting off-topic, the American Psychiatric Association has repeatedly stated that being trans is not, in itself, a disorder, e.g. here: psychiatry.org/File%20Library/Learn/Archives/…. My nascent attempts to inform the FAA of this prompted me to ask this question. I'd be happy to talk more about what I'm doing in chat at some point. $\endgroup$
    – Erin Anne
    Dec 2, 2014 at 15:43
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    $\begingroup$ I got half way through that article, @raptortech97. The constant misgendering was getting to me. You weren't wrong about its being offensive. $\endgroup$
    – TRiG
    Mar 29, 2015 at 20:22

1 Answer 1


As several commenters have noted, medical rules are different in each country. ICAO provides guidelines and recommendations, but it's up to each country to actually implement them. ICAO's personnel licensing requirements are in Annex 1 which is not freely available but their Manual of Civil Aviation Medicine implies that transgender pilots should be considered 'higher risk':

Applicants with disorders of behaviour (for example regarding habit, gender identity, sexuality) should be assessed on the basis of their ability to put aside the disorder (or any conflicts related to the disorder) in order to attend to the aviation task at hand. These persons may have significant conflicts with their environment, leading to further difficulties, which may become an impediment for them to hold an aviation licence.

Looking at specific countries, the FAA may be an unusual case by explicitly mentioning gender identity issues. I couldn't find any mention of them in the EASA, Canadian or UK medical requirements. But all countries' medical requirements include something general like this (this example is from EASA):

(g) Personality or behavioural disorder Where there is suspicion or established evidence that an applicant has a personality or behavioural disorder, the applicant should be referred for psychiatric opinion and advice.

That catch-all clause would - I assume - include gender identity disorder and therefore require psychiatric evaluation of the pilot. And in cases where a pilot has had gender reassignment surgery and/or drug treatment, the surgery and drugs regimen would almost certainly trigger additional testing and investigation (so would any other major surgical procedure or long-term drug treatment).

Finally, it's worth noting that whatever the general rules are, every case is different and the only way to get a specific answer for an individual is to consult with an aviation medical examiner for that jurisdiction.

(Disclaimer: I know nothing about medicine except that it's complicated. Consult an aviation medical specialist if you want a real answer.)

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    $\begingroup$ This answer is tremendously useful and is precisely the sort of thing I'd been after. Sources and quotes! Thank you. $\endgroup$
    – Erin Anne
    Dec 2, 2014 at 23:28
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    $\begingroup$ @ErinAnne That is exactly what this site is intended for, glad we could help! If this answers your question, you can accept the answer by selecting the check mark near the top of his answer. $\endgroup$
    – Lnafziger
    Dec 3, 2014 at 13:53

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