What the law allows
Full record
Latvia’s civil-registry law treats sex change as a medical fact. The national children’s hospital has published how it handles those diagnoses, including puberty blockers.
The Civilstāvokļa aktu reģistrācijas likums lets the birth record be updated on a medical certificate, or other document, that certifies sex change. That is a legal pathway that implies clinical activity.
Rīga Stradiņš University’s published series from Children’s Clinical University Hospital (BKUS) reviewed every child and adolescent given an ICD-10 F64 or F66 diagnosis there from 2015 to 2020. Mean age at diagnosis was about 15. Hormonal treatment with a GnRH analogue to suppress pubertal progression was given to three patients. That is a hospital record of puberty blockers.
Medical is Affirming.
Schools. Ministru kabineta noteikumi Nr. 747 (state basic-education standard) set reproductive-health outcomes in the national curriculum. On 8 March 2024 the Ministry of Education and Science launched a teacher course, Seksuālā izglītošana: starptautiskā pieeja, so social-science, science, and sports-and-health teachers can deliver sexuality education. That is CSE in schools.