People rightly flipped out across the internet last month over news that the Swedish parliament would not be repealing a barbaric law that forces sterilization on trans people seeking to change their gender on legal documents. While it’s despicable that Swedish politicians are opposing the law change, much of the outrage, no doubt, occurred because people previously didn’t realize that a forced sterilization law existed in Sweden.

Considering how shocking people find Sweden’s law, it’s worth pointing out the country is 1 of 17 in Europe (shown in red below) that require trans people to have a surgical procedure that results in sterilization before legal gender change is made to their identification ID. The law is currently under review in Denmark, the Netherlands, and Portugal, and in Ireland a name change (which acknowledged gender change) was granted for one woman after a legal challenge that went to the high courts, but no laws exist on the matter.

Data source: European Union Agency for Fundamental Rights

According to a report on transgender rights (PDF) in the EU by the Directorate-General for Internal Politics, the Commissioner for Human Rights of the Council of Europe says, “These practices run counter to the principle of respect for the physical integrity of the person, in particular because transgender people appear to be the only group in Europe subject to legally prescribed, state enforced sterilization.” For all the instances that require ID—health insurance, travel, driver’s license, university enrollment, jobs—when name and gender on a state-issued ID don’t match up with the gender a person presents, that person is subject to debilitating challenges and discrimination. It also leaves anyone who doesn’t identify and present as specifically male or female out of the conversation completely.

Surprised? Well, the discrimination doesn’t stop in Europe. On February 3, the CBC reported on an amendment to Canada’s Identity Screening Regulation stating that airlines should not transport a passenger if he or she ”does not appear to be of the gender indicated on the identification he or she presents.” Live as a woman but have an “M” on your passport? You might not be able to get on a plane in Canada, even with an accurate photo ID.

While not all countries explicitly require sterilization, many nations (and quite a few US states) demand proof of major medical procedures like sex reassignment surgery; hormone therapy; a diagnosis of gender dysphoria, a psychiatric condition defined in the Diagnostic and Statistical Manual as “a marked incongruence between one’s experienced/expressed gender and assigned gender, of at least 6 months duration”; or permission by the courts. But in order to change the gender on their passports in Canada, trans Canadians must have had or be scheduled for a gender reassignment surgery, and a doctor’s note isn’t enough.

The Council of Europe Commissioner for Human Rights 2009 “Issue Paper on Human Rights and Gender Identity“ (PDF) takes particular aim at surgical or sterilization requirements, saying they “ignore the fact that while such operations are often desired by transgender persons, this is not always the case.” People don’t always want surgery, and it’s often impossible because of physical or economic impediments. The Issue Paper’s conclusions are clear; these sterilization requirements are “putting the transgender person in a limbo without any apparent exit.”