scoring guide

All donors are assessed using the same individual health and sexual-behaviour criteria, with identical questions and deferral triggers regardless of sexual orientation, gender, sex assigned at birth, partner sex or relationship type. A temporary deferral qualifies when it is triggered by the same behaviour for every donor. The score of 100 reflects equal eligibility assessment rather than the absence of all donor-safety deferrals.

A donor-selection rule depends on sexual orientation, gender, sex assigned at birth, partner sex or relationship type, but does not create a complete or extended exclusion. This includes an identity-based deferral of up to three months or access limited to particular donation components or pathways. The exact restriction and available donation types must be recorded. The score of 50 recognises meaningful access while the assessment remains unequal.

A finite identity-based deferral longer than three months applies because of sexual orientation, gender, sex assigned at birth, partner sex or relationship type. The exact duration, affected donation types and triggering condition must be recorded. The score of 25 reflects that donation remains possible but only after a substantial unequal waiting period.

The destination does not operate a general-public domestic system for collecting blood, plasma or platelets from individual donors. This outcome does not apply when a policy is merely missing, unclear or unverified; that is an incomplete audit. The score of 0 records that there is no domestic eligibility framework through which equal or unequal access can be assessed.

A lifetime or indefinite exclusion prevents donors from standard donation pathways because of sexual orientation, gender, sex assigned at birth, partner sex or relationship type, without an individual route to eligibility. Limited access to a distinct component may qualify for Limited Identity-Based Restriction instead when it provides a genuine donation pathway. The score of -100 reflects complete identity-based exclusion.

Binding legislation, constitutional law or a final controlling judgment gives the assessed identity an individually enforceable right to medically appropriate gender-affirming care. A person can challenge an unjustified denial and obtain an effective remedy, an operational domestic or formal referral pathway exists, and financial eligibility is no less favourable than for comparable medically necessary care. A general equality clause or a right that exists only on paper does not qualify. No identity-specific restriction or operative prohibition may apply. The score of 100 reflects an enforceable equal right supported by a real care pathway.

A currently operative health, regulatory or insurance policy requires the relevant providers or payers to maintain a gender-affirming medical care pathway throughout the destination. The policy unambiguously includes the assessed identity and access is no less favourable financially than comparable specialist care, but an individually enforceable right has not been established. Advisory guidance, optional provider policy and a pathway that exists only in theory do not qualify. No identity-specific restriction or operative prohibition may apply. The score of 75 reflects a binding destination-wide guarantee without an established personal legal remedy.

At least one substantive medical intervention is lawfully available through a licensed domestic provider or formal referral pathway recognised by a health authority, regulator, insurer, public service or licensed provider. The assessed identity can genuinely qualify, but access is neither individually enforceable nor guaranteed by a binding destination-wide policy. Informal treatment, unregulated self-medication, psychological support alone and mere absence of a prohibition do not qualify. No identity-specific restriction or operative prohibition may apply. The score of 50 reflects a real official pathway without guaranteed access.

Authoritative evidence confirms that no licensed domestic pathway or formal referral route for medical gender-affirming care exists, while no binding prohibition or identity-specific restriction causes that absence. Informal overseas travel and unregulated treatment do not create a recognised pathway. Missing, outdated or inconclusive evidence does not qualify and must remain an incomplete audit. The score of 0 records a verified absence of a recognised pathway without treating missing research as a neutral outcome.

A recognised medical care pathway remains available, but an explicit condition imposed because of gender identity materially obstructs access. Qualifying restrictions are compulsory sterilisation, third-party or political approval, prior legal gender recognition, mandatory binary identity or presentation, exclusion of Non-Binary people, mandatory diagnosis of a mental disorder, psychiatric institutionalisation, an identity-specific waiting period, funding exclusion, residency rule or legally authorised provider refusal. Ordinary clinical assessment, informed consent, general waiting lists and rules applied equally to comparable care do not qualify. The score of -50 reflects unequal access without a categorical prohibition.

A currently operative law, regulation, judgment or binding policy prohibits qualified providers from delivering medical gender-affirming care to a defined age group, identity population or geographic area, or prohibits a recognised treatment class, while a meaningful medical pathway remains outside the prohibition. Individual clinical decisions, non-binding guidance, funding exclusions and general service shortages do not qualify. The affected population, treatment and geography must be recorded and displayed with the outcome. The score of -75 reflects a categorical but incomplete prohibition.

All or effectively all medical gender-affirming care is prohibited for the assessed identity across the destination's ordinary civilian population. No lawful domestic or formal referral pathway remains for puberty-related treatment, hormone therapy or surgical care. Permitting psychological support does not prevent this outcome, while general scarcity does not create it. The prohibition may arise from any controlling legal instrument because its practical legal scope, rather than its hierarchy, determines the result. The score of -100 reflects a destination-wide complete medical care ban.

Binding law or military rules expressly protect the assessed identity throughout enlistment, retention, open disclosure, assignments, promotion and discharge. An effective complaint or review process must exist. Service must operate under identity-neutral, role-relevant individual standards. No lower-scoring rule may apply to any force, branch, population or part of the destination.

Open service is formally secured through a binding general equality protection or an operative official policy that includes the assessed identity. People can enter, remain and serve openly without identity-specific restrictions, but no enforceable identity-specific equal-service protection has been established. Informal tolerance, isolated examples and policy that exists only on paper do not qualify.

A completed audit confirms that no official inclusion or exclusion policy addresses the assessed identity and no operative identity-specific restriction has been found. General eligibility language, informal tolerance and isolated examples do not establish formal inclusion. Missing, conflicting or unverifiable evidence is an incomplete audit and cannot receive this score.

People can enter, remain and serve openly, but official conditions apply because of the assessed identity. These may concern identity documents, gender recognition, uniforms, grooming, facilities, medical certification, transition, conscription or administrative classification. Individual, evidence-based requirements applied equally to a particular role do not qualify. A condition that closes a branch or role, requires concealment or prevents entry or retention receives the corresponding lower score.

People can otherwise serve openly, but the assessed identity is categorically excluded from a branch, reserve component, occupation, deployment, commission, promotion pathway or other material role. Individual role requirements applied equally do not qualify. A rule that makes open service impossible or broadly prevents entry or retention receives the corresponding lower score.

Service is possible only while the person conceals or suppresses their identity, relationship, transition, sex characteristics or lawful identity-linked conduct. Disclosure may trigger investigation, reassignment, discipline or discharge. General conduct rules applied equally to everyone do not qualify. This outcome controls even when formal enlistment remains available.

The assessed identity, or a defined group within it, is categorically barred from entering, re-entering or remaining in service. This includes blanket exclusions based on diagnosis, transition or treatment history, gender marker or sex characteristics. Unlike Mandatory Identity Concealment, there is no legitimate service pathway once the relevant identity or status is known. A rare or discretionary waiver does not remove the ban.

The entire assessed identity is effectively prohibited from both entering and remaining across all applicable forces, or military rules impose criminal punishment for the identity, its disclosure or lawful consensual identity-linked conduct so that open service is impossible. Exceptional permission does not establish a genuine service pathway. The practical effect controls regardless of whether the restriction appears in legislation, military policy, religious rules or another operative instrument.

Verified evidence confirms that residents have no applicable regular or reserve armed force, national guard, military coast guard, military gendarmerie, defence paramilitary body, conscription, mobilisation mechanism or parent-state service system. Civilian police alone do not count. This is a non-scoring state: Military Service is removed from the identity's denominator and its weight is redistributed under the subcategory summary rule.

A binding law, regulation, authoritative judgment or equivalent rule explicitly guarantees the assessed identity equal access across every core covered context. Access does not depend on changing a legal marker, medical transition, diagnosis or prior approval, and the person is not compelled to use a separate or inferior facility. For Non-Binary people, a safe and genuinely usable all-gender route is available wherever binary facilities would otherwise provide no appropriate option. Neutral, individual safety requirements applied equally to everyone do not reduce this score.

Enforceable anti-discrimination law or binding precedent protects the assessed identity across the relevant services, employment or education contexts, and authoritative evidence confirms that the protection applies to gendered facilities. Facility access is not comprehensively and expressly guaranteed across every core context, or narrow lawful exceptions remain. Merely assuming that a broad equality clause might apply is insufficient.

Explicit and enforceable equal-access protection applies only to named sectors, facility types, age groups or populations. Examples include education-only protection, government-facility rules or a requirement limited to single-user facilities. There must be no operative restriction that produces a lower tier for the assessed identity.

A completed audit finds no binding protection, access condition or restriction for the assessed identity in the covered facilities. The absence of reported disputes, an individual venue's practice or an unverified assumption about broader law does not establish protection. Missing, conflicting or unverifiable information is an incomplete audit and cannot receive this score.

The assessed identity has a lawful and genuinely usable facility route, but access depends on a legal sex marker, medical status, diagnosis, prior approval or another identity-specific condition, or the person is compelled to use a separate alternative facility. This tier applies only where the alternative is safe and reliably available and breach does not trigger a more serious sanction.

A binding rule restricts the assessed identity in one major covered sector, facility type, age group or population, while equal access remains lawful elsewhere. A single operator's policy is insufficient unless it has binding official or delegated effect. If breach carries material civil, administrative or criminal consequences, use the corresponding lower tier.

Binding restrictions apply across multiple core covered sectors or across a destination-wide class of gendered facilities. The assessed identity is broadly required to use facilities determined by assigned, registered or legally defined sex, but using another facility does not itself expose the person to the punitive consequences required for a lower tier.

Using, permitting or supporting identity-appropriate facility access can trigger a material civil or administrative penalty, expulsion, dismissal, licence consequence or substantial institutional fine. The sanction must be tied to facility access or a rule that authoritative evidence confirms applies to it. Criminal prosecution, arrest or detention requires the lowest tier.

The assessed identity has no lawful and genuinely usable facility route across the destination, or identity-appropriate access exposes a person to criminal prosecution, arrest, detention, imprisonment, corporal punishment or equivalent punitive state enforcement. A general gender-expression or morality offence qualifies only when authoritative evidence confirms its application to facility access.