Even though transgender people continue to experience violence and discrimination in many aspects of life, there has been progressive recognition of their experiences and demands in recent decades. This article analyses the process of claiming civil rights and the evolution of health care for transgender people in Spain, from the mid-1970s to the present day, paying particular attention to the narratives of key actors involved. To this end, three socio-historical periods are identified: (1) the travesti period (the mid-1970s to the early 1990s), characterised by strong social and institutional transphobia and resulting self-care practices; (2) the transexual period (mid-1990s to the 2000s), when demands for health care were institutionalised under a pathological medical model; and (3) the transgénero or trans period (2010s until the present) when identity and bodily autonomy have been re-claimed through a socio-cultural prism that has denounced pathologisation. At each stage, political, social and economic factors intervened at both national and international levels to trigger an ongoing negotiation between transgender movements and dominant social institutions, all within a changing universe of social values.