Assisted suicide legalized in the Netherlands (in 2002), Belgium (in 2002), Luxembourg (in 2008), and Canada (in 2016). Assisted suicide, where the patient has to take the final action themselves (unlike voluntary euthanasia), is legal in Canada, the Netherlands, Luxembourg, Switzerland and parts of the United States. In the United States there are assisted dying laws restricted to terminally ill adults in Oregon, Montana, Washington, Vermont, Hawaii, California, Colorado and Washington D.C. The laws require that the patient's attending physician certify mental competence. Oregon was the first United States state to legalize assisted suicide, which was achieved through popular vote. The Act
LGBT rights in Belgium and public and private accommodations were enacted in 2003 and on gender identity/expression in 2014. Transgender people have been allowed to change their legal gender since 2007, though under certain circumstances, which were repealed in 2018. Belgium has frequently been officially referred to as one of the most gay friendly countries in the world, with recent polls indicating that the majority of Belgians support same-sex marriage and adoption rights. The previous Prime Minister of Belgium, Elio Di Rupo, is an openly gay man and was one of the only few head of states in the world to identify as LGBT.