You can change your name and sex/gender with the Andalusian Health Service (SAS), even if you have not changed them at the Civil Registry. This may be especially useful for people with a non-Spanish nationality who cannot change their name and sex/gender in their country (and also not in Spain with the Trans Law), or for non-binary people or other identities in Spain for which the Trans Law does not apply.
Andalusian Health Service
- Article
Published in El Salto, 16 February 2020 (original in Spanish)
After more than three years, and more than five years of the recognition of the free determination of gender identity in Andalusia, in November 2019, I finally achieved exactly this: that the Andalusian Health Service recognized my gender identity outside the binary of man and woman, as, in my case 'indeterminate' (not to say 'genderqueer'). It has been a long and sometimes frustrating struggle.