Slovakia has changed its constitution, enshrining into law recognition of only two sexes – male and female.
The legal change, which passed in a knife-edge vote in parliament, also restricts adoption to married heterosexual couples and prohibits surrogate pregnancies.
The constitutional amendment was defined as enshrining "sovereignty in cultural and ethical matters".
Critics including Amnesty International have warned the change would make life more difficult for LGBT people, saying it brings the country's legal system closer to Hungary's illiberal government or Putin's Russia.
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Parliament's backing of the amendment came as a surprise to observers, with even the prime minister conceding as late as Thursday it might not pass.
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