Gender equality in the workplace and the good health of both women and men are key goals outlined in agendas promoting social justice and sustainable development. The Constitution of the Republic of Poland guarantees equal employment rights for women and men, and the Labor Code prohibits discrimination in establishing and terminating employment relationships, including on the basis of gender. On the one hand, an employer cannot allow an employee to work without a current medical certificate confirming the absence of contraindications for the specific job position, and is obliged to assess occupational risk related to manual handling tasks, taking into account, among other factors, the individual capabilities of the employee. On the other hand, the legislator sets different standards for women and men in terms of manual handling of objects by a single employee or during team-based work. Therefore, when a job candidate or employee is a transgender person – especially one undergoing medical procedures aimed at aligning their physical characteristics with their gender identity – difficulties arise in interpreting existing legal regulations. This article discusses the legal uncertainties in Poland related to weight-lifting criteria, the issue of disclosing an employee’s gender in order to tailor working conditions to their needs, and the principles that should guide the physician responsible for occupational health care during and after gender transition. Med Pr Work Health Saf. 2025;76(2)