Same-sex sexual activity in Bolivia has been legal since 1831 as the Penal Code did not mention homosexuality.

In July 2020, the first "free union" of a same-sex couple was registered thanks to constitutional resolution 127/2019 issued by the Second Constitutional Chamber of La Paz in which Advisory Opinion OC-24/2017 of the Inter-American Court of Human Rights was applied, via conventionality control.

The decision was reviewed by the Plurinational Constitutional Court, which confirmed the revised resolution by issuing the Plurinational Constitutional Sentence SCP0577/2022-S227 of June 2022 and notified in March 2023, which currently allows the registration of free unions between same-sex couples.

In July 2023, through Resolution TSE-RSP-ADM No. 0175/2023, the Supreme Electoral Tribunal modified the Regulations on Free Unions so that same-sex couples can legalize their union under the same conditions as heterosexual couples.

Free union is a legal institution provided for in Bolivian legislation that recognizes couples who share a common life project based on living together in conditions of stability and uniqueness, and which produce the same effects as civil marriage.

In Bolivia, there are no laws restricting the discussion or promotion of LGBTQ+ topics.

On 25 November 2015, a law was proposed that would allow transgender people to change their legal name and sex. On 19 May 2016, the Chamber of Deputies passed the Gender Identity Law (Spanish: Ley de Identidad de Género). One day later, the Chamber of Senators passed the measure by simple majority votes. On 21 May 2016, the legislation was signed into law by Vice President Álvaro García Linera, and it took effect on 1 August 2016. In October 2016, the Bolivian Congress debated whether to repeal it.

The law allows individuals over 18 to legally change their name, sex and photography on legal documents. A psychological test (not exactly a diagnosis) proving that the person knows and voluntarily assumes the change of identity is required, but sex reassignment surgery is not. The process is confidential and must be carried out before the Civil Registry Service. The processing of the new documentation will take 15 days. The change of name and sex will be reversible once, after which they cannot modify these data again.

Gender-affirming care in Bolivia is legal.

Bolivia does not legally recognize non-binary identities yet.

The law against racism and all other forms of discrimination, in article 5a explicitly includes sexual orientation and (gender) identity.

Discrimination is protected for sexual orientation and gender identity as per the law against racism and discrimination of any kind, including employment under Bolivia's Law against Racism and All Forms of Discrimination passed in 2010.

Discrimination is protected for sexual orientation and gender identity as per the law against racism and discrimination of any kind.

Law No. 548, Code for Girls, Boys and Adolescents, in its article 84, establishes that single persons, married couples or those in free union, can request adoption. Regarding the type of couples requesting adoption, it does not explicitly mention that it must be between a man and a woman.

Resolution SCP 0577/2022-S2 in relation to free unions, did not expressly address the right to adoption by having denied protection to the plaintiffs regarding the affectation of the rights that arise from the legal union of same-sex couples, avoiding making a statement on the subject.

Surgery on intersex infants is legal in Bolivia but not reported.

Serving as openly homosexual was never illegal in the military penal code. This provision was strengthened with the anti-discrimination provision proposed in 2010

In 2019, Bolivia lifted the ban on homosexual and bisexual men donating blood.

The Comprehensive Care Standard for the LGBTIQ+ population in health facilities, issued by the Ministry of Health and Sports, is applied at the national level within the framework of the current regulation of the Unified Health System, in a mandatory manner for all health establishments, whether public, private and short-term social security; as well as natural and legal persons with responsibilities in the health care of LGBTIQ+ people.

Section 10.2 on Specific Recommendations to be taken into account states that "Guidance should be given on the danger of resorting to “reconversion and reparative therapies” that have no scientific basis and can generate psychological consequences for the person. Remember that such therapies are prohibited."

Section 12.3 on Specific Recommendations for the Health Care Team states that “Reparative Therapy, which seeks to change a person's sexual orientation or gender identity, is inherently coercive and incompatible with health care."

Age of consent for Anal or Vaginal sex is 14 years old.