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Sweden No Longer Recommends Gender Transitions for Minors

Published: 12/26/2022

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Reasons for the reversal are as listed from the Guideline Regarding Hormonal Treatment of Minors with Gender Dysphoria at Tema Barn - Astrid Lindgren Children’s Hospital (ALB)…

In December 2019, the SBU (Swedish Agency for Health Technology Assessment
and Assessment of Social Services) published an overview of the knowledge base
which showed a lack of evidence for both the long-term consequences of the
treatments, and the reasons for the large influx of patients in recent years.

An addtional review of evidence is also cited within the document from, October 2020, NICE (The National Institute for Health and Care Excellence, UK). They found…

This comes in conjunction with British Courts ruling in December 2020 that informed consent with puberty-blocking treatment is ‘highly doubtful’…

GnRHa (puberty blocker) and of cross-sex hormone treatments of children and adolescents with gender dysphoria. Taken together, they show that the studies conducted to date are small, uncontrolled observational studies providing low quality evidence that the treatments have the desired effect, and that we have very little knowledge about their safety in the long term.

A highly publicized court case from Great Britain has shed light on this issue and in a
judgment from December 1st, 2020 the court establishes the overarching problem of
puberty-blocking treatment and that informed consent for this treatment is highly
doubtful, if at all possible, under 16 years of age. For ages between 16 and 18, the
court considers it advisable to request a court approval before starting hormonal
treatment, since the treatment should be regarded as experimental. As a result of
this ruling, the NHS (National Health Service) discontinued initiating hormonal
treatments in new cases of individuals under 16, while recommending a thorough
review of ongoing actively treated cases. For patients between ages 16 and 18, it is
recommended that the treating physician receives court approval before cross-sex
hormones are initiated. During the Spring of 2020 the NHS changed its public stance
regarding puberty blocking treatment, from considering it fully reversible, to now
describing it as having uncertain long-term consequences. Following the abovementioned
ruling, the NHS changed their guidelines to no longer initiate hormonal treatment of
gender dysphoria in patients under 16 years of age.

Karolinska Guideline K2021-4144 April 2021 (English, unofficial translation).pdf

Karolinska Riktlinje K2021-4144 April 2021 (Swedish).pdf

Karolinska Policy Change K2021-3343 March 2021 (English, unofficial translation).pdf

Karolinska Policyförändring K2021-3343 March 2021 (Swedish).pdf

Links to Evidence:

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Published: 12/26/2022

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