The Karolinska Institute's Astrid Lindgren Children's hospital will no longer allow the prescription of these hormones to Swedish youth under the age of 16. Meanwhile, youth between 16 and 18 years of age can only access these treatments within clinical trials, and when capable of providing informed consent.
According to a statement by the hospital, there is a "lack of evidence" for the long-term side effects of blocking puberty. It also lists concern that there is no explanation for the increase of "gender dysphoric" youth presenting to gender clinics in recent years – a trend seen not only in Sweden but also in other countries including the U.S. (Related: Child abuse: Australian doctors subject 4-year-old to sex change surgery.)
"These treatments are frequently fraught with extensive and irreversible adverse consequences such as cardiovascular disease, osteoporosis, infertility, increased cancer risk and thrombosis," reads the hospital's statement. "This makes it challenging to assess the risk/benefit for the individual patient, and even more challenging for the minors and their guardians to be in a position of an informed stance regarding these treatments."
Karolinska's banning of puberty blockers and cross-sex hormones to youths has been called "a watershed moment" by the Society for Evidence Based Gender Medicine (SEGM). The group pointed out that it made Sweden the first country where a renowned hospital explicitly stopped following the "Dutch Protocol."
The Dutch Protocol is a multidisciplinary treatment for "gender dysphoria" that allows for the administration of puberty blockers in children as young as 12 years old – with an increasing number of children eight to nine years of age being given the drugs as well. It also allows the use of cross-sex hormones at the age of 16.
In addition to going against the Dutch Protocol, Karolinska's ban also makes Sweden the first country to go against guidance from the World Professional Association for Transgender Health (WPATH). For some time now, WPATH has positioned itself as the world's authority on transgender health. But in recent months, the health authorities of several countries have conducted their own reviews and found that there is not enough evidence to justify the early medical interventions promoted by the WPATH guidance.
Karolinska's ban comes as the Swedish government put on hold legislation that aims to lower the age at which youth can access "gender affirmation" surgery.
Sweden's new policy is consistent with moves by other European nations to limit or outright ban medical interventions for so-called gender dysphoria in minors.
One such country is Sweden's Scandinavian neighbor Finland. In June 2020, the Council for Choices in Health Care in Finland (COHERE Finland) released a revised guideline that prioritizes psychological interventions and support, rather than medical interventions, for youth with no childhood history of gender dysphoria.
"In Finland we have no legislation that gives the person the right to decide what services that person can get from publicly financed health care," stated the council to the Canadian Gender Report. "There has to be a medical ground for both the diagnosis and the treatment. Our legislation about equality and non-discrimination does not change the situation."
Meanwhile, across the North Sea in the U.K., the British government has outright banned the use of puberty blockers for youths under the age of 16 following the Keira Bell case. In the latter, the High Court deemed hormonal interventions for minors as experimental. More importantly, it cautioned that minors are "unlikely to be able to" provide truly informed consent. As such, the U.K.'s National Health Service (NHS) has suspended the initiation of hormonal interventions to minors under 16.
That said, the High Court's ruling is currently under appeal, with a hearing scheduled for June 2021.
Follow GenderConfused.com for more on how countries around the world are moving to limit the use of puberty blockers and cross-sex drugs on minors.