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Karolinska 2021 — Swedish policy change
In March 2021 Karolinska Universitetssjukhuset in Stockholm — internationally a leading centre for adolescent transgender care — decided to offer hormone treatment to minors only within clinical research.
2021 decision
In March 2021 Karolinska Universitetssjukhuset in Stockholm — internationally a leading centre for adolescent transgender care — decided to offer hormone treatment to minors only within clinical research. The decision followed an internal evaluation and concern about a sharp rise in referrals, particularly of adolescent girls.
Rationale
The hospital referred to systematic reviews carried out by SBU (Statens beredning för medicinsk och social utvärdering) which concluded that the evidence for the effectiveness of puberty blockers and cross-sex hormones in young people is limited and that risks are under-reported.
Subsequent policy
In 2022 the Swedish National Board of Health and Welfare published national guidelines confirming this cautious approach. Similar policy changes followed in Finland and Norway.
Sources
Karolinska Universitetssjukhuset (2021). Beslut om hormonbehandling av minderåriga med könsdysfori. SEGM summary
PALKO/COHERE Finland (2020). Recommendation of the Council for Choices in Health Care in Finland: Medical treatments for dysphoria associated with variations in gender identity in minors. English translation (SEGM)