Gender Care in Norway

In 2023, Norway clearly joined the Nordic reorientation in pediatric gender care. The Norwegian Healthcare Investigation Board (Ukom) published a damning report on existing Norwegian practice and concluded that puberty blockers and cross-sex hormones for minors should be considered experimental. Ukom recommended revising the national guideline and classifying these treatments as experimental treatment. That recommendation has not been incorporated into regulations: the Helsedirektoratet guideline from 2020 has not been substantively amended since June 2021, and no revised version has yet been issued. There is therefore no formal requirement in Norway to provide these treatments only in a research setting.

Read more about this on this site: Ukom (Norway).

The Ukom Report (2023)

Statens undersøkelseskommisjon for helse- og omsorgstjenesten (Ukom), Norway’s independent healthcare investigation board, published a comprehensive report on pediatric gender care in March 2023. Its conclusions were stark:

• Norway’s 2020 national guideline was insufficiently supported by scientific evidence.
• Puberty blockers and cross-sex hormones for minors should be considered experimental treatments.
• Diagnostics for Norwegian patients were inadequate; comorbid mental health issues were given too little consideration.
• Follow-up care for treated young people was insufficiently organized, meaning that the actual treatment outcomes are unknown.
• Too little attention was paid to the risk of detransition and regret.

Ukom made three recommendations: revise the national guideline based on a systematic review of the evidence, classify puberty blockers and hormonal and surgical treatment for children and adolescents as experimental treatment, and establish a national quality registry. Treatment of minors in Norway is concentrated at Rikshospitalet in Oslo. Under the current guideline, puberty blockers may still be provided there after a comprehensive assessment; the recommendation to restrict them to experimental treatment has not yet been implemented.

The Helsedirektoratet and the Guideline Revision

Following the Ukom report, the Helsedirektoratet (the Norwegian Directorate of Health) was expected to consult with professional groups about revising the 2020 national guideline, as the Minister of Health reported to parliament in 2023. As of October 2026, no revised guideline has been issued. The approach advocated by Ukom and Norwegian critics runs parallel to that of Sweden, Finland and Denmark: psychotherapy and treatment of comorbid conditions come first, hormonal interventions require extensive multidisciplinary assessment and are permitted only in cases of severe, persistent dysphoria where other treatments have had insufficient effect.

Similarities with Scandinavian Neighbouring Countries

With this change in direction, Norway is aligning itself with Sweden, Finland and Denmark. All four countries have independently reached similar conclusions — based on their own scientific evaluations: the evidence base for hormonal treatment of minors is weak; psychotherapy should come first; comorbidities should be investigated; and follow-up is essential. This convergence of independent evaluations strengthens the international credibility of the Nordic reorientation and is fully consistent with the findings of the Cass Review. A 2026 overview shows that surgery for gender dysphoria is reserved almost everywhere in the Nordic countries for adults. Why Sweden and Finland restricted puberty blockers, and how the United Kingdom followed, is explained on transtijd.nl.

Psychological Care as the Starting Point

In its report, Ukom called for clearer requirements for assessment before treatment, the criteria for starting treatment and aftercare. Additional issues, such as autism, trauma, depression and eating disorders, should be systematically assessed as part of this process. Whether these requirements will be included in the guideline depends on the revision that has yet to be published.

Legal Gender Change

In 2016, Norway introduced a law allowing legal gender change through self-declaration for people aged sixteen and over. For children aged six to sixteen, parental consent is required. This legal arrangement is separate from medical policy and remained unchanged after the tightening of pediatric gender care.