Sweden’s Karolinska Ends All Use of Puberty Blockers and Cross-Sex Hormones for Minors Outside of Clinical Studies
Update May 08, 2021: Following a new policy statement from the Karolinska Hospital that went into effect May 2021, this article has been updated to reflect the changes. Update February, 2022: Sweden's National Board of Health and Welfare has followed the Karolinska's lead and issued a national...
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Sweden's Karolinska Ends the Use of Puberty Blockers for <16: New policy statement from the Karolinska Hospital
The "Dutch protocol" for treating gender dysphoric minors has been discontinued over concerns of medical harm and uncertain benefits
The Karolinska Hospital in Sweden recently issued a new policy statement regarding treatment of gender dysphoric minors at its pediatric gender services division. This policy, which took effect in April 2021, ended the practice of prescribing puberty blockers and cross-sex hormones for minors under age 16. Hormonal intervention for youth ages 16-18 is still allowed, but can only occur in research settings approved by Sweden’s ethics review board, following a thorough informed consent that discloses the significant risks and uncertainties of hormonal interventions, and considers the minor’s maturity level and ability to provide true informed consent.
This is a watershed moment. Sweden is the first country whose renowned hospital has explicitly stopped following the Dutch protocol, which allows for administration of puberty blockers at age 12 (and increasingly, as young as 8-9, at the early stage of puberty known as Tanner 2), and cross-sex hormones at the age of 16. It also is the first country to officially deviate from WPATH guidance. WPATH has long positioned itself as the world authority in transgender health. However, in recent months, several countries’ health authorities have conducted their own reviews of the evidence and found the evidence insufficient to justify early medical interventions promoted by WPATH’s guidelines.
The Karolinska University Hospital is one of the largest University Hospitals in Europe and together with Karolinska Institutet it forms the largest site for health care, research and medical education in Northern Europe.
