In a move which will have ramifications around the world, Sweden’s Karolinska Hospital has banned the regular use of puberty blockers and cross-sex hormones for minors. From now on, these drugs will only be prescribed to Swedes under 18 when they are taking part in clinical trials.
This is a major policy U-turn when it comes to gender-questioning minors in Sweden. Much like the case brought (and won) by Keira Bell and Mrs. A against Britain’s GIDS clinic, the message is clear: children can’t consent to consequences they’re too young to understand. As the Karolinska’s Fredrika Gauffin and Svante Norgren put it:
These treatments are potentially fraught with extensive and irreversible adverse consequences such as cardiovascular disease, osteoporosis, infertility, increased cancer risk, and thrombosis. This makes it challenging to assess the risk / benefit for the individual patient, and even more challenging for the minors or their guardians to be in a position of an informed stance regarding these treatments.
The Swedish decision has been in the mail for some time. Referrals to gender clinics in Sweden tumbled by almost a half between 2017 and 2019, with clinicians calling for government to revisit the care protocols — and for the media to be less biased on the topic of transition regret. Like their British counterparts, Swedish doctors are deeply concerned about the possibility of social contagion, which itself is rarely studied.
Scandinavia’s most populous country, then, is waving goodbye to its Germanic cousin, the Netherlands. The Karolinska previously followed the Dutch Protocol, according to which kids as young as twelve can be given access to puberty blockers. But this Protocol seems to be losing ground left, right and centre. To Sweden and the UK can be added Finland, whose new guidelines, issued in 2020, prevent the use of any drug associated with medical transition until “identity and personality development appear to be stable” — in practice, until early adulthood is well underway.
In the Karolinska’s case, it is not just the adverse consequences which Gauffin and Norgren note: it is the “lack of evidence for both the long-term consequences of the treatments, and the reasons for the large influx of patients in recent years.” Ultimately, the Dutch Protocol is an experiment without a formalized control group — a fact never articulated by media outlets describing the model as “life-saving” without examining the evidence for and against this assertion.
Transition regret is a hot topic in Sweden, thanks in part to the three-part documentary Trans Train (Part 1, Part 2, Part 3) investigating the phenomenon. Sweden is frequently lauded for its progressive social values, not least by American liberals, making it harder to dismiss this cultural shift as mere prejudice. Yet certain Americans seem to have a blind spot within their fondness for the Scandinavian social model.
US legislators, take note: while the American culture war rages on, in Europe the tide is turning.