Sweden’s Karolinska Hospital announced it will no longer prescribe puberty-blockers and cross-sex hormones to minors under the age of 16. While hormonal intervention is still permitted for minors ages 16 to 18, such treatment is only allowed to occur in scientific research areas designated by the ethics review board in Sweden.
“The hormonal treatment of children and adolescents with gender dysphoria may consist of puberty-blocking treatment initiated at the onset of puberty, and cross-sex hormones initiated at the age of 16,” the hospital said in a statement. “These treatments are controversial and have recently become subject to increased attention and scrutiny both nationally and internationally.”
Karolinska Hospital warned these treatments may have “irreversible adverse consequences.”
“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,” the hospital said.
The decision makes Sweden the first country with a major hospital to abandon the Dutch protocol of administering puberty blockers for minors as young as eight years old. Furthermore, Sweden now becomes the first country to abandon the World Professional Association for Transgender Health’s guidelines. The international non-profit group claimed in 2011 there ought to be “a flexible framework, rather than rigid rules, of appropriate care” for children with gender dysphoria, and, “physician/health care provider protocols for diagnosis and assessment.”
Arkansas became the first state in the U.S. to ban genital mutilation and the administering of puberty blockers to those under 18-years-old, but it was not an easy bill to pass. Republican Gov. Asa Hutchinson vetoed the measure in April and went so far as to invoke the name of former President Ronald Reagan to support his position.
Other states have advanced legislation on the issue. The Senate in Alabama voted in April to pass a bill to ban puberty-blockers and hormones to minors and it now heads to the House. However, efforts in Utah, Florida, Tennessee, and Georgia have stalled. In Georgia specifically, HB 401 sponsored by state Rep. Ginny Ehrhart is unlikely to advance “after failing to meet a key deadline,” according to a local paper. The bill could be reintroduced in 2022.
As for children in Sweden who are already undergoing treatment with puberty blockers or cross-sex hormones, the hospital said they will be individually assessed by the treating provider to “determine whether treatment should be stopped or continued.”