Swedish health authorities have distanced themselves from hormone and surgery based gender affirmation practices after questions were raised by doctors about the ethics of providing such treatments to under 18s.
New guidelines supporting the approach of “psychological support to help youth live with the healthy body they were born with.” are expected to be published before the end of the year.
An article written by paediatrician Mats Reimer and featured in medical journal Läkartidningen described evidence for the previously held approach, which was based on guidelines from the The World Professional Association for Transgender Health (WPATH), as “extremely weak” saying that “new knowledge support will advise against surgery, puberty blockers and sex-opposite hormones before adulthood”.
Swedish practices were hitherto aligned with those of WPATH who openly advocated for adolescents experiencing gender dysphoria to practice chest binding and genital tucking as well as placing no age limit on young children accessing gender affirmation treatments.
WPATH’s Standards of Care also advocated for young teens to be given cross sex hormone treatments to ‘avoid the damage done by long term use of puberty blockers’ for which it says there is need for further research.
Two key issues that fuelled debate in Sweden about the WPATH guidelines, which were in place since 2015, were lack of specification of a “lower age limit for any drug or surgical procedure”, and “a new gender identity is coined that requires recognition and care: the eunuch.”
The article continues that the term eunuch “does not mean men who have lost their testicular function due to illness or accident, but transgender people who feel that their inner true gender should be reflected in a castrated male body.”
It adds that the National Board of Health and Welfare’s updated guidelines “should no longer be based on such an obviously activist organization as WPATH” .
It continues that the new guidelines for the care of youngsters experiencing gender dysphoria should “become more reasonable than the previous ones and advocate great caution with irreversible interventions in healthy bodies, as we know that some will regret it.”
The article concludes that in Sweden “child psychiatry will continue to be responsible for treating those under the age of 18 who experience gender incongruity and suffer from it., and that care “will now primarily consist of psychological support to help the youth live with the healthy body they were born with.”