The Swedish National Board of Health and Welfare (NBHW) has published new treatment guidelines for children and young people with gender dysphoria, stating that psychosocial support should be the first line of treatment, rather than hormone therapy or surgery.
The guidelines state that “the risks of puberty suppressing treatment with GnRH-analogues and gender-affirming hormonal treatment currently outweigh the possible benefits, and that the treatments should be offered only in exceptional cases.”
This marks a significant departure from the guidelines adopted in 2015, which were based on recommendations from the activist organization World Professional Association for Transgender Health (WPATH).
The NBHW explained that its decision was based on a lack of reliable scientific evidence supporting the WPATH guidelines, as well as an increase in the number of individuals detransitioning and seeking to reverse the effects of gender-affirming treatments.
The NBHW also noted a rise in the number of young people experiencing gender dysphoria without a clear cause, particularly among teenage girls who had not previously experienced gender distress.
The new guidelines state that “psychosocial support that helps the young person live with the body’s pubertal development without medication needs to be the first option when choosing care measures.”
The NBHW emphasized that “gender dysphoria rather than gender identity should determine access to care and treatment.”
This approach aligns with the position of an international group of mental health professionals, public health scientists, and allied organizations and individuals, who have denounced WPATH for its “adherence to ideological views unsupported by evidence, its exclusion of ethical concerns, and its mischaracterization of basic science.”
“The need for good clinical studies is clear from the knowledge gaps that SBU lists. Follow-up and evaluation was something we already emphasized in the knowledge support in 2015, and since then very little knowledge has been added,” said Thomas Lindén, Head of Sweden’s NBHW. “It is important that the health care regions work to ensure that systematic documentation and follow-up of care at national level is realized and for clinical studies to start.”
“The National Board of Health therefore wishes to emphasize the importance of decision-makers in the health care regions acting for improvement in both issues, and that this needs to be done in the near future,” Lindén said elsewhere. “Young people suffering from gender dysphoria need to be able to quickly get an investigation and be offered adequate care measures, based on health care assessments of health care needs. Good psychosocial care is fundamental.”