Swedish doctors will no longer prescribe hormones or drugs to halt or delay puberty for children under the age of 16 as part of gender-transitioning procedures. 

The Karolinska University Hospital, which treats minors with gender dysphoria, announced in March that as of April 1, 2021, they would not be providing “puberty blocking” drugs or cross-sex hormones to children under the age of 16. The decision was reported in English-speaking media on May 5.

A statement from the hospital, translated from Swedish, cited concerns about long-term effects of the drugs and hormone procedures, as well as questions about the fully informed consent of patients under the age of 16. 

Ryan Anderson, president of the Ethics and Public Policy Center, praised the changes and called for additional protections for children with gender dysphoria. Anderson has authored a book critical of the transgender movement, “When Harry Became Sally: Responding to the Transgender Moment.”

“Prudent legislation is needed to prevent adults from interfering with a child’s normal, natural bodily development. ‘Gender affirmation’ procedures violate sound medical ethics,” Anderson told CNA on Wednesday. 

“These procedures are entirely experimental. There is not a single long-term prospective study of the long-term consequences of blocking an otherwise physically healthy child from undergoing normal pubertal development,” he said. 

The hospital’s statement cited the December 2020 Bell v. Tavistock decision, where the High Court of Justice for England and Wales found that it was “highly unlikely” that children under the age of 13 could give fully informed consent to receiving puberty blockers and cross-sex hormones; the court added that it was “very doubtful” that children ages 14 and 15 could give full consent to the procedures. 

Minors between the age of 16 and 18 who wish to receive hormone treatments may do so only in clinical trial settings approved by an institutional review board, the hospital said. 

The hospital further stated that children with gender dysphoria will still be able to receive psychological and psychiatric care under the new policies. All minors currently receiving cross-sex hormonal treatments and puberty blockers will be assessed for future treatment, and should be informed as well as possible of the risks of gender-transitioning procedures, the hospital said.

Anderson claimed it is “profoundly unethical to intervene in the normal physical development of a child as part of ‘affirming’ a ‘gender identity’ at odds with bodily sex.”  

“While puberty-blocking drugs may be an appropriate treatment for precocious puberty—the early onset of puberty—in order to delay puberty to a biologically appropriate age, that is not what is going on here,” he said. “The use of puberty blockers to delay or permanently block natural biological puberty is unethical and violates the bodily integrity of children.”

Among the side effects reported by those who were prescribed Lupron, a prostate cancer drug that is also used to delay or halt puberty, include infertility, osteoporosis, and cardiovascular disease. 

“Adults should not interfere with the natural, healthy development of the bodies and minds of children,” said Anderson, who added that “Children must be provided with the time and space to develop to maturity.”

This marks a departure from the “Dutch protocol” for treating minors with gender dysphoria. The protocol allows for certain preteen adolescents to be given drugs to halt or delay the progression of puberty, followed by the possible application of cross-sex hormones in their teen years. 

Prior to the new policy changes, Karolinska provided gender-transition procedures, including surgeries, to children and adults. In October 2019, a Swedish investigative television show reported that the hospital performed a double mastectomy on children as young as 14 years old.