Thread by @SEGMtweets

Yesterday, Sweden released its long-awaited guidelines for the care of gender-dysphoric youth. These guidelines represent a major departure from the WPATH "Standards of Care," and are a vital step towards safeguarding vulnerable youth from medical harm./1
socialstyrelsen.se/om-socialstyre…

SEGM will be undertaking an analysis of Sweden's new guidelines, which we will share at a later date. Below is a summary of our initial take-aways and observations. /2

Sweden’s new guidelines emphasize that gender-dysphoric youth will continue to receive care. However, health care for gender dysphoria is no longer reduced to “hormones and surgeries.” The recommendations now call out a key role for psychiatric and psychosocial services. /3

The guidelines assert that based on current evidence, the risks of hormonal interventions outweigh the possible benefits. Thus, these interventions (often referred to as "gender-affirming care") will not be available outside of research settings, except as "last-resort." /4

Sweden is realigning with the classic “Dutch Protocol” model, where only early childhood-onset gender dysphoria cases will be considered for hormones and surgeries. Those with post-puberty onset of trans identity will not be candidates for hormones/surgeries as minors. /5

The guidelines highlight the unexplained rapid rise in trans identification in youth, especially teenage girls. They also note the worrying rise of detransitioners & regretters, which contradicts prior estimates of "low regret." They cite Littman 2021. /6
link.springer.com/10.1007/s10508…

The guidelines also note the lack of knowledge about how to treat "non-binary" youth (the predominant presentation today). They assert that access to medical interventions should be based on the presence of gender dysphoria, rather than the presense of a transgender identity. /7

Sweden is centralizing its gender care for minors to a few centers for highly specialized care. Individual clinics and private providers will not be allowed to provide "gender-affirming" services. /8

The guidelines express concern that little advance in quality knowledge has occurred since "gender-affirming" interventions were first recommended in Sweden in 2015, and that generally, little is known about how to best care for gender-dysphoric youth. /9

In summary, Sweden has changed direction because of a lack of evidence to support medical interventions for gender-dysphoric minors. A new emphasis has been placed on psychiatric care and psychosocial support. Hormonal interventions for minors will be highly restricted. /10