Today Sweden’s National Board for Health & Welfare calls for “restraint” in the use of hormones by under 18s suffering gender dysphoria. “the risks of blockers & cross-sex hormones for under 18s currently outweigh the possible benefits for this group”.
Epidemiological changes that are not yet understood (especially the growth in patient numbers, new adolescent-onset presentation, females now outnumbering males) “constitute an uncertainty” that warrants caution, said Thomas Lindén at the Board.
The Board’s literature review found that very little knowledge has been added since 2015 (the date of the previous treatment recommendations). Thus other than in exceptional cases, hormone treatment should proceed only within a research study.
It’s right to be cautious when permanently life-changing treatments aren’t supported by good evidence and are proposed for patients unlike those for whom the treatments were devised originally, and whose problems may turn out to be fundamentally different.
It’s also right that rigorous research is undertaken into the effects and safety of these treatments, both in the near and longer-term. Like Sweden, our NHS also devised its protocols for under 18s in 2015-16 and we’ve learned precious little since then about these interventions.
In another 5-6 years, when the next treatment reviews happen, we cannot allow ourselves to be in the same state of ignorance, nor for the debate to be so clouded by social justice campaigning, rather than focused on health, families and the basic life chances of vulnerable kids.