International › Comparison · Last reviewed 2026-05-16

International comparison

Policy and current status of adolescent gender care in eight countries, in one overview. Each cell links to the dossier where the claim is substantiated.

Country	Key document	GnRHa < 18	CSH < 18	Required setting	Dossier
Netherlands	Quality Standard Transgender Care 2018/2023	Permitted	Permitted from 16	Clinical care	current status NL
UK	Cass Review 2024 + NHS England 2024	Research only	Restrictive	Research / specialist hubs	UK · Cass
Sweden	SBU 2022 + Socialstyrelsen 2022	Research only	Restrictive	Research	Sweden · SBU
Finland	COHERE 2020	Selective, psychotherapy first	Selective	Two specialised centres	Finland · COHERE
Norway	Ukom 2023	Experimental	Experimental	Specialist centre	Norway
Denmark	Sundhedsstyrelsen 2024	Restrictive	Restrictive	Specialist centre	Denmark
Germany	AWMF S2k-Leitlinie 2024 (draft)	Permitted	Permitted	Specialised centres	Germany
US (federal)	Endocrine Society 2017 + AAP 2018	Permitted (varies by state)	Permitted (varies by state)	Clinical care	US
US (Tennessee, Florida etc.)	State laws 2023–2024	Prohibited	Prohibited	n/a	Skrmetti
Australia	RCH Melbourne SoC 2018	Permitted	Permitted from 16	Clinical care	Australia

What the table shows

Two groups are recognisable: (a) countries that largely continue the Dutch Protocol (Netherlands, Germany, Australia, part of the US) and (b) countries that have introduced substantial restrictions on the basis of systematic evidence reviews (UK, Sweden, Finland, Norway, Denmark, part of the US). The turn took place between 2020 and 2024.

Critical note

The countries that have revised their policy almost without exception base themselves on formal systematic reviews. The countries that continue the original protocol — including the Netherlands — had not published a comparable national evidence review as of May 2026. This makes the Dutch position an international outlier: the protocol was invented here, and has not yet been independently tested in its own house.