International › Finland · Last reviewed 2026-05-16

Finland — COHERE guideline 2020

1. COHERE guideline June 2020

The Finnish Palveluvalikoimaneuvosto (Council for Choices in Health Care, COHERE) — a body that gives binding advice on the composition of the public health package — issued a guideline in June 2020 including (see the extensive summary under /evaluations/finland-2020/):

• Psychotherapy and psychosocial support are first-line treatment.
• Hormone treatment may only be considered after extensive diagnostics by a specialised team.
• Non-early-onset gender dysphoria is explicitly distinguished from early-onset; for non-early-onset, hormone treatment is restricted.
• Surgical interventions are not allowed in minors.

2. Rationale

COHERE motivated the restriction explicitly with reference to the reported rise in adolescent referrals, a higher proportion of comorbid psychiatric problems and the limited evidence base for long-term effectiveness. The original distinction in early-onset versus late-onset is central in COHERE's interpretation.¹

3. Effects on practice

Since 2020, substantially fewer GnRHa prescriptions for minors have been issued in Finland. The two centres for adolescent gender care (Helsinki, Tampere) follow stricter diagnostic pathways.