International › Sweden · Last reviewed 2026-05-16
Sweden — Karolinska and SBU
Summary
Sweden was the first country to impose major restrictions on the Dutch Protocol for minors. Karolinska University Hospital announced in May 2021 that it would no longer prescribe GnRHa and cross-sex hormones to minors outside approved research protocols. The SBU systematic review (2022) classified the underlying evidence as "very low certainty"; the Socialstyrelsen issued a national recommendation in December 2022 restricting hormone treatment for minors.
1. Karolinska University Hospital — policy May 2021
Karolinska University Hospital published an internal policy on 1 May 2021 stating that puberty blockers and cross-sex hormones may from now on only be prescribed to minors within an approved study design, given uncertainty about long-term effects. See the extensive summary under /evaluations/karolinska-2021/.1
2. SBU — systematic review (February 2022)
The Swedish Agency for Health Technology Assessment (SBU) published a systematic review in 2022 which concluded that the evidence base for hormone treatment in adolescents with gender dysphoria was of "very low certainty" per GRADE.2 See /evaluations/sbu-2022/.
3. Socialstyrelsen — guideline December 2022
The Swedish Socialstyrelsen (National Board of Health and Welfare) published in December 2022 a revised guideline for adolescent gender care in which GnRHa and CSH were restricted to exceptional cases, with stricter diagnostic criteria.3
See also
- Karolinska policy document: Karolinska 2021
- SBU systematic review: SBU 2022
- Comparable national policy changes: Finland, Norway, UK
- Worldwide overview: Status 2025
- International comparison — Sweden alongside other countries in table.
- People register — Karolinska and Socialstyrelsen figures.
- Timeline — policy decisions chronologically.
- FAQ · Glossary.
Footnotes
- Karolinska Universitetssjukhuset. Policy regarding hormonal treatment for minors with gender dysphoria. May 2021.
- SBU. Hormone therapy at gender dysphoria in adolescents. Stockholm: SBU; 2022. Report 327.
- Socialstyrelsen. Vård vid könsdysfori — Kunskapsstöd för vård av barn och ungdomar. Stockholm; December 2022.
Karolinska / Sweden across the network
Other sites in this network also cover this topic:
Karolinska leaves the Dutch Protocol
genderballast.nl
Karolinska stops puberty blockers — May 2021
gendergekte.nl
Karolinska 2021
transgenderidentiteit.nl
Karolinska + Socialstyrelsen (Sweden)
genderrisico.nl