International › Status 2025 · Last reviewed 2026-05-16

Worldwide status 2025

Summary

As of 2025 jurisdictions diverge in their treatment of the Dutch Protocol. A first group — Sweden, Finland, the United Kingdom, Norway, Denmark — restricts paediatric medical interventions to research settings. A second group — the Netherlands, Spain, Argentina — maintains the traditional approach. In the United States, policy varies sharply by state. Germany and France are still under review.

Overview by country

Country	Policy 2025	Source / body
Netherlands	Continuation of Dutch Protocol, ZonMw evaluation ongoing	Quality Standard 2018
United Kingdom	Restrictive, GnRHa only in trial	NHS / Cass Review
Sweden	Restrictive, Karolinska + Socialstyrelsen	SBU 2022
Finland	Restrictive, psychotherapy first-line	COHERE 2020
Norway	Restrictive, experimental status	Ukom 2023
Denmark	Stricter diagnostics	Sundhedsstyrelsen 2024
Germany	Under revision	AWMF S2k
France	Under revision (Académie de médecine 2022)	HAS evaluation
Spain	Continuation, regionally varied	Sociedad Española de Endocrinología
US — federal	Endocrine Society / AAP under pressure	HHS, US v Skrmetti
US — restrictive states	Bans up to 18	25+ states
Canada	Continuation, regionally varied	CPATH
Australia	NSW review under way	RCH Melbourne 2018
Argentina	Continuation, broad legal framework	Ley de Identidad de Género 2012
Italy	Restrictive since 2024	Comitato Nazionale per la Bioetica

Critical note

Notable in this overview is that countries that have since 2020 carried out the most careful systematic research (UK, Sweden, Finland, Norway) consistently arrive at restrictions. The countries that maintain continuation (Netherlands, Spain, Argentina) have so far not carried out comparable independent evidence reviews. The ZonMw evaluation in the Netherlands (expected 2026) is important in this context: it is the first independent Dutch investigation into the evidence base since 2014.¹