The United States is not alone in reassessing and restricting youth gender medicine. Several countries, including progressive Nordic nations, have put the brakes on puberty blockers, hormones and surgeries for minors. Other countries are hotly debating the issue. In contrast to the United States, their medical societies are not marching in lockstep with activists. They have warned about the lack of evidence for mental health benefits from interventions that carry the risk of lasting physical and psychological harm.

United Kingdom
In 2024, the UK government banned puberty blockers for all youth, with the exception of patients participating in clinical trials. (A clinical trial expected to begin in 2025 has yet to get underway.) Opposite-sex hormones are still permitted for youth between the ages of 16 to 18. The tight restrictions on puberty blockers followed the four-year evidence review of youth gender medicine headed by pediatrician Hilary Cass. Dr. Cass concluded that puberty blockers carry “significant risks,” while evidence for their mental health benefits is “remarkably weak.” Notably, in December 2024, the UK’s new Labour government made indefinite the temporary ban issued by the previous Conservative government.

Ireland
Ireland does not provide publicly-funded hormones and surgeries for gender-distresed youth under 18. Some interventions, however, are available through private clinicians. Historically, Irish practitioners referred patients who wanted medical interventions to England’s Tavistock Clinic. Following the Cass Review (see UK) that clinic closed.

Finland
Hormones and surgeries for minors are strictly limited to exceptional cases.  Finland started medicalizing gender-distressed youth in 2012. After clinicians reported declining mental health in some patients, Finnish health authorities commissioned a systematic evidence review. It found that psychological functioning did not improve with the interventions and in some cases worsened. As a result, in 2020 Finland prioritized psychotherapy over hormones and surgeries to treat young people with gender distress.

Sweden
Since 2022, Swedish health authorities have advised clinicians to limit puberty blockers, opposite-sex hormones and mastectomies to exceptional cases. This guidance followed a systematic evidence review that found low quality evidence for the benefits of youth gender “transition.” Sweden’s National Board of Health and Welfare concluded that “the risks of puberty suppressing treatment and gender-affirming hormonal treatment currently outweigh the possible benefits.”

Norway
Although pediatric gender interventions are still available in Norway, in 2023 the Norwegian Healthcare Investigation Board, an independent government agency, called for a revision of national guidelines to treat gender dysphoria. The panel said the research base for puberty blockers, opposite-sex hormones and surgeries is lacking, particularly with respect to long-term outcomes. It recommended that the interventions for children and adolescents be defined as experimental. 

Denmark
Denmark has quietly changed policy and now emphasizes psychological care for gender-distressed youth over medical interventions. At its peak in 2018, Danish clinicians prescribed hormonal interventions to 67% of youth who presented to gender clinics. In 2022, only 10% of youth received such treatment, according to a report prepared by Danish health authorities. The report noted the changing patient profile in recent years — more female with a higher proportion of psychiatric disorders, including anxiety, self-harm and suicidal ideation. This and transition regret, the report said, had led to greater caution.

France
In 2022, the French National Academy of Medicine urged “great caution” in prescribing medical interventions for gender-distressed youth. A press release stated, “The Academy draws attention to the fact that hormonal and surgical treatments carry health risks and have permanent effects, and that it is not possible to distinguish a durable trans identity from a passing phase of an adolescent's development.” The Academy attributed the soaring numbers of young people claiming a trans identity to social influences. In 2024, the French Senate voted for a bill that would prohibit puberty blockers and opposite-sex hormones for minors, but the legislation was not enacted.

Italy
Italy’s cabinet, led by prime minister Giorgia Meloni, has endorsed draft legislation to tighten controls on medical interventions for gender-distressed minors. The law still needs parliamentary approval. The bill states that hormonal interventions will be dispensed according to protocols yet to be drafted by the health ministry, and, pending that, only after approval by a national ethics committee of pediatricians. The proposed law would create a national registry of minors receiving puberty blockers and hormones, and data from this registry would be sent to the health ministry for evaluation every six months. In 2023 the Italian Psychoanalytic Society sent a letter to the prime minister expressing “great concern” over puberty blockers. In 2024, Italy’s National Bioethics Committee recommended that puberty blockers for gender dysphoria be used only after psychotherapy or psychiatric interventions have failed — and only within the context of clinical research trials.

Chile
Chile is engaged in a fierce debate over pediatric gender medicine. In 2024, both houses of the country’s legislature voted to ban public funding for new prescriptions of puberty blockers and opposite-sex hormones for youth. Chile’s Constitutional Court, however, struck down this vote in January 2025. Since then, a special investigative commission in the lower house of congress has called for prohibiting hormonal treatment for minors.