In 2024, following a four-year evidence review headed by pediatrician Hilary Cass, the UK government banned puberty blockers for all youth outside of clinical trials. Dr. Cass had concluded that puberty blockers carry “significant risks,” while evidence for their mental health benefits is “remarkably weak.” Notably, both Conservative and Labour governments endorsed the restrictions.  A clinical trial involving more than 200 adolescents was to begin in January 2026, but the UK’s Medicines and Healthcare products Regulatory Agency (MHRA) has put the trial on hold, citing "unquantified risk of long-term biological harm” including sterility. In March of 2026, NHS England paused new prescriptions of opposite-sex hormones for patients under 18, pending a 90-day consultation period on plans to remove such prescriptions as a routine treatment for gender dysphoria. After Dr. Cass issued her report, NHS England conducted its own evidence review of exogenous estrogen and testosterone use in minors. According to Dr. James Palmer of the NHS, "This review has established that the available evidence does not support the continued use of masculinizing or feminizing hormones to treat gender incongruence or dysphoria for young people under 18.” Minors already prescribed these hormones may continue to receive them, but their treatment must be reviewed individually with clinicians.

Ireland does not provide publicly funded hormones and surgeries for gender-distressed 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 United Kingdom), that clinic closed.

Hormones and surgeries for minors are strictly limited to exceptional cases. After opening its gender clinic in 2011, practitioners found that most of their patients were teen-aged girls with pubertal or post-pubertal onset gender dysphoria and many psychiatric co-morbidities. Clinicians reported that their patients with significant mental illness did not improve after the gender interventions. After conducting a systematic evidence review, in 2020 Finland prioritized psychotherapy over hormones and surgeries to treat young people with gender distress.

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.”

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 evidence 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 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.

* In Danish; requires free translation app.

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’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. In 2023 the Italian Psychoanalytic Society wrote 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. Pending enactment of the new legislation, the main clinic dispensing puberty blockers in Italy has reportedly imposed a de facto ban on new prescriptions.

Chile is engaged in heated debate over pediatric gender medicine. In 2024, the country’s main gender clinic reportedly stopped providing puberty blockers and hormones to new minor patients. That same year, both houses of the country’s legislature voted to ban public funding for new prescriptions of puberty blockers and opposite-sex hormones for youth. However, Chile’s Constitutional Court later struck down this legislation. Since then, a special investigative commission in the lower house of congress has called for prohibiting hormonal treatment for minors.

New Zealand is banning new prescriptions of puberty blockers, starting December 19, 2025. Health Minister Simeon Brown said his ministry had found a “lack of high-quality evidence that demonstrates the benefits or risks” of the drugs to treat gender dysphoria. The drugs, known as gonadotropin-releasing hormone agonists, will still be available to current users and to patients with precocious puberty, endometriosis or prostate cancer.