The medical directors of Norway’s four health regions have determined that puberty blockers and cross-sex hormones for gender-distressed minors are experimental treatments and should be restricted to clinical trials.
The Directorate of Health will be asked to revisit its 2020 “gender-affirming” treatment guidelines and “clearly state” the experimental nature of these hormonal and surgical treatments, according to a February 29 news report in the Norwegian newspaper Verdens Gang (VG).
If these proposals are implemented, Norway would join Sweden, Finland and England in formally adopting new, cautious treatment policies for gender distress based on confirmation that the evidence for medicalised gender change in minors is very weak and uncertain.
“We are, of course, very pleased with this result, and the fact that the health authorities have finally begun to follow evidence-based research in the field of gender medicine,” said a spokeswoman for the parents’ group Gender Challenge Scandinavia (GENID), which advocates for a cautious, evidence-led response to gender distress in young people.
“We hope that in future, the cautious approach to medical treatment will be extended further to all adolescents up to the age of 23-25 because of brain and identity development. I personally, would love to see stricter gatekeeping for neurodivergent youth.”
Isak Bradley, head of the Patient Organisation for Gender Incongruence (PKI), said it was a violation of human rights to classify gender-affirming medical interventions as experimental. Complaining that patients were not consulted, PKI said it had hired lawyers to contest the decision.
Citing minutes of a December meeting of Norway’s four regional medical directors, VG said experimental status for puberty blockers and cross-sex hormones would mean these treatments would no longer be offered to minors as routine interventions within the specialist health service.
Nor would this gender medicine be available from private providers, municipal clinics or family doctors.
The December minutes noted that—
“The medical directors request that Oslo University Hospital [which is home to the national specialist gender service] investigate how it can be facilitated that experimental medical and surgical treatment of children and adolescents with gender incongruence is carried out primarily through a prospective clinical treatment study.” (Gender incongruence is a feeling of conflict between the body and an inner “gender identity.”)
Oslo University Hospital would also be asked to establish a national medical quality register to improve data collection on patients and treatment.
The gender service at Oslo University Hospital had received referrals of 915 people (268 of them children), according to its 2022 annual report.
Of the children, 198 were natal females. A previous report from the service said that 75 per cent of referrals had a mental illness, and about 20 per cent had autism spectrum disorder, ADHD/ADD or Tourette’s.
In March last year, Norway’s independent healthcare investigator (Ukom) handed down a report declaring paediatric gender transition to be experimental, and warned that the 2020 treatment guideline with its non-medical focus on equality and rights “may pose a patient safety risk.”
“We know little about the long-term effects of puberty blockers and side effects of treatment with [cross-sex] hormones. Patients must be informed about this, and patients must be able to understand the consequences of the choices.
“There is no Norwegian comprehensive overview or systematic mapping of the patients’ past history, [of] how many are refused [treatment], who withdraws during the course of treatment, [who] completes the treatment or how patients with gender incongruence and gender dysphoria fare after treatment.”—Norwegian Healthcare Investigation Board (Ukom), report, March 2023
Activists at the wheel
The Directorate of Health’s 2020 treatment guideline was heavily influenced by gender-affirming activists, according to “Oskar”, not his real name, a father involved in GENID who spoke to GCN last year.
Ukom’s report followed complaints from relatives of gender patients aged 16-21 about insufficient information on treatment effects and side effects, and failure to follow-up competing, non-gender diagnoses pointing to treatment options other than risky gender-affirming interventions.
The report found that puberty blockers and cross-sex hormones were “potentially harmful” and raised concerns about side effects including osteoporosis, mental health problems, liver damage, blood clots and heart attacks as well as sterility.
VG quoted Ukom director Pål Iden as saying—
“The whole purpose of our work is to bring about a change that can increase patient safety. In the current report [on paediatric transition], we pointed out weaknesses in how treatment is currently organised in Norway. It is those in authority who have the opportunity to follow up on our recommendations.”
Following Ukom’s report, the head of Norway’s Directorate of Health, Bjørn Guldvog, held talks with authorities of the country’s four health regions, the Oslo University Hospital clinic and patient groups, among others. Seemingly under pressure from trans activists mid-last year, Dr Guldvog sent mixed signals about whether treatment policy would be tightened.
In VG’s latest news report, one of Dr Guldvog’s colleagues said the directorate would revise the 2020 guideline if treatment options changed, and said it was up to the regional authorities to implement the change such that hormonal and surgical interventions would be mostly confined to clinical trials within the specialist health service.
The GENID spokeswoman told GCN: “After some time of uncertainty, we are now pretty sure that Norway’s Directorate of Health will change the guidelines, at least for the minors, stating that the medical transition is experimental. The decision [on the experimental status of gender-affirming treatment] was left to the medical directors, and they are relying on the Ukom report.”
Well done Norway!
The referenced cohort referred to the Oslo Hospital included 268 children. 75% had been diagnosed with a mental illness, and some 20% had autism spectrum disorder, ADHD/ADD or Tourette’s.
The rationale of subjecting such children to an experimental, invasive, mutilating, irreversible, sterilising procedure that has not undergone a clinical trial to confirm efficacy and safety could be compared with one of medicine’s most dark experiments:
Frontal lobotomy, an invasive, irreversible, un-trialled, grotesque procedure was developed in the 1930’s for the treatment of mental illness and to solve the pressing problem of overcrowding in mental institutions in an era where no other form of effective treatment was available.
Norway now joins Sweden, Finland and the UK in strictly limiting use of the affirmative treatment model and Germany, Netherlands and Italy are not far behind.
But not Australia. Nothing to see here. We are still “leading the world”
This will inevitably lead to higher risks for physicians in Australia who persist using these treatments in the face of increasing criticism of their lack of evidence of efficacy in any hard end point and conversely increasing evidence of harm.
But bring it on. The proponents are practising ideology not medicine and perhaps the only thing that will stop them is a massive successful negligence claim.