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Link is in Swedish, below the translation to English by Iris the Iceland Mama Bear!
The Medical Journal, 12/13/2022
Mats Reimer, pediatrician
The National Board of Health and Welfare's updated knowledge support/guidelines for care of children with gender dysphoria is to be published in its entirety before the end of the year. Since the extremely weak scientific foundation of the previous guidelines/knowledge support emerged, both the National Board of Health and Welfare and healthcare providers such as Karolinska Hospital have changed the guidelines point by point. The new knowledge support/guidelines will advise against surgery, puberty blockers and sex-opposite hormones before adulthood.
The knowledge support from 2015 was largely based on the activist organization WPATH's (World Professional Association for Transgender Health) »Standards of Care« version 7 (SOC7). Several Swedish doctors are members of WPATH, and as the guidelines have just been updated to SOC8, two issues in particular have caused debate.
On the one hand, WPATH no longer specifies a lower age limit for any drug or surgical procedure, and on the other hand a new gender identity is coined that requires recognition and care: the eunuch. This does not refer to men who have lost their testicular function due to illness or accident, but to transgender people who feel that their inner true gender should be reflected in a castrated male body. It seems as a rule it is the testicles that are surgically removed, and some then want to have testosterone on prescription to avoid the symptoms of hormone deficiency.
SOC8 claims that eunuchs can discover their gender identity as early as childhood but makes no specific treatment recommendations for young people. Had this been published elsewhere than in a supposedly scientific article, people would have thought that it was satire driving the trans movement. But even Norway's most famous trans person, Esben Esther Pirelli Benestad (doctor and professor of sexology), on Norwegian television had eunuchs on the list of the seven different genders she believes exist.
That the National Board of Health and Welfare's updated guidelines are no longer based on such an obviously activist organization as WPATH is of course welcome, even if one still wants care to "confirm" the young person's perceived gender identity.
We are expected to address the patient by the preferred name, and in journal text to use the pronoun that is preferred and to name body parts with the terms the patient wishes. Whether this means that clinicians must record pronouns other than he, she or her is not specified. In the US, the flora of self-chosen non-binary neopronouns has grown wildly, with examples such as they, ey, xe, ze, ve, tey, hir and princeself.
As a whole, the new guidelines are more reasonable than the previous ones and advocate for great caution regarding irreversible interventions on healthy bodies, as we know that some will regret it. The same policy changes have been made in Finland, Great Britain, France and New Zealand. In the US, on the other hand, the division is total, with federal authorities approving medical interventions on trans children while the attitude and access to trans care increasingly differs between Republican and Democratic states.
Even within the World Health Organization (WHO), the issue is highly politicized, and succumbing to lobbying, the psychiatric diagnosis of transsexualism has changed its name and place in ICD-11. The new diagnosis of "gender incongruence" is not placed in the chapter on mental illnesses, but in a completely new chapter on sexual health is combined with diagnoses such as reduced libido, premature ejaculation, intercourse pain and difficulty achieving orgasm.
In Swedish healthcare, child psychiatry will continue to be responsible for treating those under the age of 18 who experience gender incongruity and suffer from it. Care will now primarily consist of psychological support to help the youth live with the healthy body they were born with.
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