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Gender-affirming care in Sweden

Gender-affirming care is the term for the medical treatments that trans people may need. This often involves changing certain aspects of your body to better match your gender identity. This can be done, for example, through hormone treatment, hair removal or various types of surgery. Not all trans people need gender-affirming care. For many, however, gender-affirming care is needed in order for the body and/or legal gender to better reflect their gender identity and personality.  

Other words that are used for this process are gender transition and trans care. In the past, the word sex change was also used. That word is rarely used today as a person does not change sex but instead changes their body so that it better matches how they feel. Some may also find the word sex change to be offensive, so we recommend using other words for gender-affirming care.

What is gender-affirming care?

Gender-affirming care aims to reduce gender dysphoria in people by making the body more in line with the perceived gender identity. Within gender-affirming care, you can get access to different treatments, depending on your needs. All treatments are voluntary and there is no requirement that you have to undergo all treatments that are available.

There may be a focus on gender-affirming surgery that is one-sided and gives a misleading picture of what gender-affirming treatment entails. For some people with gender dysphoria, the need for genital surgery is of course extremely important. But many people wait with genital surgery or refrain from undergoing that type of surgery altogether. For example, because there are medical risks with a major operation, or you may not want any of the surgical methods used or you want to leave your genitals as they are.

Examples of gender-affirming treatments

These are some examples of different gender affirming treatments that are usually offered in public healthcare in Sweden:

There may also be other treatments offered via private care, but then you have to pay for them yourself. Which treatments are available and how much they cost vary widely. For certain types of surgery, such as mastectomies, some private surgeons may require a gender dysphoria diagnosis.

How to access gender-affirming care in Sweden

In order to undergo gender affirming treatment via public health care in Sweden, a gender dysphoria diagnosis is required , which can only be given by the assessment teams. The diagnosis is made after a gender dysphoria assessment has been carried out.

If you want to undergo genital surgery you also need a special permit to do this. You can read more about this here.

Treatments for people under 18 years of age

For young people under the age of 18, different treatments may be relevant. However, just like for adults, a diagnosis is required to gain access to the treatments. Which ones are available depends, among other things, on how far one has entered puberty. A gender-affirming treatment specifically for young people is puberty blockers. They aim to "pause" puberty so that the body does not undergo puberty changes that feel wrong. Puberty blockers are taken for a limited time, and they can only be used for a certain period: puberty must have started and reached a certain stage, but not be completely finished in order for the treatment to be started. You can read more about puberty blockers here .

It is good to know that in 2022 the National Board of Health and Welfare updated the guidelines for gender-affirming treatments for young people. Since then, treatment with puberty blockers is only given in exceptional cases. The same also applies to treatment with gender-affirming hormones such as testosterone and oestrogen, as well as mastectomy, an operation where breast tissue is removed to create a flatter chest.

According to the National Board of Health and Welfare's guidelines, young people with gender dysphoria should still be able to be offered, among other things, hair removal and voice training. However, the guidelines are only recommendations and thus no rules that the assessment teams must follow. Some assessment teams want to follow the guidelines to a greater extent than they do, but do not always receive enough resources to do this. The care can therefore look different depending on which team you go to or where in Sweden you live.

Transition - a personal process

Often the word transition is used to describe that a person is in the process of confirming their gender. Exactly when a transition starts varies. Some consider it to be from the very first contact with psychiatry. Others from the day they received their diagnosis. Some from when they start with gender-affirming treatment. Many who undergo a gender dysphoria assessment already live as the gender they identify as. Therefore they have already started the social part of their transition.

Sometimes you hear things like "going all the way" about medical transition. It is an expression of the fact that a norm has been created around what you should want to do as a transgender person. However, there is no requirement to undergo all treatments that are available and when you feel you’re done with your transition, you are done. If this means that you want all available gender-affirming care or parts of the available treatment, that is something that you decide yourself. It’s not something that someone else can judge you for. The main thing is that you discuss with the assessment team exactly what you yourself need in order to feel as well as possible. Everyone is different and even if the gender dysphoria assessment follows a certain pattern, the medical part of the transition itself is something that can be very individual.

Sometimes people also talk about getting "finished" with their transition. Here, it is important to be aware that those who undergo gender-affirming hormone treatment often do so for a long time. Sometimes a lifetime. The treatment is therefore not "finished" as in "completed", but is ongoing.

Senast ändrad: 
14 januari, 2025 - 14:49

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