Understanding the landscape on European trans health care policy

Access to trans health care in Europe varies

In 2024, the U.K. government banned new prescriptions of puberty blockers to those under 18. (Patients who are already taking these medications can continue to do so; similarly, some youth may be able to receive care through future clinical trials.) Over the past five years, national health officials in Finland, Sweden, Norway, and Italy have also issued more conservative treatment recommendations for trans youth, though none of this guidance is legally binding. Russia under the leadership of President Vladimir Putin has completely banned all access to trans care, regardless of age.

At the same time, two thirds of EU countries still allow trans youth at least some access to puberty blockers. In March, medical organizations in Germany, Austria, and Switzerland reaffirmed access to gender care for minors.

In short, access to trans health care varies across Europe, as it does in the U.S. Headlines describing a “Big Shift in Europe” or stating that “European Countries Restrict Trans Health Care for Minors,” as some outlets have published in recent months, don’t reflect the whole reality.

It’s important not to over-generalize. Instead, ensure readers understand the full context of access to care in Europe. 

Research commissioned by politicians requires extra contextual consideration

Any decision made by governments about access to health care likely has a political component. News organizations recognize this when they report on, for example, vaccination guidance from the Department of Health and Human Services issued by Secretary Robert F. Kennedy, Jr.

European government agencies also have different political leanings. Be specific about who’s making or recommending changes, and to consider their motivations. 

For example, the widely quoted Cass Review was commissioned by the U.K. National Health Service when the Conservative Party was in power. The British Medical Association has called for a pause on implementation of the Cass Review’s recommendations while it independently evaluates the report. (After British Medical Association councilmembers reported “online harassment and abuse … so despicable, it cannot be repeated,” the group clarified that its evaluation will proceed from “a neutral position.”) A Yale-led group of independent researchers also found that the Cass Review “violates its own evidentiary standards” and “subverts widely accepted processes for development of clinical recommendations.”

Meanwhile, independent international groups like the European Society of Contraception and Reproductive Health and the World Association for Sexual Health have criticized such restrictions, stating that medical evidence supports “the availability, accessibility and affordability of transgender health care for all individuals who seek it.” Recent research by nongovernmental medical teams in Germany, Austria, Switzerland, France, and the U.S. has concluded that substantial evidence supports transgender health care.

A University of Utah-led study reported that in regards to youth gender care, “the consensus of the evidence supports that the treatments are effective” — even though the study was commissioned by state Republicans to support a care ban. Utah Republicans have continued to assert that “the science isn’t there,” despite this scientific report finding the opposite conclusion.

When reporting on health care policy changes in Europe, note the political context, the broader medical consensus, and the breadth of variation in policy across the continent. Don’t cite revised guidelines in some countries while ignoring similar developments in other countries.

Consider the governments making the decisions

Some coverage suggests that the governments reducing health care access are progressive “exemplars of gender progress,” and that these changes prove “evidence is lacking” when it comes to gender care. Reporting on this topic sometimes jumps to assuming that the debate over youth gender care in Europe is “less politicized than in the United States.”  

In reality, far-right European politicians have led many of the recent restrictions to trans care. Last year, Germany — under the leadership of a progressive Chancellor — removed legal barriers to name and gender changes on ID. But since conservative politicians gained power in the 2025 elections, they’ve attempted to add a requirement that all gender marker changes be registered with law enforcement.

Similarly, in Sweden, the National Board of Health and Welfare has recommended that puberty blockers be limited to “exceptional cases.” Those guidelines came out in December 2022, just two months after Prime Minister Ulf Kristersson took office. He appointed the right-wing Christian Democrats’ Jakob Forssmed to lead the Ministry of Health and Social Affairs, which oversees the National Board of Health and Welfare. Forssmed has stated publicly that he thinks religious freedom should come before LGBTQ+ rights.

Still, leaders of parties with a history of progressive social reforms have advanced policies that harm trans people — as in the U.K., where the current ban on puberty blockers was first implemented by Conservative Party leadership, but then made permanent by Labour Party officials.

It’s also important to consider that explicit restrictions aren’t the only barrier to care. Some conservative-led countries, like Hungary and Poland, have increasingly limited LGBTQ rights in areas besides health care, which can discourage trans youth from seeking support. According to a 2024 report from the Council of Europe, more than a quarter of trans Europeans lack access to gender care — for reasons including cost, medication shortages, and wait times up to many years long.

Even states with Democratic leadership — like California and New York — have had recent anti-trans policies passed by conservative politicians, especially at more local levels of government. Just as U.S. journalists should avoid inaccurate generalizations about “red” and “blue” states, we should avoid broad oversimplifications about the political orientation of European governments.