The European timeline
Publications, decisions and rulings from across the continent, newest first. Between them they show that the European retreat from the affirmative model began years before it was reported in English.
11 September 2026
As at 11 September 2026, the government had not issued its promised substantive response to the Health Council’s advice
As at 11 September 2026, the government had not issued its promised substantive response to the Health Council’s advice.
30 June 2026
The Health Council said the Dutch pathway fitted the health-law framework but found important evidential gaps
On 30 June 2026, the Health Council said the Dutch pathway fitted the health-law framework but found important evidential gaps.
5 May 2026
The Haute Autorité de santé began work on national recommendations for minors; they had not yet been issued. ([has-sante
On 5 May 2026, the Haute Autorité de santé began work on national recommendations for minors; they had not yet been issued. ([has-sante.fr](https://www.has-sante.fr/jcms/p_3892586/fr/transidentite-accompagnement-du-mineur-et-de-son-entourage-et-soins-proposes-note-de-cadrage))
6 March 2025
Germany’s final S2k guideline on gender incongruence in children and adolescents was issued on 6 March 2025 and editoria
Germany’s final S2k guideline on gender incongruence in children and adolescents was issued on 6 March 2025 and editorially updated on 24 June 2025.
19 June 2024
Germany’s Self-Determination Act was enacted on 19 June 2024 and took effect, apart from its advance-notice rule, on 1 N
Germany’s Self-Determination Act was enacted on 19 June 2024 and took effect, apart from its advance-notice rule, on 1 November 2024.
28 May 2024
The Senate passed a related bill by 180 votes to 136, retaining bans on cross-sex hormones and surgery but replacing the
On 28 May 2024, the Senate passed a related bill by 180 votes to 136, retaining bans on cross-sex hormones and surgery but replacing the proposed blocker ban with strict conditions. ([senat.fr](https://www.senat.fr/travaux-parlementaires/textes-legislatifs/la-loi-en-clair/proposition-de-loi-visant-a-encadrer-les-pratiques-medicales-mises-en-oeuvre-dans-la-prise-en-charge-des-mineurs-en-questionnem
13 May 2024
The Ministry of Health, Welfare and Sport asked the Health Council for an independent assessment
On 13 May 2024, the Ministry of Health, Welfare and Sport asked the Health Council for an independent assessment.
1 April 2024
Amsterdam UMC rejected Cass Review’s conclusion of insufficient evidence for puberty blockers in April 2024
Amsterdam UMC rejected Cass Review’s conclusion of insufficient evidence for puberty blockers in April 2024.
20 March 2024
The Senate’s Les Républicains group published La transidentification des mineurs , a political group report. ([lesrepubl
On 20 March 2024, the Senate’s Les Républicains group published La transidentification des mineurs , a political group report. ([lesrepublicains-senat.fr](https://lesrepublicains-senat.fr/la-transidentification-des-mineurs/))
1 March 2024
The German draft was publicly discussed in March 2024, which explains why it is often described as the “2024 guideline”
The German draft was publicly discussed in March 2024, which explains why it is often described as the “2024 guideline”.
1 January 2024
107 of 1,359 people, or 7.9%, discontinued established cross-sex hormones during a mean follow-up of 8.5 years (Kaltiala
In Finland, 107 of 1,359 people, or 7.9%, discontinued established cross-sex hormones during a mean follow-up of 8.5 years (Kaltiala et al., 2024).
1 January 2024
Oslo University Hospital was asked to explore a clinical study for investigational drug treatment, while medical treatme
In 2024, Oslo University Hospital was asked to explore a clinical study for investigational drug treatment, while medical treatment remained available.
9 March 2023
Ukom published Patient safety for children and young people with gender incongruence on 9 March 2023
Ukom published Patient safety for children and young people with gender incongruence on 9 March 2023.
1 March 2023
Norway’s UKOM concluded in March 2023 that evidence for appropriate management of children and young people with gender
Norway’s UKOM concluded in March 2023 that evidence for appropriate management of children and young people with gender incongruence was inconclusive.
1 March 2023
Norway’s UKOM reported in March 2023 that no national system then tracked withdrawals, completion, outcomes or detransit
Norway’s UKOM reported in March 2023 that no national system then tracked withdrawals, completion, outcomes or detransition across services.
1 March 2023
The law was published on 1 March 2023 and replaced the 2007 law governing legal sex registration
The law was published on 1 March 2023 and replaced the 2007 law governing legal sex registration.
16 February 2023
Spain’s Ley 4/2023 was passed by the Congress of Deputies on 16 February 2023 by 191 votes to 60, with 91 abstentions
Spain’s Ley 4/2023 was passed by the Congress of Deputies on 16 February 2023 by 191 votes to 60, with 91 abstentions.
31 January 2023
Y v. France found no Article 8 right to registration as “neutral” or “intersex”
On 31 January 2023, Y v. France found no Article 8 right to registration as “neutral” or “intersex”.
1 January 2023
Denmark’s Equal Treatment Board upheld a swimming-pool provider’s use of a separate changing room for a trans-identifyin
In January 2023, Denmark’s Equal Treatment Board upheld a swimming-pool provider’s use of a separate changing room for a trans-identifying male.
1 January 2023
The Swedish SBU concluded in 2023 that the literature on regret and detransition is heterogeneous, sparse and generally
The Swedish SBU concluded in 2023 that the literature on regret and detransition is heterogeneous, sparse and generally of low certainty.
25 February 2022
The Académie nationale de médecine called for “great medical caution” in treating children and adolescents. ([academie-m
On 25 February 2022, the Académie nationale de médecine called for “great medical caution” in treating children and adolescents. ([academie-medecine.fr](https://www.academie-medecine.fr/la-medecine-face-a-la-transidentite-de-genre-chez-les-enfants-et-les-adolescents/))
22 February 2022
Socialstyrelsen issued revised hormone recommendations on 22 February 2022 and published its completed national knowledg
Socialstyrelsen issued revised hormone recommendations on 22 February 2022 and published its completed national knowledge support on 16 December 2022 (Socialstyrelsen, 2022).
22 February 2022
Sweden’s SBU published its systematic evidence assessment of puberty blockers and cross-sex hormones on 22 February 2022
Sweden’s SBU published its systematic evidence assessment of puberty blockers and cross-sex hormones on 22 February 2022 (SBU, 2022).
1 February 2022
Sweden’s National Board of Health and Welfare concluded in February 2022 that, for under-18s as a group, the risks of ho
Sweden’s National Board of Health and Welfare concluded in February 2022 that, for under-18s as a group, the risks of hormonal treatment then outweighed its possible benefits.
1 January 2022
A 2022 Dutch cohort found that 704 of 720 patients, or 98%, continued gender-affirming hormones at follow-up
A 2022 Dutch cohort found that 704 of 720 patients, or 98%, continued gender-affirming hormones at follow-up.
1 January 2022
Its 2022 statement did not call for a statutory ban on puberty blockers, hormones or surgery. ([academie-medecine.fr](ht
Its 2022 statement did not call for a statutory ban on puberty blockers, hormones or surgery. ([academie-medecine.fr](https://www.academie-medecine.fr/la-medecine-face-a-la-transidentite-de-genre-chez-les-enfants-et-les-adolescents/))
1 January 2022
SBU found insufficient scientific evidence to assess effects on dysphoria, psychosocial outcomes, cognition, body compos
SBU found insufficient scientific evidence to assess effects on dysphoria, psychosocial outcomes, cognition, body composition or metabolism (SBU, 2022).
1 January 2022
Socialstyrelsen said puberty blockers and cross-sex hormones should ordinarily be provided within research, with excepti
Socialstyrelsen said puberty blockers and cross-sex hormones should ordinarily be provided within research, with exceptional individual use pending such studies (Socialstyrelsen, 2022).
1 January 2022
Sweden’s SBU found no randomised studies of hormonal treatment for gender dysphoria in under-18s in its 2022 systematic
Sweden’s SBU found no randomised studies of hormonal treatment for gender dysphoria in under-18s in its 2022 systematic review.
1 January 2022
The investigation followed two 2022 concerns from relatives of young people aged 16 to 21
The investigation followed two 2022 concerns from relatives of young people aged 16 to 21.
1 April 2021
Karolinska University Hospital’s child service changed its policy in March 2021, effective from 1 April 2021 (Karolinska
Karolinska University Hospital’s child service changed its policy in March 2021, effective from 1 April 2021 (Karolinska, 2021).
19 January 2021
X and Y v. Romania found that requiring surgery before recognition violated Article 8
On 19 January 2021, X and Y v. Romania found that requiring surgery before recognition violated Article 8.
1 January 2021
For 16- to 17-year-olds, Karolinska limited new hormonal treatment to ethics-approved clinical studies (Karolinska, 2021
For 16- to 17-year-olds, Karolinska limited new hormonal treatment to ethics-approved clinical studies (Karolinska, 2021).
1 January 2021
The policy said hormonal treatment would not be started for gender-dysphoric patients under 16 (Karolinska, 2021)
The policy said hormonal treatment would not be started for gender-dysphoric patients under 16 (Karolinska, 2021).
23 June 2020
Norway’s national guideline was first published on 23 June 2020 and last professionally amended on 9 June 2021
Norway’s national guideline was first published on 23 June 2020 and last professionally amended on 9 June 2021.
11 June 2020
COHERE Finland adopted its recommendation on 11 June 2020; the English summary is dated 16 June 2020
COHERE Finland adopted its recommendation on 11 June 2020; the English summary is dated 16 June 2020.
11 June 2020
Finland’s COHERE recommendation of 11 June 2020 stated that evidence on treatment of minors was limited and excluded sur
Finland’s COHERE recommendation of 11 June 2020 stated that evidence on treatment of minors was limited and excluded surgery for minors.
1 January 2020
COHERE stated in 2020 that surgical treatment was not part of treatment for gender-related dysphoria in minors
COHERE stated in 2020 that surgical treatment was not part of treatment for gender-related dysphoria in minors.
1 January 2020
Reported referrals to Dutch specialist and mental-health providers rose from 1,179 in 2020 to 2,772 in 2022
Reported referrals to Dutch specialist and mental-health providers rose from 1,179 in 2020 to 2,772 in 2022.
18 June 2019
Iceland adopted its Act on Gender Autonomy, Act No. 80/2019, on 18 June 2019
Iceland adopted its Act on Gender Autonomy, Act No. 80/2019, on 18 June 2019.