evidence: The Karolinska Hospital’s new policies echo a growing international concern over the proliferation of medical interventions that have a low certainty of benefits, while carrying a significant potential for medical harm. The latest policy issued by the Karolinska cites the UK NICE evidence review, which found the risk / benefit ratio of hormonal interventions for minors highly uncertain; the 2020 UK judicial review, which highlighted the overarching ethical problems with the practice of medical "affirmation" of minors; as well as Sweden's own Health and Technology Assessment (SBU) evidence review conducted in 2019, which found a lack of evidence for medical treatments, and a lack of explanation for the sharp increase in the numbers of adolescents presenting with gender dysphoria in recent years. [...] In North America, the debate about treatments for gender-dysphoric minors has become highly politicized. A number of US states have recently introduced laws banning the use of hormonal interventions in gender-dysphoric minors. In contrast, other states have introduced laws mandating public and private insurance coverage for a wide range of gender-"affirming" medical and surgical interventions for "gender incongruence," regardless of a patient's age or mental health status. In Canada, Bill C-6 goes even further, seeking to criminalize psychological treatment modalities, which represent the primary non-invasive alternative to medical and surgical "affirmation."