evidence: Last July, the country’s National Health Service said it would shutter the public Gender Identity Development Service at the Tavistock clinic in London, the only provider of gender-affirming care for minors in England and Wales. The NHS cited an internal review that raised concerns that children were being referred too quickly, causing an unsustainable surge in patients. [...] While Sweden was the first country in the world to allow people to legally change their gender in 1972, it has recently tightened its eligibility criteria for gender-affirming care for minors. But it hasn’t banned it. [...] A year and a half after the Karolinska decision, the National Board of Health and Welfare, a Swedish government agency, updated its guidelines on gender-affirming care for minors. It stated that puberty blockers, hormones, and mastectomies should only be used in "exceptional cases," as the risks are likely to outweigh the benefits. In addition, the board said, mental health care should be offered to patients when doctors are assessing them.