Response to interpellation 2025/26:496 on the right to choose the gender of staff

Äldre- och socialförsäkringsministern Anna Tenje (M)

Madam Speaker! Patrik Björck has in summary asked the Minister for Health and Care how the government intends to design the proposal regarding the right for the elderly to choose staff based on biological sex, and whether the Minister for Health and Care intends to propose that employers shall register the staff's gender identity. Patrik Björck has further asked whether the proposal in that case will mean that staff are treated differently depending on whether biological and legal sex coincide or not, and whether it will be clarified how care recipients shall be informed about the staff's gender identity. Patrik Björck has finally asked whether the Minister for Health and Care has taken the initiative for an analysis of how the new law on gender identity affects the possibility of designing these rules, and what result such an analysis has in that case yielded.

The work within the government is distributed in such a way that it is I who shall answer the interpellation.

During the recent period, Madam Speaker, there have unfortunately occurred several cases of abuse committed against elderly persons who receive services within elderly care. It is an unacceptable development. That elderly persons should feel safe is a priority issue for the government. This applies regardless of where one lives and regardless of which forms of support one receives to get help in one's everyday life. The government has during the mandate period taken several measures to strengthen the safety for elderly persons.

From March 1, 2026, the municipalities will have a clear legal basis to request extracts from both the burden register and the suspicion register before employment in elderly care. It is an important step to strengthen safety for the elderly and raise the requirements for those who wish to work in elderly care.

In September 2025, the government also appointed an inquiry with the mandate to analyze the need for and the conditions for conducting background checks in both public and private operations (dir. 2025:83). The purpose is, among other things, to provide operations with appropriate tools before and during employment in order to be able to prevent the risks that the presence of persons with criminal or other harmful intentions poses in workplaces.

During the past year, the government has also decided on several assignments aimed at preventing crime and strengthening safety. Socialstyrelsen has been tasked, among other things, with mapping the occurrence of checks of information from the suspicion register and the criminal record register regarding persons within elderly care (S2025/02119). Socialstyrelsen shall also develop support for the social services, particularly regarding the conditions for the social services to, without hindrance from confidentiality, provide information concerning suspicion of crime to law enforcement authorities.

The Health and Social Care Inspectorate, Ivo, has been tasked with strengthening the supervision within elderly care. The supervision shall, among other things, review how social welfare committees and operations prevent, detect, and address risks and deficiencies, and whether the measures taken remedy the shortcomings (S2026/00115). The Government has also tasked the Swedish National Council for Crime Prevention (Brå) with mapping out what types of crimes are committed against the elderly within elderly care (S2026/00116). Brå shall, among other things, highlight gender differences in the vulnerability.

Regarding the question of the right for elderly persons to choose the gender of staff within elderly care who perform the most intimate personal hygiene, the government intends to return in the near future with a decision.

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Patrik Björck (S)

Mr. Speaker! It is customary to say thank you for the answer. I hope I will have the opportunity to do so when I have received an answer to my questions. There is absolutely nothing in the way of an answer to my questions.

Mr. Speaker! The Minister enumerated my questions in his answer, and then the Minister answered a number of other questions that I have not asked. It is certainly good information that Ivo has been strengthened, that work is being done to increase safety and so on. That is absolutely excellent, and I have no comments on that. But it becomes a bit strange in an interpellation debate that the only hint of trying to answer the question is that the government will return in the near future.

It will be a strange interpellation debate, Mr. Speaker. The interpellation is part of the Riksdag's important oversight power where answers are expected from the Minister to its questions. It will be a bit strange to debate otherwise.

Originally, I had intended to submit my interpellation to the Prime Minister, but I was advised against doing so by the Chamber Office because it did not quite follow the rules. I submit to that. I instead submitted the interpellation to the Minister for Health and Social Affairs, and the government referred the interpellation to Anna Tenje, who is responsible for elderly care. I have no objections to that either.

But I am actually a bit irritated, Mr. Speaker, that I am not getting answers to my questions. For those listening, I shall repeat the questions, and I hope that I can then thank the Minister for answers to my questions.

How does the government intend to design the proposal regarding the right to choose biological sex for staff? This is something that the government – the Prime Minister – has promised. Does the minister intend to propose that the employer shall register the gender identity of the staff? Will the minister's proposal imply that staff are treated differently depending on whether the biological and legal gender match or not? Will the minister's proposal clarify how the healthcare recipient shall be informed about the staff's gender identity? Has the minister taken the initiative for an analysis of how the new law on gender identity affects the possibility of designing these rules? Can the minister, in that case, account for the result? It is a question that one can, of course, answer yes or no to, but one can at least answer the question.

If one puts forward that type of promises, one can of course discuss whether the promises are good. One can have different opinions on whether they are reasonable promises to make. But what is important, and which is part of my opportunity to exercise oversight over the government in an interpellation debate, is to ask whether the government can fulfill the promises at all. Or are they empty promises that the government has made to the elderly, to the citizens? Furthermore, one can imagine that the promises apply to more groups in society than the elderly. I will return to that in my next contribution.

If one, as Sweden's Prime Minister, promises something, one should actually also be able to explain how one can fulfill the promise. If one promises it, one should be able to answer the simple questions in an interpellation debate in Sweden's Riksdag. I listen in anticipation of receiving answers to my questions.

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Äldre- och socialförsäkringsministern Anna Tenje (M)

Mr. Speaker! I have some understanding for the member's frustration over not quite receiving answers to the questions he has posed in his interpellation. Given that the member was so kind and in such a pedagogical way could explain how the process of interpellation debates works, one can also state that I, as minister, have quite rightly said that I consider that the elderly should have the right to choose the gender of the staff who perform the most intimate care hygiene in their own home. There, one is often in a strong situation of dependency.

I explained in my first contribution all our arguments for why we have concluded that it is reasonable to proceed in this manner. I have also been very clear that it is required that an investigation looks into these issues. These are very complex issues, just as the member has explained. There are certain considerations to be taken into account.

I have, just like the Prime Minister, several other ministers and also members of Parliament, been involved in the fact that one would really want that elderly people should be able to choose the gender of the staff who perform the most intimate nursing hygiene. But an investigation is required to see in what way it can be done. And if it were to mean increased burdens on the municipalities to satisfy that request and promise, some co-financing will surely also be required.

The reason why I cannot answer all of the member's questions, which the member is not quite satisfied with, is that the investigation has not been commissioned yet. It is therefore not known which questions it is to concern, what directive a future investigation will receive, and how much it should be delimited or, for that matter, developed. It is also not something that I intend to convey here in the chamber.

I think the questions are very interesting and I look forward to the debate and the discussion. Perhaps I will take something that the member raises with me to the directive and the investigation. But an investigation is required. What the investigation then lands on, what trade-offs are actually made, and what analysis is included in that investigation is far too early to say. It would also be wrong of me to offer speculations about what will be landed on.

But a promise is a promise, and I keep it. I think and want that the elderly should have the right to be able to choose the gender of the staff who perform the most intimate care hygiene. One should have the right to choose and feel comfortable and safe with the person who steps across the threshold into one's own home and whom one is often in great need of and is furthermore in a position of dependency towards.

It is important to safeguard the safety and security of the elderly, and it is important to safeguard the freedom of choice for the elderly. I therefore stand by that promise, and I will return to it.

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Patrik Björck (S)

Mr. Speaker! Those who listened can note that I still have not received an answer to a single one of the questions I have asked. And those who listened carefully can note that the Minister said four or five times that it is important that the elderly have the right to choose the gender of the staff within elderly care.

Now that was not the question, Mr. Speaker, but it is about what the Prime Minister has explicitly promised: that one shall have the right to choose the biological sex of the staff. The Minister avoids saying it carefully. The Minister has probably begun to wonder whether what the Prime Minister promised is possible to implement.

That the government promises something is one thing. The government has promised what is mentioned in the answer: that one shall be able to choose gender. What the Prime Minister has promised is that one shall be able to choose biological sex. It is not quite the same thing.

For the sake of safety, I want to say that there are protocols from this chamber from when the Prime Minister, during the Prime Minister's question time – when the Prime Minister was here and represented the government and himself as Prime Minister – answered a direct question like this: ”I am a little surprised by the debate that has arisen regarding the proposal that one as an elderly person should be able to choose the biological sex of the person who performs very intimate tasks. It is quite remarkable that this has caused criticism. Is it not quite obvious that one can be in a situation where one feels quite vulnerable – long before abuse is committed? Do the abuses that have been committed not speak for themselves that this is a real problem? I am genuinely surprised by the municipalities that are said not to have wanted to report incidents to the police. All of this is seriously serious, and therefore we have proposed an amendment that allows one as an elderly person to be able to choose which biological sex the person who is to do the most private things for them in their home should have.” That is what the Prime Minister has explicitly promised here in this chamber, and the Minister avoids answering, mentioning, or even discussing it altogether.

So, it is not just about the Minister refusing to answer the very justified questions that are linked to that promise from the Prime Minister; they are completely relevant questions if that promise is to be fulfilled. Now the Minister is also backing down from this position by avoiding what the question is actually about, that is, biological sex.

I cannot interpret it in any other way, Mr. Speaker, than that the Minister has been instructed by the Prime Minister to try to back out of that promise. The Prime Minister may have begun to realize that the Prime Minister has promised something that the Prime Minister perhaps cannot keep. The Prime Minister may think that this is becoming embarrassing. And then one wants to back out.

If I base this on the Minister's answer and the posts here earlier, it was consistent gender and not biological sex that was used as a term. This is also included in the written answer that has been submitted.

In the written response, it is also stated that the government will return in the near future. Even that the Minister is backing out from now, in his oral contribution. Now the Minister is talking about that the investigation has not been appointed, that it might come – who knows when and where – that there are no directives or thoughts regarding this investigation and that it might come at some point. It is not in the near future, Mr. Speaker. The government cannot return in the near future. In the near future is, in that case, during the current mandate period.

One is therefore systematically backing away from the question and will probably never answer it.

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Äldre- och socialförsäkringsministern Anna Tenje (M)

Mr. Speaker! I never back down. I never back down when it comes to increasing the safety and security for the elderly. I and the government have, during this parliamentary term, step by step raised the requirements for working within elderly care. We have step by step increased the opportunities for competence initiatives to increase competence. We have introduced the language requirement, so that the elderly can understand and make themselves understood. We have created the opportunity and a clear legal basis for municipalities to be able to extract information from background check registers and suspicion registers. Then one can truly clear out among those who are directly unsuitable to work within elderly care.

We have recently read about horrific incidents of violence and robbery directed against the elderly. That one, in their own home, risks being both assaulted and subjected to indescribable violations by their own staff is completely unacceptable.

We need to do everything in our power to ensure that this never happens again. I have now urged the municipalities to take the opportunity to make extracts from burden registers and suspicion registers. We are also seeing in an investigation, which is underway, the possibility of making it mandatory – not optional but mandatory – to make these extracts from burden registers and suspicion registers, even during existing employment.

During many of my study visits and conversations with the elderly, I have felt that there is a fear and an anxiety, often among older women but also among older men. One does not feel comfortable, perhaps especially with the fact that there are so many different people from the staff running around in one's home – we have problems with continuity. But one would also really want to choose the gender of the staff who perform the most intimate care hygiene.

I have embraced that. And it was precisely that promise I put forward. I said that we must look at this. It is the next step, not because municipalities around the country, elderly care homes, unit managers, and even home care groups do not do what they can to actually already today meet these demands, but because there are those who feel anxiety and fear over not having the right to choose the gender of the staff who perform the most intimate care hygiene.

That is exactly why I said that I think it is obvious that we must look at this issue. We need to look a bit more broadly, take into account more different issues and aspects and analyze this carefully. What consequences can this have? Is it possible to carry it out? I clearly believe that it is possible. It concerns both the right to choose and the right to opt out. In that way, one can increase the safety and security for the elderly and ensure that their freedom of choice and influence over their own lives becomes stronger than it is today.

However, for this to be possible, we need to appoint an investigation. I have been very clear about that. I have understanding and respect for the fact that the member may not follow everything I say, but I have been very clear on that issue. This is nothing strange. It applies to pretty much everything we propose. For a proposal to be able to become a reality, the issue must be investigated, completely regardless of whether it is the members of the Riksdag who submit motions or the government that takes the initiative. Things and matters need to be investigated in Sweden so that it becomes right, proper, and correct in all 290 municipalities, for example for everyone who is in need of elderly care, completely regardless of whether it is a question of housing and home care in private or municipal administration.

When I say near future, I mean just near future.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Patrik Björck (S)

Mr. Speaker! I refer to the minutes from the Prime Minister's question time because his statement there is something that he naturally cannot crawl out of. I could have referred to a debate article in Aftonbladet, where the Prime Minister expresses himself even more broadly about what one wants to propose. According to the Prime Minister, "women must always be able to feel safe in Sweden. Therefore, biological sex must be decisive in more situations, where it might otherwise lead to increased insecurity." He brings up this with prisons, changing rooms, sports competitions, etcetera. Here, the Prime Minister is very careful not to sign as Prime Minister. The Prime Minister signs the debate article as party leader for Moderaterna together with two ministers, Gunnar Strömmer and Camilla Waltersson Grönvall, who sign only as representatives for Moderaterna. He is thus very carefully avoiding expressing himself as the government.

What is exciting about this question period is that the Prime Minister expresses himself as Prime Minister and, in the answer to a question from a Member of Parliament, gives this very specific promise. In his answer, he also expresses that this is something that is easy and will come soon. It is completely uncomplicated, the Prime Minister is heard saying in that answer. The Prime Minister says that one shall have the right to choose biological sex – exactly that and nothing else.

The Minister says that she never backs down. It was indeed exciting that we saw that happen for the first time then. I am not so familiar with the Minister from before. Maybe it was the first time, maybe it has happened before – what do I know. But this time the Minister backs down all the way into the wall. One could possibly excuse the Minister by saying she does it on behalf of the Prime Minister. That is loyal and nice and good. But it is no answer to my questions.

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Äldre- och socialförsäkringsministern Anna Tenje (M)

Mr. Speaker! Again: I will never back down from increasing the safety and security for the elderly. That is what I am here for. Every time I ask myself "Who am I here for?", the answer in this regard shall be: the elderly. It is the safety and security of the elderly that I have in mind when I move forward step by step to strengthen the quality within elderly care. I am determined to increase the safety and security for the elderly. To ensure that one has the right to choose the gender of the staff who perform the most intimate care hygiene, I believe can be such a step.

We have worked on increasing competence within elderly care. We are introducing the language requirement on July 1. We are also ensuring the development and maintenance of Äldreomsorgslyftet. From March 1, municipalities can request extracts from load registers and suspicion registers. The next step this mandate period will be to appoint an inquiry into exactly the issue we are now debating.

I cannot say exactly how it will turn out and what impact assessments the investigation will conduct. It would be incredibly arrogant of me to stand in the speaker's chair and dictate which proposals the investigation should present. I believe the member and the entire plenum understand that. That is not how we work in Sweden, and that is not how we are going to work in Sweden.

But the direction is crystal clear: The safety and security for the elderly shall be strengthened. I believe this is a very good step forward.

The interpellations debate was hereby concluded.

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