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Iceland runs a pediatric clinic pathway.
The Act on Gender Autonomy No. 80/2019 lets people from 15 change registered sex; younger children may apply with guardians or an expert committee. Permanent changes to genitals, gonads, or other sex characteristics of people 16 or older need written consent; ages 16–18 also need a BUGL gender-identity-team assessment that surgery is in the child’s best interests. Under 16, those permanent changes are not provided for unless physical-health reasons require them.
Landspítali’s BUGL trans team assesses and treats under-18s who seek information about or access to medical interventions, cites WPATH (the World Professional Association for Transgender Health), and refers to pediatric endocrinology after 6–12 months. That is a live pediatric door. Medical is Affirming.